Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Study protocol

Supporting Physical Activity in the Childcare Environment (SPACE): rationale and study protocol for a cluster randomized controlled trial

Authors: Patricia Tucker, Shauna M. Burke, Anca Gaston, Jennifer D. Irwin, Andrew M. Johnson, Brian W. Timmons, Leigh M. Vanderloo, Molly Driediger

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Young children are prone to low levels of physical activity in childcare. Researchers have identified that preschoolers tend to be more active outdoors than indoors, with higher activity levels occurring during the first 10 minutes of outdoor playtime. Additionally, interventions incorporating either staff training or the inclusion of play equipment have been effective at increasing children’s activity in this setting. As such, the overarching objective of the Supporting Physical Activity in the Childcare Environment (SPACE) intervention is to improve the physical activity levels of preschoolers during childcare hours, utilizing a combination of the above components. The purpose of this manuscript is to provide a detailed account of the protocol, innovative methods, and evaluation plans used in the implementation of the SPACE study; in an effort to support the development of further research in this field.

Methods/Design

The SPACE study, a cluster randomized controlled trial, involves 22 childcare centres randomly allocated to either the experimental (n = 11) or the control (n = 11) group. Childcare centres receiving the intervention will adopt an 8-week physical activity intervention with the following components: 1. shorter, more frequent bouts of outdoor playtime (4 × 30 min periods rather than 2 × 60 min periods); 2. new portable play equipment (e.g., obstacle course, balls); and, 3. staff training (1 × 4 hr workshop). Actical accelerometers will be used to assess total physical activity with measurements taken at baseline (i.e., week 0), immediately post-intervention (i.e., week 8), and at 6- and 12-month follow-up. As secondary objectives, we aim to evaluate the effectiveness of the intervention on preschoolers’: a) sedentary time; b) standardized body mass index scores (percentiles); c) health-related quality of life; and childcare providers’ physical activity-related knowledge and self-efficacy to implement physical activity.

Discussion

The SPACE study aims to increase the low levels of physical activity observed within childcare centres. The findings of this work may be useful to policy makers and childcare providers to consider modifications to the current childcare curriculum and associated outdoor play time.

Trial registration

ISRCTN70604107 (October 8, 2014)
Literature
1.
Vanderloo LM, Tucker P, Johnson AM, Burke SM, Irwin JD. Environmental influences on preschoolers’ physical activity levels in various early learning facilities. Res Q Exerc Sport. 2015;19:1–11.
2.
Vanderloo LM, Tucker P, Johnson AM, Van Zandvoort MM, Burke SM, Irwin JD. The influence of centre-based childcare on preschoolers’ physical activity levels: A cross-sectional study. Int J Environ Res Public Health. 2014;11:1794–802.CrossRefPubMedPubMedCentral
3.
Colley RC, Garriguet D, Adamo KB, Carson V, Janssen I, Timmons BW et al. Physical activity and sedentary behavior during the early years in Canada: A cross-sectional study. Int J Behav Dev. 2014;10. doi:10.​1186/​1479-5868-10-54.
4.
Obeid J, Nguyen T, Gabel L, Timmons BW. Physical activity in Ontario preschools: Prevalence and measurement issues. Appl Physiol Nutr Metab. 2011;36:291–7.CrossRefPubMed
5.
Hinkley T, Salmon J, Okely AD, Hesketh K, Crawford D. Correlates of preschool children’s physical activity. Am J Prev Med. 2012;43:159–67.CrossRefPubMed
6.
7.
8.
Pate RR, McIver KL, Dowda M, Brown WH, Addy C. Directly observed physical activity levels in preschool children. J Sch Health. 2008;78:438–44.CrossRefPubMed
9.
Tucker P. The physical activity levels of preschool-aged children: A systematic review. Early Child Res Q. 2008;23:547–58.CrossRef
10.
Moore LL, Gao D, Bradlee ML, Cupples LA, Sundarajan-Ramamurti A, Proctor MH, et al. Does early physical activity predict body fat change throughout childhood? Prev Med. 2003;37:10–7.CrossRefPubMed
11.
Taylor RW, Murdoch L, Carter P, Gerrard DF, Williams SM, Taylor BJ. Longitudinal study of physical activity and inactivity in preschoolers: The FLAME study. Med Sci Sports Exerc. 2009;41:96–102.CrossRefPubMed
12.
Tremblay MS, Leblanc AG, Carson V, Choquette L, Gorber SC, Dillman C, et al. Canadian physical activity guidelines for the early years (aged 0-4 years). Appl Physiol Nutr Metab. 2012;37:345–56.CrossRefPubMed
13.
Timmons BW, Leblanc AG, Carson V, Gorber SC, Dillman C, Janssen I, et al. Systematic review of physical activity and health in the early years (aged 0-4 years). Appl Physiol Nutr Metab. 2012;37:773–92.CrossRefPubMed
14.
15.
Leblanc AG, Spence JC, Carson V, Connor Gorber S, Dillman C, Janssen I, et al. Systematic review of sedentary behaviour and health indicators in the early years (aged 0-4 years). Appl Physiol Nutr Metab. 2012;37:753–72.CrossRefPubMed
16.
Temple VA, Naylor PJ, Rhodes RE, Wharf HJ. Physical activity of children in family child care. Appl Physiol Nutr Metab. 2009;34:794–8.CrossRefPubMed
17.
Pate RR, Pfeiffer KA, Trost SG, Ziegler P, Dowda M. Physical activity among children attending preschools. Pediatrics. 2004;114:1258–63.CrossRefPubMed
18.
Irwin JD, He M, Sangster Bouck LM, Tucker P, Pollett GL. Preschoolers’ physical activity behaviours: Parents’ perspectives. Can J Public Health. 2005;96:299–303.PubMedPubMedCentral
19.
20.
Benjamin SE, Cradock A, Walker EM, Slining M, Gillman MW. Obesity prevention in child care: A review of U.S. state regulations. BMC Public Health. 2008;8:188.CrossRefPubMedPubMedCentral
21.
Kaphingst KM, Story M. Child care as an untapped setting for obesity prevention: State child care licensing regulations related to nutrition, physical activity, and media use for preschool-age children in the U.S. Prev Chronic Dis. 2009;6(1):A11.PubMed
22.
Finn K, Johannsen N, Specker B. Factors associated with physical activity in preschool children. J Pediatr. 2002;140:81–5.CrossRefPubMed
23.
Geoffroy MC, Power C, Touchette E, Dubois L, Boivin M, Seguin JR, et al. Childcare and overweight or obesity over 10 years of follow-up. J Pediatr. 2012;162:753–8.CrossRefPubMed
24.
Gordon ES, Tucker P, Burke SM, Carron AV. Effectiveness of physical activity interventions for preschoolers: A meta-analysis. Res Q Exerc Sport. 2013;84:287–94.CrossRefPubMed
25.
Hinkley T, Crawford D, Salmon J, Okely AD, Hesketh K. Preschool children and physical activity: A review of correlates. Am J Prev Med. 2008;34:435–41.CrossRefPubMed
26.
Ward DS, Vaughn A, McWilliams C, Hales D. Interventions for increasing physical activity of child care. Med Sci Sports Exerc. 2010;42:526–34.CrossRefPubMed
27.
Vanderloo LM, Tucker P, Johnson AM, Holmes JD. Physical activity among preschoolers during indoor and outdoor childcare play periods. Appl Physiol Nutr Metab. 2013;38:173–5.CrossRef
28.
Alhassan S, Nwaokelemeh O, Mendoza A, Shitole S, Whitt-Glover M, Yancey A. Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study. BMC Public Health. 2012;12:582.CrossRefPubMedPubMedCentral
29.
30.
Green LW, Kreuter MW. Health program planning: An educational and ecological approach. 4th ed. New York: McGraw-Hill Higher Education; 2005.
31.
Campbell MK, Piaggio G, Elbourne DR, Altman DG, for the CONSORT Group. Consort 2010 statement: Extension to cluster randomised trials. BMJ. 2012;345:5661.CrossRef
32.
Cohen J. A coefficient for agreement for nominal scales. Educ Psychol Meas. 1960;20:37–46.CrossRef
33.
34.
Reilly JJ, Kelly L, Montgomery C, Williamson A, Fisher A, McColl JH, et al. Physical activity to prevent obesity in young children: Cluster randomized controlled trial. BMJ Clinical Research Edition. 2006;333:1041.CrossRef
35.
36.
Vanderloo LM, Tucker P, Ismail A, Van Zandvoort MM. Physical activity opportunities in Canadian childcare facilities: A provincial/territorial review of legislation. J Phys Act Health. 2012;9:461–72.CrossRefPubMed
37.
Bower JK, Hales DP, Tate DF, Rubin DA, Benjamin SE, Ward DS. The childcare environment and children’s physical activity. Am J Prev Med. 2008;34:23–9.CrossRefPubMed
38.
39.
40.
McKenzie TL, Sallis JF, Elder JP, Berry CC, Hoy PL, Nader PR, et al. Physical activity levels and prompts in young children at recess: A two-year study of a bi-ethnic sample. Res Q Exerc Sport. 1987;68:195–202.CrossRef
41.
Pate RR, O’Neill JR, Brown WH, McIver KL, Howie EK, Dowda M. Top 10 research questions related to physical activity in preschool children. Res Q Exerc Sport. 2013;84:448–55.CrossRefPubMed
42.
Tucker P, Van Zandvoort MM, Burke SM, Irwin JD. Physical activity at daycare: Childcare providers’ perspectives for improvements. J Early Child Res. 2011;9:207–19.CrossRef
43.
Oliver M, Schofield GM, Kolt GS. Physical activity in preschoolers: Understanding prevalence and measurement issues. Sports Med. 2007;37:1045–70.CrossRefPubMed
44.
Cliff DP, Reilly JJ, Okely AD. Methodological considerations in using accelerometers to assess habitual physical activity in children aged 0-5 years. J Sci Med Sport. 2009;12:557–67.CrossRefPubMed
45.
Wong SL, Colley RC, Connor Gorber S, Tremblay MS. Actical accelerometer sedentary activity thresholds for adults. J Phys Act Health. 2011;8:587–91.CrossRefPubMed
46.
Adolph AL, Puyau MR, Vohra FA, Nicklas TA, Zakeri IF, Butte NF. Validation of uniaxial and triaxial accelerometers for the assessment of physical activity in preschool children. J Phys Act Health. 2012;9:944–53.CrossRefPubMed
47.
Varni JW, Seid M, Rode CA. The PedsQL(TM). Measurement model for the pediatric quality of life inventory. Med Care. 1999;37:126–39.CrossRefPubMed
48.
Varni J, Limbers C, Burwinkle T. Parent proxy-report of their children’s health-related quality of life: an analysis of 13,878 parents’ reliability and validity across age subgroups using the PedsQLTM 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:2.CrossRefPubMedPubMedCentral
49.
Putnam SP, Rothbart MK. Development of short and very short forms of the children’s behavior questionnaire. J Pers Assess. 2006;87:102–12.CrossRefPubMed
50.
Rothbart MK, Ahadi SA, Hershey KL, Fisher P. Investigations of temperament at three to seven years: The children’s behavior questionnaire. Child Dev. 2001;72:1394–408.CrossRefPubMed
51.
Craig CL, Marshall AL, Sjostrom M, Bauman A, Booth M, Ainsworth BE. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed
52.
Froehlich CA, Humbert L. Physical activity and nutrition in early years care centres: Barriers and facilitators. J Child Studies. 2011;36:26–30.
53.
Bandura A. Guide for constructing self-efficacy scales. In: F. Pajares F, Urdan T, editors. Self-efficacy beliefs of adolescents. Greenwich: Information Age Publishing; p. 307-337.
54.
Patton MQ. Qualitative research evaluation methods. London: Sage; 2002.
55.
Guba EG, Lincoln YS. Fourth generation evaluation. London: Sage; 1989.
56.
57.
58.
Shen B, Alexander G, Milberger S, Jen K-LC. An exploratory study of seasonality and preschoolers’ physical activity engagement. J Phys Act Health. 2013;10:993–9.CrossRefPubMed
Metadata
Title
Supporting Physical Activity in the Childcare Environment (SPACE): rationale and study protocol for a cluster randomized controlled trial
Authors
Patricia Tucker
Shauna M. Burke
Anca Gaston
Jennifer D. Irwin
Andrew M. Johnson
Brian W. Timmons
Leigh M. Vanderloo
Molly Driediger
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2775-9

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue

Research article

Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up

Research article

Design and management of public health outreach using interoperable mobile multimedia: an analysis of a national winter weather preparedness campaign

Research article

Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study

Study protocol

Characterisation of exposure to non-ionising electromagnetic fields in the Spanish INMA birth cohort: study protocol

Research article

Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety

Research article

Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey