Jump Start childcare-based intervention to promote physical activity in pre-schoolers : six-month findings from a cluster randomised trial

Okely, Anthony D. and Stanley, Rebecca M. and Jones, Rachel A. and Cliff, Dylan P. and Trost, Stewart G. and Berthelsen, Donna and Salmon, Jo and Batterham, Marijka and Eckermann, Simon and Reilly, John J. and Brown, Ngiare and Mickle, Karen J. and Howard, Steven J. and Hinkley, Trina and Janssen, Xanne and Chandler, Paul and Cross, Penny and Gowers, Fay (2020) Jump Start childcare-based intervention to promote physical activity in pre-schoolers : six-month findings from a cluster randomised trial. International Journal of Behavioral Nutrition and Physical Activity, 17. 6. ISSN 1479-5868

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    Abstract

    BACKGROUND: Participation in adequate levels of physical activity during the early years is important for health and development. We report the 6-month effects of an 18-month multicomponent intervention on physical activity in early childhood education and care (ECEC) settings in low-income communities. METHODS: A cluster randomised controlled trial was conducted in 43 ECEC settings in disadvantaged areas of New South Wales, Australia. Three-year-old children were recruited and assessed in the first half of 2015 with follow-up 6 months later. The intervention was guided by Social Cognitive Theory and included five components. The primary outcome was minutes per hour in total physical activity during ECEC hours measured using Actigraph accelerometers. Intention-to-treat analysis of the primary outcome was conducted using a generalized linear mixed model. RESULTS: A total of 658 children were assessed at baseline. Of these, 558 (85%) had valid accelerometer data (mean age 3.38y, 52% boys) and 508 (77%) had valid accelerometry data at 6-month follow-up. Implementation of the intervention components ranged from 38 to 72%. There were no significant intervention effects on mins/hr. spent in physical activity (adjusted difference = - 0.17 mins/hr., 95% CI (- 1.30 to 0.97), p = 0.78). A priori sub-group analyses showed a greater effect among overweight/obese children in the control group compared with the intervention group for mins/hr. of physical activity (2.35mins/hr., [0.28 to 4.43], p = 0.036). CONCLUSIONS: After six-months the Jump Start intervention had no effect on physical activity levels during ECEC. This was largely due to low levels of implementation. Increasing fidelity may result in higher levels of physical activity when outcomes are assessed at 18-months. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry  ACTRN12614000597695.