Impact of the Supporting Physical Activity in the Childcare Environment (SPACE) intervention on preschoolers’ physical activity levels and sedentary time: a single-blind cluster randomized controlled trial

Abstract

BackgroundPhysical activity levels among preschoolers in childcare are low and sedentary time high. The Supporting Physical Activity in the Childcare Environment (SPACE) intervention had three components: 1. portable play equipment; 2. staff training; and, 3. modified outdoor playtime (i.e., shorter, more frequent periods). This study aimed to examine the effectiveness of the SPACE intervention on preschoolers’ physical activity levels and sedentary time during childcare hours (compared to standard care).MethodsVia a single-blind cluster randomized controlled trial, 338 preschoolers (39.86 ± 7.33 months; 52% boys) from 22 centre-based childcare facilities (11 experimental, 11 control) were enrolled. Preschoolers wore an Actical™ accelerometer for 5 days during childcare hours at baseline, post-intervention, and 6- and 12-month follow-up, and were included in the analyses if they had a minimum of two valid days (5 h each day) at baseline and one additional time point. Intervention effectiveness was tested using a linear mixed effects model for each of the four outcome variables (i.e., sedentary time, light physical activity [LPA], moderate-to-vigorous physical activity [MVPA], and total physical activity [TPA]). Fixed effects were further evaluated with t-tests, for which degrees of freedom were estimated using a Satterthwaite approximation.ResultsOne hundred and ninety-five preschoolers were retained for analyses. The intervention did not significantly impact LPA. MVPA was significantly greater among children in the experimental group when comparing post-intervention to pre-intervention, t(318) = 3.50, p = .0005, but no intervention effects were evident at 6- or 12-month follow-up. TPA was significantly greater for children in the intervention group at post-intervention when compared to pre-intervention, t(321) = 2.70, p = .007, with no intervention effects evident at later time periods. Finally, sedentary time was significantly lower among preschoolers in the experimental group when comparing post-intervention to pre-intervention, t(322) = 2.63, p = .009, with no significant effects at follow-up.ConclusionsThe SPACE intervention was effective at increasing MVPA and TPA among preschoolers, while simultaneously decreasing sedentary time. The ability of the SPACE intervention to target higher intensity activity is promising, as MVPA levels have been documented to be low in centre-based childcare. The changes in physical activity were not sustained long term (6- or 12-month follow-up).Trial registration ISRCTN70604107 (October 8, 2014).

Implementation of continuous free play schedules in Australian childcare services: A cross‐sectional study

“…To date, a small number of randomised trials have been conducted specifically targeting childcare scheduling of physical activity opportunities, for example through the provision of more frequent or longer periods of outdoor free play . The study conducted by Razak and colleagues reported a similar level of implementation as found in the current study, with 58% (n = 127) of childcare services found to be currently implementing a continuous free play schedule during an assessment of eligibility.…”

Feasibility and effectiveness of two built environmental interventions on physical activity among 3–5‐year‐old preschoolers

“…Previously used combination interventions, which include both environmental and educational interventions, have also had mixed results. No response was noted in PA or step count in preschoolers in two studies (Finch et al, ; Tucker et al, ). However, Engelen et al () reported an increase in MVPA and total PA ( p = .006 & p = .002, respectively) among preschoolers with a combination intervention that added loose materials, such as crash mats, weighed boxes, and milk crates to the playground and an educational intervention for parents, teachers, and staff.…”

“…However, preschool children may not be getting the recommended daily amount or intensity (Tucker et al, ). Measuring PA objectively via accelerometers, results from two studies found U.S. preschool children spent more than 60 percent of the time in light activity (Hnatiuk, Salmon, Hinkley, Okely, & Trost, ), and more than 6 hr each day being sedentary with only about 15 min per day in moderate‐to‐vigorous PA (MVPA; Katapally & Muhajarine, ).…”

“…Measuring PA objectively via accelerometers, results from two studies found U.S. preschool children spent more than 60 percent of the time in light activity (Hnatiuk, Salmon, Hinkley, Okely, & Trost, ), and more than 6 hr each day being sedentary with only about 15 min per day in moderate‐to‐vigorous PA (MVPA; Katapally & Muhajarine, ). Results from two studies with data from children attending Head Start indicated that children played outdoors only about 36–37 min per school day whether enrolled in either a half or full day program (Henderson et al, ) and spent most of their time at school in sedentary and light PA with less than 1 min per hr in MVPA (Tucker et al, ).…”

Study Protocol for the Evaluation of “SuperFIT”, a Multicomponent Nutrition and Physical Activity Intervention Approach for Preschools and Families

“…These materials were aligned with the PA cards to enable all preschools to perform the activities described on the cards. The box contained a variety of materials that could promote PA both indoors and outdoors, such as bean bags, hoops, balls, sidewalk chalk, and clothespins [59]. In addition, an assessment of preschool-specific needs for materials was performed in order to provide these additional materials (e.g., stepping-stones or foam blocks).…”