Active play in ASP –a matched-pair cluster-randomized trial investigating the effectiveness of an intervention in after-school programs for supporting children’s physical activity

Abstract

Background: Interventions directed at after school programs (ASPs) have the potential to support physical activity (PA) in young children. Research has indicated that interventions that emphasize competence building among the ASP staff can lead to increased PA among the children. The present study evaluates the effectiveness of the Active Play in ASP intervention-a program for ASP staff aimed at supporting physical activity among first graders in ASP. Methods: We used a matched-pair cluster randomized design and included 456 first graders from 14 schools in Norway. From these, 7 ASPs received the intervention (N = 229), while 7 acted as controls (N = 227). Measurements were taken at baseline, immediately post intervention (7 month follow-up) and after a year (19 month follow-up). The primary outcome was moderate to vigorous physical activity (MVPA), which was estimated with predefined cut points of counts per minute (CPM) and expressed as minutes/hour. Secondary outcomes were vigorous and light intensity physical activity (VPA and LPA) and sedentary behavior. The analyses of intervention effects were based on between-group differences in outcome changes between the 3 measurement points and were conducted using a mixed-effects model for repeated measures using categorical time. In exploratory analyses, we investigated gender, baseline body mass index, and baseline CPM as potential effect modifiers. Results: No significant intervention effects was observed on MVPA (0.55 min/hour [99% CI-0.55:1.64]) or on the secondary outcomes, min/hour of LPA, VPA or sedentary behavior. Exploratory analyses indicated that among the 50% least physically active children at baseline, children in intervention ASPs reduced sedentary time from baseline to 19 months follow up by 1.67 min/hour (95% CI-3.12:-0.21) compared to the controls.

Intervention Effects of the Health Promotion Programme “Join the Healthy Boat” on Objectively Assessed Sedentary Time in Primary School Children in Germany

“…More comparable results to the ones reported here were found in a one-year school-based intervention study in the Netherlands [57] as well as a recent Scandinavian study in first graders, intervening on teacher level in an after school care setting [61]. Similar to this study, teachers in Norway were trained to create a physical activity supporting environment in order to promote physical activity and reduce sedentary time.…”

Effect of Linear and Nonlinear Pedagogy Physical Education Interventions on Children’s Physical Activity: A Cluster Randomized Controlled Trial (SAMPLE-PE)

“…This study also has some limitations, such as the presence of 39% missing data within PA variables due to children moving to another school, dropping out from the study, not wearing the monitor enough to obtain a valid a PA measurement, or losing the accelerometer during the assessment period. However, the amount of missing data reported in this in this study is similar to that reported in previous research using device-based measurements of PA [106,107]. A further limitation is that most of the children did not wear the monitor overnight and that there was low compliance from parents with filling in PA wear time diaries, leading to the impossibility to calculate the waking time for each individual.…”

Changing Trajectory of Daily Physical Activity Levels Among At-Risk Adolescents: Influences of Motivational Mechanisms

“…Second, despite clear gender and race differences in youth MVPA at baseline, gender and race were not signi cant predictors of adolescents' daily MVPA change trajectories, suggesting that across gender and race, youth had a similar rate of change in MVPA across the 16-week intervention. Third, change in intrinsic motivation, but not autonomous extrinsic motivation, was a signi cant predictor of adolescents' daily MVPA changes.Although there are signi cant bene ts of MVPA to the health and well-being of youth(Fullmer et al, 2018) and ASPs are an ideal setting to support youth recommended daily PA accrual, several ASPs intervention studies that have aimed to increase adolescent MVPA through improving the motivational climate have reported a lack of adequate daily MVPA and challenges with maintaining children's attendance over time(Riiser et al, 2020;Wilson et al, 2011). Grounded in SDT, the Active Play Trial emphasized the necessity of retaining the self-chosen and child-managed character of play, as well as supporting the children's need for competence, relatedness, and autonomy(Riiser et al, 2020).…”

“…Third, change in intrinsic motivation, but not autonomous extrinsic motivation, was a signi cant predictor of adolescents' daily MVPA changes.Although there are signi cant bene ts of MVPA to the health and well-being of youth(Fullmer et al, 2018) and ASPs are an ideal setting to support youth recommended daily PA accrual, several ASPs intervention studies that have aimed to increase adolescent MVPA through improving the motivational climate have reported a lack of adequate daily MVPA and challenges with maintaining children's attendance over time(Riiser et al, 2020;Wilson et al, 2011). Grounded in SDT, the Active Play Trial emphasized the necessity of retaining the self-chosen and child-managed character of play, as well as supporting the children's need for competence, relatedness, and autonomy(Riiser et al, 2020). The Active Play Trial showed no signi cant intervention effects were observed for children's MVPA in ASPs compared with control programs(Riiser et al, 2020).…”

“…Grounded in SDT, the Active Play Trial emphasized the necessity of retaining the self-chosen and child-managed character of play, as well as supporting the children's need for competence, relatedness, and autonomy(Riiser et al, 2020). The Active Play Trial showed no signi cant intervention effects were observed for children's MVPA in ASPs compared with control programs(Riiser et al, 2020). The Active by Choice Trial integrated principles from SDT that aimed to test the e cacy of a motivational plus behavioral skills intervention on increasing MVPA in underserved adolescents(Wilson et al, 2011).…”