'Jump start' childcare-based intervention to promote physical activity in pre-schoolers: six-month findings from a cluster randomised trial
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Published on: July 27, 2022
Anthony D Okely1, Rebecca M Stanley2, Rachel A Jones2
1Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia. tokely@uow.edu.au.
Insights
The Jump Start intervention did not increase physical activity in young children after six months. Low implementation fidelity was a key factor, suggesting improved adherence may yield better results at 18 months.
Area of Science:
- Public Health
- Pediatrics
- Behavioral Science
Background:
- Early childhood physical activity is crucial for long-term health and development.
- Low-income communities face unique challenges in promoting physical activity in early years.
- The study investigates a multicomponent intervention in early childhood education and care (ECEC) settings.
Purpose of the Study:
- To evaluate the 6-month impact of the Jump Start intervention on physical activity levels in preschool children.
- To assess the intervention's effectiveness in low-income communities within Australia.
- To identify potential moderators of intervention effects on physical activity.
Main Methods:
- A cluster randomised controlled trial involving 43 ECEC settings in disadvantaged areas.
- Recruitment and assessment of 3-year-old children using Actigraph accelerometers over 6 months.
- Intention-to-treat analysis guided by Social Cognitive Theory with five intervention components.
Main Results:
- No significant intervention effect on minutes per hour of physical activity was observed (adjusted difference = -0.17 mins/hr).
- Intervention component implementation ranged from 38% to 72%, indicating suboptimal adherence.
- A potential positive effect was noted in overweight/obese children in the control group compared to the intervention group.
Conclusions:
- The Jump Start intervention showed no significant effect on physical activity levels at the 6-month follow-up.
- Low implementation fidelity is a primary reason for the lack of observed intervention effects.
- Improved implementation fidelity is hypothesized to lead to greater physical activity gains at the 18-month assessment.
Background:
Participation in adequate levels of physical activity during the early years is important for health and development. We report the 6-month effects of an 18-month multicomponent intervention on physical activity in early childhood education and care (ECEC) settings in low-income communities.
Methods:
A cluster randomised controlled trial was conducted in 43 ECEC settings in disadvantaged areas of New South Wales, Australia. Three-year-old children were recruited and assessed in the first half of 2015 with follow-up 6 months later. The intervention was guided by Social Cognitive Theory and included five components. The primary outcome was minutes per hour in total physical activity during ECEC hours measured using Actigraph accelerometers. Intention-to-treat analysis of the primary outcome was conducted using a generalized linear mixed model.
Results:
A total of 658 children were assessed at baseline. Of these, 558 (85%) had valid accelerometer data (mean age 3.38y, 52% boys) and 508 (77%) had valid accelerometry data at 6-month follow-up. Implementation of the intervention components ranged from 38 to 72%. There were no significant intervention effects on mins/hr. spent in physical activity (adjusted difference = - 0.17 mins/hr., 95% CI (- 1.30 to 0.97), p = 0.78). A priori sub-group analyses showed a greater effect among overweight/obese children in the control group compared with the intervention group for mins/hr. of physical activity (2.35mins/hr., [0.28 to 4.43], p = 0.036).
Conclusions:
After six-months the Jump Start intervention had no effect on physical activity levels during ECEC. This was largely due to low levels of implementation. Increasing fidelity may result in higher levels of physical activity when outcomes are assessed at 18-months.
Trial Registration:
Australian New Zealand Clinical Trials Registry ACTRN12614000597695.
