Active Play in After School Programs

Study Overview
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Brief Summary
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Background: Physical activity (PA) is a key component in health promotion and prevention of overweight. Interventions delivered in after-school programs (ASP) have the potential to become a means of ensuring PA among young schoolchildren. This requires a motivational climate, allowing for self-determination and the intrinsic values of the activity, on the activity's character of play. ASP staff could be trained in stimulating all children in physical activities in their everyday life. Physiotherapists in primary care possess knowledge of motor development and learning, and are important contributors to an ASP-based physical activity intervention. Aim: To develop a complex intervention that emphasizes physical activity play, and to examine through a cluster-randomized trial the extent to which the intervention promotes PA and health-related quality of life and prevents overweight in a population of young children. We aim to increase the knowledge and autonomy supportive skills among ASP staff members, enabling them to promote physical activity through play among all first graders in ASP. In addition to investigate if the children benefit from receiving autonomy support, we aim to study whether the ASP staff themselves benefit from giving autonomy support in terms of increased need satisfaction and autonomous motivation for work. The intervention: Includes training of ASP-staff members in the fundamental principles of self-determination theory and practical applications for motivating young children in PA through play. Information will be given on the benefits of a physically active lifestyle and the staff will be encouraged to map opportunities for PA in their local ASP and to incorporate strategies to increase PA through play among the children throughout the day. Methods/design: A complex intervention using a mixed methods approach will be developed and evaluated. A pilot trial will assess the potential of this approach and provide information necessary to perform a cluster-randomized controlled trial (RCT). The cluster-randomized controlled trial (RCT) will together with qualitative interviews and observations, evaluate the effectiveness of the intervention. Outcomes will be measured at baseline (September /October 2016) at the end of the intervention which lasts for 7 months (May 2017), and 1 year after the end of the intervention (May 2018)

Official Title
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Active Play -an After-school-program Intervention to Promote Physical Activity and Health-related Quality of Life in Young Children

Conditions
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Physical Activity, Activity Play, Motor Activity, Quality of Life, Autonomy, Competence, Children, After-School Program

Intervention / Treatment
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* Behavioral: Active play in after school programs (ASP)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Attends first grade in one of the ASPs included Exclusion Criteria: Does not attend first grade in one of the ASPs included

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 6 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Active play in after school programs (ASP). Training program for ASP staff. | Behavioral: Active play in after school programs (ASP)<br>* A 15 hour training-program for ASP-staff aimed to increase active play and physical activity among children in ASPs. The program includes lectures, guided discussions and practical tasks focusing on increasing the staffs competence in how to support active play and PA among all children in the ASP A 8 hour course for local physiotherapists enabling them to guide ASP-staff during parts of the intervention period<br>|
| No Intervention: Control group<br>ASP as usual. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in minutes spent in moderate to vigorous physical activity in after school programs from baseline to end of intervention (7 months) and 1 year after end of intervention. | Measures at baseline of a cluster randomized controlled intervention study and measures at the end of the 7 month intervention (measures of change) and 1 year after the end of the intervention (long-term effects). Physical activity is measured objectively by accelerometer (ActiGraph GM3X and GM3X+). | Baseline, end of intervention (7 months), 1 year after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heath-related quality of life | Parent-reported, measured by KIDSCREEN-27 questionnaire (parent version) | Baseline, end of intervention (7 months), 1 year after intervention | 
| Leisure time physical activity | Self-reported/parent-reported, measured by UngKan-2 questionnaire | Baseline, end of intervention (7 months), 1 year after intervention | 
| Active play in the ASP | Self-reported/parent-reported, measured by questionnaire | Baseline, end of intervention (7 months), 1 year after intervention | 
| Body mass index | kg/(m2), height and weight measured objectively | Baseline, end of intervention (7 months), 1 year after intervention | 
| Physical activity and play (observations) | Qualitative observations of physical activity and play among children during one day in the ASP (sub sample) | Baseline or end of intervention (7 months) | 
| Physical activity and play (interviews) | Qualitative interviews with children about active play and physical activity in ASP (sub sample) | End of intervention (7 months) |