Evaluating the Sustaining Play, Sustaining Health programme in Australian early childhood education and care
Noor Imad1,2,3, Alix Hall4,5,6, Luke Giles2
1School of Health Sciences, Department of Allied Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC 3122, Australia.
Abstract:
Early childhood education and care (ECEC) services are a recommended setting to deliver interventions improving children's physical activity (PA). Indoor-outdoor free play, where children move freely between indoor-outdoor environments, can increase child PA. However, these programmes in ECECs are often not sustained. This study aims to assess the acceptability, feasibility, impact, adoption and cost of the Sustaining Play, Sustaining Health (SPSH) programme on sustainment of indoor-outdoor free play programmes in ECECs. A 6-month parallel-group pilot randomized controlled trial was conducted with 16 ECEC services across New South Wales, Australia, following removal of COronaVIrus Disease of 2019 (COVID-19) recommendations. Services implementing indoor-outdoor programmes were randomized to (i) SPSH programme (n = 8) or (ii) usual care control group (n = 8). The intervention included eight strategies to target identified barriers, informed by the Integrated Sustainability Framework. Primary outcomes at 6 months were acceptability, feasibility, adoption, cost, and barriers/facilitators. Potential impact (sustainment) was measured at 6 (primary) and 12 months using nonparametric analysis. Overall, 31.48% (17/54) of eligible services consented and 16 randomized. Statistically insignificant mean differences between groups in indoor-outdoor free play were 26.27 minutes at 6 months, and 2.87 minutes at 12 months, favouring the intervention group. The SPSH programme was considered acceptable and feasible and costed AUD $452.38 ($289.74 USD) to deliver per service. There were no changes in sustainability barriers/facilitators. This pilot found mean differences favouring the intervention group for sustaining indoor-outdoor free play programmes in ECECs, particularly at 12 months. Future fully powered trials should consider addressing broader barriers including staff turnover, motivation/attitudes, and fit within broader contexts to increase impact.
