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“Pre-schoolers in the playground” an outdoor physical activity intervention for children aged 18 months to 4 years old: study protocol for a pilot cluster randomised controlled trial

This pilot study aimed to evaluate the feasibility of conducing a full-scale trial to assess a playground physical activity intervention for preschool children. The results showed that a full-scale study would be feasible if the physical activity intervention is adapted to increase sustained participation. 

Why did we do this research?

Physical activity levels at preschool age predict those in childhood and adulthood, therefore establishing healthy movement habits in early years is vital. Playground interventions have been shown to increase physical activity in school aged children, however there are very few playground-based interventions for preschool age children and evaluations of these have found mixed results. Therefore, new interventions to promote physical activity in preschool years are needed.  

What did we do?

Preschool children were recruited for the pilot study and randomised to either a playground physical activity intervention group or control group (their normal activities). The intervention invited families to attend 3 x 30 minute outdoor play sessions per week for 30 weeks. Children in both groups wore an accelerometer to measure activity levels. Data were collected at 10 weeks, 30 weeks and 52 weeks looking at physical activity levels and other secondary outcomes. The pilot trial was then evaluated to assess the feasibility of conducting a full-scale trial to assess the playground intervention. 

Who was involved?

The study involved 164 preschool children aged 18 months to 4 years from 10 primary schools in Bradford, West Yorkshire, UK. Half the schools delivered the intervention and the other half acted as the control group. 

What did we find?

Evaluation showed the trial was feasible but is weather dependent due to the intervention being delivered outdoors.  Also, wear time of the accelerometers to measure activity was low meaning less than half the children had valid data. Those implementing the playground sessions agreed that the intervention was deliverable however, adherance to the intervention was low and there was no evidence of intervention effectiveness.  

What have we learned? 

From the pilot study, a revised playground intervention should be considered, making changes to improve attendance such as only running the intervention in the summer term. 

Publications

Barber S E, Jackson C, Akhtar S, Bingham DD, Ainsworth H, Hewitt C et al. “Pre-schoolers in the playground” an outdoor physical activity intervention for children aged 18 months to 4 years old: study protocol for a pilot cluster randomised controlled trial. Trials. 2013;14 (326) doi: https://doi.org/10.1186/1745-6215-14-326

Barber S E, Jackson C, Hewitt C, Ainsworth H, Buckley H, Akhtar S, et al. Assessing the feasibility of evaluating and delivering a physical activity intervention for pre-school children: a pilot randomised controlled trial. Pilot feasibility stud. 2016;2 (12) DOI: 10.1186/s40814-016-0052-4

Other outputs

https://borninbradford.nhs.uk/research/publications/preschoolers-in-the-playground-a-pilot-cluster-randomised-controlled-trial-of-a-physical-activity-intervention-for-children-aged-18-months-to-4-years/

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