A PATH (Promoting Activity and Trajectories of Health) for Children
Condition: Motor Performance; Physical Activity
Study type: Interventional

Summary: 
      Physical inactivity in children is a major public health risk factor and a health objective
      for the nation. This study aims to investigate the short- and long-term effects of a movement
      and physical activity program - the Children Health and Motor Programs (CHAMP) on motor
      competence, perceived motor competence, and physical activity. A secondary aim of this
      project (i.e., Science of Behavior Change Administrative Supplement) is to examine the
      immediate (pre- to post-test) effects of the CHAMP intervention on self-regulation and
      associations between self-regulation and changes in motor competence, perceived motor
      competence, and physical activity. The long term goal is to provide evidence-based movement
      experiences during the early childhood years that promote and contribute to overall healthy
      growth and development.
    

Detailed description: 
      Ethnic-minorities and low income children engage in less physical activity (PA)1 and, as a
      result, have an increased risk of cardiovascular disease. Promoting health-enhancing and
      sustainable PA levels across childhood and adolescence in low income and minority populations
      provides important health benefits. However, most PA interventions in children have not led
      to long-term, sustainable PA behavior. We propose a potential limitation in PA interventions
      has been the lack of focus on critical developmental processes (i.e., motor development and
      psychological constructs including perceived competence) that are established correlates of
      PA and may strongly impact the long-term sustainability of children's PA behaviors.

      Co-investigator, Stodden et al. proposed a developmental model hypothesizing mechanisms that
      promote positive longitudinal change in PA from early (≈3 yrs) to late childhood (≈12 yrs).
      In this model, a causal pathway that impacts PA is the development of motor competence (MC,
      i.e., coordination and control of human movement) and perceived motor competence (PMC; i.e.,
      perceptions of movement capabilities). PMC is directly linked to MC and influences PA as it
      mediates the relationship between MC and PA across childhood. Empirical evidence supports the
      model's hypotheses showing that MC, PMC, and PA are positively related across childhood.
      Principal Investigator, Robinson found that children as early as 3 yrs old demonstrate
      positive associations among MC, PMC, and PA, which suggests early childhood is an optimal
      time to promote positive MC and PMC in order to decrease the risk of developing unhealthy PA
      habits.

      Robinson has conceptualized and tested a theoretically grounded intervention (the Children's
      Health Activity Motor Program; CHAMP), which aligns with tenets of the Stodden et al. model
      by focusing on improving MC and PMC. Studies by the PI show highly impactful results on MC
      and PMC. CHAMP produced strong increases in MC (improvement to the 70th%tile, up from the
      15th%tile) and PMC (30% improvement) over a 9-week intervention and results were sustained
      following a 12-week retention. During the 30-min intervention, CHAMP participants engaged in
      more PA (i.e., 50% more time) compared to children in the control.13 While these intervention
      results are very encouraging, there is a need to examine the long-term effects of the
      intervention on MC and PMC and whether improvements lead to sustained PA. To date, there have
      been no large-scale treatment studies that have examined the long-term effects of a MC and
      PA-based intervention on MC, PMC, and PA in young children.

      This proposed study will address these gaps utilizing a cluster randomized control trial. The
      CHAMP intervention will be implemented in a high minority and low-income population, namely
      Head Start preschoolers (N = 300; 3.5-5 yrs old), with a 3-year follow-up to examine the
      immediate (pre- to post-test) and sustained (across middle childhood) impact on MC, PMC, and
      daily PA. 30 classes of preschool children will be randomly assigned to either the treatment
      (CHAMP, n = 15) or control (normal preschool free-play/recess, n = 15) conditions. The CHAMP
      intervention will be implemented for 30 minutes/day, 4 days/week, for 30 weeks (dose of 3000
      minutes). Measurements of MC (product and process), PMC (via self-perceptions of MC), and PA
      (via accelerometry), will occur at baseline (month 0), post-intervention (month 9), and
      follow-up at May of Year 2, 3, and 4. The specific aims of this study are to:

      Aim 1: Examine the immediate post-intervention effect of CHAMP (compared to control
      participants) on MC, PMC, and PA in preschool-age children.

      Aim 2: Assess the sustainable effect of CHAMP (compared to control participants) on MC, PMC,
      and PA across middle childhood.

      Aim 3: Examine and compare the immediate and long-term mediating effect of PMC on the
      relationship between MC and PA in preschool-age children in the CHAMP and control.

      IMPACT: Positive findings will support the development of early childhood education MC and PA
      programs that promote positive and sustainable PA behaviors that contribute to healthy growth
      and development.
    

Intervention name(s): Motor Skills Intervention
Intervention type(s): Behavioral
Intervention description(s): The behavioral motor skills intervention (CHAMP) is an intervention strategy that uniquely addresses differences in children's developmental levels on an individualized basis. CHAMP does not equate to a "one size fits all" approach. Children will be in an environment that promotes opportunities for them to develop improvements in motor skills based on their specific individual needs and choices. The CHAMP intervention promotes a mastery climate that allows each individual child to be successful and learn while promoting intrinsic motivation and autonomy. CHAMP will be implemented 4x/week for 30 minutes across ≈30 weeks for ≈3000 minutes of intervention time.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other