Clinical trial NCT05470621: A Playground Training to Improve Children's Health After-school and During Recess: The PLAYground Project
Official title: A Cluster Randomized Controlled Trial of an After-school Playground Intervention to Improve Children's Physical, Social, and Emotional Health: The PLAYground Project
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Physical Inactivity
Social Skills
Behavior, Child
Keywords: Physical Activity
Schools
Lead sponsor: Arizona State University
Sponsor class: OTHER
First posted: 2022-07-22
Enrollment: 294
Sex: ALL
Minimum age (years): 7
Maximum age (years): 13
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: Schools are critical settings to foster children's health. The purpose of this two-year cluster-randomized trial is to enhance both the after-school and recess settings to provide children with knowledge and skills to facilitate active and inclusive play. The primary aim of the project is to assess the impact of a playground curriculum intervention on children's physical, social, emotional, and behavioral health. The secondary aim of the project to understand the appropriateness, feasibility, fidelity, and sustainability of implementing a playground curriculum in after-school and recess settings.

Detailed description: Physical, social, and emotional health are critical for children and predict good health later in life. Schools are essential settings to foster children's health as they provide access to the majority of children during crucial stages of development. In particular, recess and before/after school programming are critical sources of children's health and well-being, and core components of a whole school approach to health and wellness. The purpose of this two-year cluster-randomized trial is to enhance the quality of these existing settings through the integration of a playground curriculum designed to promote active and inclusive play.

Based on Social Cognitive Theory aligned with the Theory of Expanded, Extended, and Enhanced Opportunities, it is hypothesized that active and inclusive play through a playground curriculum intervention will improve enjoyment, knowledge, and self-efficacy (personal conditions), social and emotional learning (behavioral conditions), and the development of peer relationships (environmental conditions) among children, leading to increased physical activity and reduced behavioral incidents. The implementation (appropriateness, feasibility, fidelity, and sustainability) of the playground curriculum intervention to improve children's health will be assessed as a secondary outcome.

Participants will be recruited from elementary schools in Mesa Public Schools (Arizona) that offer after-school programming (N=14). The intervention includes the delivery of a curriculum aimed at providing students with knowledge and skills to initiate activities using playground structures. Trainings will be delivered to staff (after-school staff, recess aides, and Physical Education teachers) and students in the after-school setting. Students attending the after-school program will become Play Leaders to transfer the knowledge and skills they learn from PlayOn! to the recess setting.

The impact of the playground curriculum intervention on children's physical, social, emotional, and behavioral health after school and during recess will be measured using surveys, observations, interviews, physical activity devices, and de-identified school behavioral information. Data will be collected at all 14 school sites each fall and spring semester. In year one, seven schools will receive the intervention. Schools will be stratified to either the intervention or control group by Title 1 status - an indicator of school-level income. In year two, the seven control schools will receive the intervention to allow all schools the opportunity to benefit from the project.

Eligibility criteria: Inclusion Criteria:

* Students enrolled an after-school program in Mesa Public Schools

Exclusion Criteria:

* Students in grades kindergarten or first grade will be excluded due to their young age.

Primary outcomes:
measure: Mean change in accelerometer-derived physical activity from baseline to six months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Mean change in accelerometer-derived physical activity from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Mean change in accelerometer-derived physical activity from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
measure: Mean change in student-reported personal (emotional) health from baseline to 6 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Mean change in student-reported personal (self-efficacy) health from baseline to 6 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Mean change in student-reported personal (social) health from baseline to 6 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Mean change in student-reported environmental health from baseline to 6 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Mean change in student-reported behavioral health from baseline to 6 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Mean change in student-reported personal (emotional) health from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Mean change in student-reported personal (self-efficacy) health from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Mean change in student-reported personal (social) health from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Mean change in student-reported environmental health from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Mean change in student-reported behavioral health from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Mean change in student-reported personal (emotional) health from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
measure: Mean change in student-reported personal (self-efficacy) health from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
measure: Mean change in student-reported personal (social) health from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
measure: Mean change in student-reported environmental health from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
measure: Mean change in student-reported behavioral health from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
measure: Change in number of school-reported behavioral incidents from baseline to 6 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 6 months)
measure: Change in number of school-reported behavioral incidents from baseline to 12 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 12 months)
measure: Change in number of school-reported behavioral incidents from baseline to 18 months
timeFrame: Baseline (month 0) and Post-intervention (approximately 18 months)
Secondary outcomes:
measure: Mean perceived implementation appropriateness
timeFrame: Post-intervention (approximately 6 months)
measure: Mean perceived implementation feasibility
timeFrame: Post-intervention (approximately 6 months)
measure: Mean observed implementation fidelity
timeFrame: Monthly post-intervention through end of school year
measure: Mean observed implementation sustainability
timeFrame: Post-intervention (approximately 12 months)
measure: Mean observed implementation sustainability
timeFrame: Post-intervention (approximately 18 months)
Other outcomes:
Locations:
city: Mesa
country: United States
facility: Mesa Public Schools
state: Arizona
Study officials:
affiliation: Assistant Professor, College of Health Solutions, Arizona State University
name: Allison Poulos, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Professor, Mary Lou Fulton Teachers College, Arizona State University
name: Pamela Kulinna, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Simonton KL, Garn AC, Mercier KJ. Expanding the Discrete Emotions in Physical Education Scale (DEPES): Evaluating Emotions With Behavior and Learning. Res Q Exerc Sport. 2023 Mar;94(1):35-44. doi: 10.1080/02701367.2021.1935434. Epub 2021 Dec 14.
citation: Saunders RP, Pate RR, Felton G, Dowda M, Weinrich MC, Ward DS, Parsons MA, Baranowski T. Development of questionnaires to measure psychosocial influences on children's physical activity. Prev Med. 1997 Mar-Apr;26(2):241-7. doi: 10.1006/pmed.1996.0134.
citation: Jackson SL, Cunningham SA. Social Competence and Obesity in Elementary School. Am J Public Health. 2015 Jan;105(1):153-158. doi: 10.2105/AJPH.2014.302208.
citation: Poulos A, Kulinna PH. A cluster randomized controlled trial of an after-school playground curriculum intervention to improve children's physical, social, and emotional health: study protocol for the PLAYground project. BMC Public Health. 2022 Sep 1;22(1):1658. doi: 10.1186/s12889-022-13991-3.