Gary S Goldfield1, Alysha L J Harvey2, Kimberly P Grattan3, Viviene Temple4, Patti-Jean Naylor4, Angela S Alberga5, Zachary M Ferraro6, Shanna Wilson3, Jameason D Cameron2, Nicholas Barrowman7, Kristi B Adamo8. 1. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Department of Psychology, Carleton University, Ottawa, Ontario, Canada. Electronic address: ggoldfield@cheo.on.ca. 2. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada. 3. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. 4. School of Exercise Science, Health and Physical Education, University of Victoria, Victoria, British Columbia, Canada. 5. Werklund School of Education, University of Calgary, Calgary, Alberta, Canada. 6. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Division of Maternal-Fetal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 7. Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. 8. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Paediatrics, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Abstract
INTRODUCTION: This study evaluated whether intervening with child care providers would increase physical activity (PA) and reduce adiposity in preschoolers. METHODS: This was a two-arm, parallel group, cluster RCT whereby six child care centers were randomly assigned in equal numbers to intervention (n=40 children) or control (n=43 children). Participants were aged 3-5 years and attended licensed child care centers. Child care providers received two 3-hour train-the-trainer workshops and a training manual at program initiation aimed at increasing structured and unstructured PA through active play. Control child care centers implemented their standard curriculum. PA and sedentary behavior were measured by accelerometry, and body composition was measured using bioelectrical impedance at baseline and 6 months. Data were collected in 2011-2012 and analyzed in April 2015. RESULTS: Linear mixed-effects modeling showed that at 6 months, children in the intervention group demonstrated greater increases in minutes per preschool day spent in overall PA (22.5 minutes, 95% CI=8.9, 36.1, p=0.002), and light-intensity PA (16.1 minutes, 95% CI=5.2, 26.7, p=0.004), but changes between groups in moderate to vigorous PA did not differ. The intervention group showed greater reductions in body fat percentage (-1.9%, 95% CI=-3.5, -0.3, p=0.023) and fat mass (-0.3 kg, 95% CI=-0.7, -0.1, p=0.018), but groups did not differ on fat-free mass, BMI, or z-BMI. CONCLUSIONS:Provider-led intervention in child care centers increased preschoolers' PA and reduced adiposity, therefore may represent a viable approach to promoting PA and related health benefits in preschool-aged children. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02293278.
RCT Entities:
INTRODUCTION: This study evaluated whether intervening with child care providers would increase physical activity (PA) and reduce adiposity in preschoolers. METHODS: This was a two-arm, parallel group, cluster RCT whereby six child care centers were randomly assigned in equal numbers to intervention (n=40 children) or control (n=43 children). Participants were aged 3-5 years and attended licensed child care centers. Child care providers received two 3-hour train-the-trainer workshops and a training manual at program initiation aimed at increasing structured and unstructured PA through active play. Control child care centers implemented their standard curriculum. PA and sedentary behavior were measured by accelerometry, and body composition was measured using bioelectrical impedance at baseline and 6 months. Data were collected in 2011-2012 and analyzed in April 2015. RESULTS: Linear mixed-effects modeling showed that at 6 months, children in the intervention group demonstrated greater increases in minutes per preschool day spent in overall PA (22.5 minutes, 95% CI=8.9, 36.1, p=0.002), and light-intensity PA (16.1 minutes, 95% CI=5.2, 26.7, p=0.004), but changes between groups in moderate to vigorous PA did not differ. The intervention group showed greater reductions in body fat percentage (-1.9%, 95% CI=-3.5, -0.3, p=0.023) and fat mass (-0.3 kg, 95% CI=-0.7, -0.1, p=0.018), but groups did not differ on fat-free mass, BMI, or z-BMI. CONCLUSIONS: Provider-led intervention in child care centers increased preschoolers' PA and reduced adiposity, therefore may represent a viable approach to promoting PA and related health benefits in preschool-aged children. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02293278.
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