An Intervention to Improve Motor Skills in Young Children

Study Overview
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Brief Summary
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The goal of PLAY is to adapt and test a developmentally appropriate intervention delivered on a mobile app to parents, with the goal of teaching fundamental motor skill (FMS) proficiency to their preschool-aged children (ages 3 to 5 y). Seventy-two children (3 to 5 y of age) were randomized. Of these children, 36 parents were randomized to use the FMS app and 36 were randomized to use a version of the app that promotes unstructured PA as a comparator group. Parents in the FMS condition accessed instructional lessons, peer modeling videos, and activity breaks to deliver 720 minutes of targeted, structured FMS instruction time to their child over a 12-week period. Parents in the comparator arm used a version of the app that provides instructional lessons to promote the equivalent amount of unstructured PA for their child. Parents were asked to guide the intervention, as parental support, modeling, and co-participation predict children's engagement in PA.

Detailed Description
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Preschoolers spend 4 hours/day in front of a screen, while fewer than one-quarter engage in the recommended two hours of daily physical activity (PA). The decline in PA, increase in screen-based behaviors, and onset of obesity during preschool years have been linked to lifetime risk of obesity and related comorbidities. However, emerging evidence indicates that screen time can actually be leveraged as a tool to increase children's PA and promote healthy weight. Specifically, PA interventions delivered over digital devices can provide real-time encouragement for children to be physically active. Prior interventions delivered over mobile devices were effective in increasing PA levels, including our own P-Mobile study that provided behavioral strategies to parents of children aged 6 to 10 years. When considering how to support and motivate parents whose children are preschool-aged, teaching and modeling fundamental motor skills (FMS) are critical to enable children's PA. FMS like running, jumping, or throwing a ball, are basic, goal-directed movement patterns developed in early childhood that provide a foundation for children to be physically active and competent movers. These skills enable a child to function independently in their surrounding environment, engage with peers, and contribute to their ability to be physically active. Evidence has shown that children must establish a minimal level of FMS proficiency to continue participating in PA opportunities as they age. FMS and PA behaviors have a dynamic and reciprocal relationship. Children with higher levels of FMS are more physically active both during childhood and into adolescence. Therefore, a PA intervention for preschoolers should focus on developing FMS competence.

Official Title
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PLAY: An Intervention to Improve Motor Skills in Young Children

Conditions
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Physical Activity, Fundamental Motor Skills, Development, Child, Self-regulation

Intervention / Treatment
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* Behavioral: Fundamental Motor Skills App
* Behavioral: Unstructured Physical Activity App


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 3-5 years of age Physically capable of exercise Has no parent-reported mobility limitations that impairs performance of fundamental motor skills Exclusion Criteria: • Gross Motor Quotient at gifted or very advanced based on the Test of Gross Motor Development (TGMD-3)

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 5 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Fundamental Motor Skills (FMS)<br>The FMS group will utilize the PLAY FMS app that provides instructional lessons, peer modeling videos, and activity breaks to deliver 720 minutes of targeted, structured FMS instruction time to the child over a 12 week period. | Behavioral: Fundamental Motor Skills App<br>* Lessons will be provided over the app each week with notifications sent 5 days/week over 12 weeks specific to randomized experimental group.<br>|
| Active Comparator: Unstructured Physical Activity<br>The active comparator group will use a version of the PLAY app that provides instructional lessons to promote the equivalent dosage of unstructured physical activity for the child. | Behavioral: Unstructured Physical Activity App<br>* Lessons will be provided over the app each week with notifications sent 5 days/week over 12 weeks specific to randomized active comparator group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| App Adherence | Adherence to the app intervention based on number of activity breaks completed over the 12 week intervention | From date of randomization until completion of the 12 weeks of intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Test of Gross Motor Development (TGMD-3) Percentile Rank Between Baseline and Week 12 | A validated, reliable observation assessment to evaluate fundamental motor skills performance. Percentile ranks range from 1st (lowest) to 99th (highest/best). | baseline and 12 weeks (primary outcome) |