Active Learning Norwegian Preschool(er)s (ACTNOW) - Design of a Cluster Randomized Controlled Trial of Staff Professional Development to Promote Physical Activity, Motor Skills, and Cognition in Preschoolers

Effects of a staff physical activity professional development intervention on preschoolers' mental health and self-regulation: The active learning Norwegian Preschool(er)s (ACTNOW) cluster randomised controlled trial

BACKGROUND AND AIM

Physical activity may have positive effects on preschoolers' mental health and self-regulation. The preschool setting provides children with opportunities to meet physical activity guidelines and could improve with staff training in delivering physical activity. This study examined the effect of physical activity professional development for preschool staff on preschoolers' proxy-measured mental health and self-regulation.

METHODS

In total, 1265 children from 46 preschools were cluster randomised to either the intervention or the control group. The intervention was nested within two levels implemented concurrently: the preschool level, formed as a professional development where preschools conducted development work, and the child level, with whom the staff implemented physical activity with four core components. Data were analysed using an ANCOVA model through structural equation modelling with latent outcome factors of: emotional problems, peer problems, hyperactivity, and prosocial behaviour from the Strength and Difficulties Questionnaire; and cognitive, emotional, and behavioural self-regulation from the Child Self-regulation and Behaviour Questionnaire.

RESULTS

No effects of the intervention (standardised effect sizes -0.195-0.145, p-values 0.118-0.893) were observed. Secondary analysis showed that children with initially high prosocial behaviour and behavioural self-regulation positively benefited from the intervention (p = 0.035 and p = 0.047, respectively).

CONCLUSION

The ACTNOW intervention had no effects on preschoolers' mental health or self-regulation after 18 months, besides effects for children with initially the highest prosocial behaviour and behavioural self-regulation. Although the professional development was more extensive than previous studies it may have been insufficient to change the preschools physical activity practices.

CLINICAL TRIAL REGISTRATION

www.

CLINICALTRIALS

gov identifier NCT04048967.

Effects of a staff-led multicomponent physical activity intervention on preschooler's fundamental motor skills and physical fitness: The ACTNOW cluster-randomized controlled trial

BACKGROUND

Fundamental motor skills (FMS) and physical fitness (FIT) play important roles in child development and provide a foundation for lifelong participation in physical activity (PA). Unfortunately, many children have suboptimal levels of PA, FMS, and FIT. The Active Learning Norwegian Preschool(er)s (ACTNOW) study investigated the effects of a staff-led PA intervention on FMS, FIT, and PA in 3-5-year-old children.

METHODS

Preschools in Western Norway having ≥ six 3-4-year-old children were invited (n = 56). Of these, 46 agreed to participate and were cluster-randomized into an intervention (n = 23 preschools [381 children, 3.8 yrs., 55% boys]) or a control group (n = 23 [438, 3.7 yrs., 52% boys]). Intervention preschools participated in an 18-month PA intervention involving a 7-month staff professional development between 2019 and 2022, amounting to 50 h, including face-to-face seminars, webinars, and digital lectures. Primary outcomes in ACTNOW were cognition variables, whereas this study investigated effects on secondary outcomes. FMS was measured through 9 items covering locomotor, object control, and balance skills. FIT was assessed as motor fitness (4 × 10 shuttle-run test) and upper and lower muscular strength (handgrip and standing long jump). PA was measured with accelerometers (ActiGraph GT3X +). All measures took place at baseline, 7-, and 18-month follow-up. Effects were analysed using a repeated measures linear mixed model with child and preschool as random effects and with adjustment for baseline scores.

RESULTS

Participants in the intervention preschools showed positive, significant effects for object control skills at 7 months (standardized effect size (ES) = 0.17) and locomotor skills at 18 months (ES = 0.21) relative to controls. A negative effect was found for handgrip strength (ES = -0.16) at 7 months. No effects were found for balance skills, standing long jump, or motor fitness. During preschool hours, sedentary time decreased (ES = -0.18), and light (ES = 0.14) and moderate-to-vigorous PA (ES = 0.16) increased at 7 months, whereas light PA decreased at 18 months (ES = -0.15), for intervention vs control. No effects were found for other intensities or full day PA.

CONCLUSIONS

The ACTNOW intervention improved some FMS outcomes and increased PA short-term. Further research is needed to investigate how to improve effectiveness of staff-led PA interventions and achieve sustainable improvements in children's PA, FMS, and FIT.

TRIAL REGISTRATION

Clinicaltrials.gov, identifier NCT04048967 , registered August 7, 2019.

FUNDING

ACTNOW was supported by the Research Council of Norway (grant number 287903), the County Governor of Sogn og Fjordane, the Sparebanken Sogn og Fjordane Foundation, and the Western Norway University of Applied Sciences.

Effectiveness of a Preschool Motor Skill Intervention on Body Mass Index and Movement Behavior: 6-, 18-, and 30-Month Findings From a Cluster Randomized Controlled Trial

PURPOSE

To study the effectiveness of a preschool staff-delivered motor skills intervention on body composition and physical activity over a 2.5-year time frame.

METHODS

In this pragmatic parallel cluster randomized controlled trial (16 preschools), outcome data were collected after 6 (body composition only), 18, and 30 months of intervention. The main physical activity outcomes were accelerometer behavior measures summarizing the total percentage of child daily movement (walk, run, cycle, and standing that included minor movements) and preschool movement during preschool attendance. To estimate between-group mean differences in outcomes, mixed-linear regression analyses including baseline value of the selected outcome and a treatment × time interaction term as a fixed effect were applied. In addition, the baseline preschool and child were included as a random effect.

RESULTS

For body mass index, a total of 437 children (90%) had at least one valid baseline and one follow-up assessment. The corresponding numbers for preschool movement and daily movement were 163 (55%) and 146 (49%), respectively. No significant between-group mean difference was identified for body mass index, waist-to-height ratio, or any physical activity outcomes.

CONCLUSION

Overall, this preschool motor skills intervention had no effect on either child anthropometry or physical activity, consistent with previous studies.

Multivariate physical activity association patterns for fundamental motor skills and physical fitness in preschool children aged 3-5 years

Physical activity (PA) is important for children's development of fundamental motor skills (FMS) and physical fitness (FIT) but evidence regarding which intensities are associated with these outcomes in early childhood is limited. The aim of this study was to determine the cross-sectional multivariate PA intensity signatures associated with FMS and FIT in children aged 3-5 years. We used a sample of 952 Norwegian preschoolers (4.3 years, 51% boys) who provided data on PA (ActiGraph GT3X+), at least one FMS (locomotor, object control and/or balance skills) or FIT (speed agility, standing long jump, and/or handgrip strength) outcome, body mass index, and socioeconomic status in 2019-2020. We created 17 PA intensity variables (0-99 to ≥15000 counts per minute) from the vertical axis and used multivariate pattern analysis for analyses. The PA intensity spectrum (including sedentary time) was significantly associated with all outcomes. Associations for PA intensities were positive (negative for sedentary time), strongest for moderate and vigorous intensities, and were significant across sex and age groups. Our findings show that the PA intensity spectrum is associated with FMS and FIT in young children and that promotion of PA, in particular moderate- and vigorous-intensity activity, from an early age benefits children's physical development.

Structural validity of the Norwegian version of the Strengths and Difficulties Questionnaire in children aged 3-6 years

Introduction

This study examined the structural validity of the teacher-report Strength and Difficulties Questionnaire (SDQ) in Norwegian preschoolers aged 3-6 years. We tested the original five-factor structure, the five-factor structure with two broader second-order factors, and a three-factor structure, all suggested in the literature. Since the positively worded items in SDQ have been shown to introduce noise, we also examined all three structures with a positive construal method factor for these items.

Methods

Preschool teachers from 43 preschools completed the SDQ questionnaire for 1,142 children [48% girls, mean age 4.3 (SD 0.9) years]. Confirmatory factor analyses were used to estimate and compare the six models. Measurement invariance was tested across sex (multi-group approach) and age (multiple-indicator multiple-cause approach).

Results

The original five-factor structure of SDQ was supported, where the model fit improved when including a method factor for positively worded items. Both models showed scalar invariance across sex and age. The second-order and the three-factor structures were not supported.

Conclusion

We recommend using the original five-factor structure when using SDQ for both clinical and research purposes in young children and adding a method factor when using structural equation modeling.

Structural validity of a test battery for assessment of fundamental movement skills in Norwegian 3-6-year-old children

Fundamental movement skills (FMS) are building blocks of more advanced movements, including subdomains of locomotion, object control and balance skills, but limited evidence exists for this three-factor structure. The aim of this study was to examine the structural validity of a three-factor modified test battery of FMS across age and sex in two large samples of preschoolers aged 3-6 years (sample 1: n = 1213, mean age 4.8 (.09); sample 2: n = 1198, mean age 4.3 (.09)). We used a test battery of FMS consisting of movement tasks for locomotion (run, horizontal jump and hop) and object control (catch, overhand throw and kick) from the Test of Gross Motor Development and balance skills (single-leg standing, walking line backward and walking line forward) from the Preschoolers Gross Motor Quality Scale. Confirmatory factor analysis was used to analyse the data. We found support for both a three-factor and a two-factor structure. Measurement invariance testing showed invariance over age and partial scalar invariance over sex. We conclude that our modified test battery is an appropriate measure of young children's FMS across the domains of locomotion, object control and balance, but that locomotion and object control subdomains provide limited unique information.

The Multivariate Physical Activity Signatures Associated With Self-Regulation, Executive Function, and Early Academic Learning in 3-5-Year-Old Children

The evidence regarding associations between intensity-specific physical activity and cognitive and learning outcomes in preschoolers is inconsistent and limited by low sample sizes and analytical approaches that cannot handle the multicollinearity among multiple physical activity intensity variables. We aimed to determine the multivariate physical activity intensity signatures associated with self-regulation, executive function, and early academic learning in preschool children aged 3–5 years. A 711 Norwegian preschool children (mean age 4.6 years, 52% boys) provided valid data on physical activity (ActiGraph GT3X+), self-regulation, executive function, and early academic learning during 2019–2020. Multivariate pattern analysis was used to determine associations between uniaxial and triaxial intensity spectra (time spent in intensities from 0–99 to ≥15,000 counts per minute) and the outcomes in the total sample and in subgroups split by sex and age (median split). Uniaxial data led to the highest explained variances (R²) and were reported as the primary findings. We found significant association patterns between physical activity and numeracy (R² = 4.28%) and inhibition (R² = 1.48%) in the total sample. The associations with numeracy were negative for time spent sedentary (0–99 counts per minute) and positive for time spent in moderate to vigorous intensities (≥ 1,000 counts per minute). The associations with inhibition were positive for time spent sedentary (0–99 counts per minute) and in vigorous intensities (≥ 8,500 counts per minute) and negative for time spent in low to moderate intensities (100–3,499 counts per minute). Associations with numeracy were stronger in boys (R² = 5.58%) and older children (R² = 7.27%), and associations with inhibition were stronger in girls (R² = 3.12%) and older children (R² = 3.33%). In conclusion, we found weak associations with numeracy and inhibition across the physical activity intensity spectrum in preschool children.

Teacher-Rated Executive Functions, Gender and Relative Age: Independent and Interactive Effects on Observed Fundamental Motor Skills in Kindergarteners

Fundamental motor skills (FMS) of children can be affected by different variables, such as executive functions (EF), gender and relative age. However, the effects of these variables on FMS have been scarce studied, especially in early childhood, and show inconsistent results. To clarify these relationships, this study was carried out. Its aim was to analyze whether EF, gender and relative age influenced FMS in 43 Spanish kindergarteners. A multimethod and mixed methods approach was used. Kindergarteners' teachers completed the Childhood Executive Functioning Inventory to know the children level of EF (working memory and inhibition control). Kindergarteners' parents complimented ad hoc questionnaire reporting the children gender and birth data (to know their relative age). A Nomothetic/Punctual/Multidimensional observational design was used to observe children FMS in their habitual motor sessions at school. Two-way ANOVAs were performed to know the independent and interactive effects of working memory level (lower/higher), inhibition control level (lower/higher), gender (boys/girls) and relative age (according to the birth semester in the year) on FMS. Results showed these variables have independent and interactive effects on some FMS, but not on others. FMS influenced by these variables vary depending what independent variable(s) is/are considered. Therefore, it can be concluded that the influences of teacher-rated EF, gender and relative age on observed FMS in kindergarteners are complex and specific. Results obtained must be taken into to design and implement instructional and intervention strategies, as well as educational and sport policy changes, especially in early childhood, when FMS are more malleable.

Field-based physical fitness assessment in preschool children: A scoping review

Physical fitness, which can be measured using various health- and skill-related components, is an important indicator of child development and health status. This study undertakes a scoping review on physical fitness assessment methods in preschool children to summarize the most widely used field-based physical fitness batteries and specific test items for preschool children. A search of the literature in English was undertaken using two major electronics databases, which yielded 76 literatures that met the inclusion and exclusion criteria. These literatures took the quantitative indicators of physical fitness as the outcome variables in 3-6-year-old children. This review found that of these 76 literatures analyzed, 71.1% came from Europe and 89.5% were published after 2010. The results showed six physical fitness test batteries, with the assessing FITness in PREschoolers (PREFIT) battery is the most widely used, and specific test items such as body mass index (BMI), standing long jump, handgrip, one-leg stance, sit and reach, 20 m shuttle run test (SRT)-PREFIT, and 4 × 10 m SRT are widely used in corresponding components. Therefore, we recommend that an international standard for some specific test items should be developed for preschool children to facilitate more widespread adoption and promote physical fitness assessment for preschool children.