Doctor of Philosophy
Faculty of Education
Riethmuller, Annaleise, Promoting physical activity and motor development among preschool-aged children: The Jump Start pilot randomised controlled trial, Doctor of Philosophy thesis, Faculty of Education, University of Wollongong, 2011. http://ro.uow.edu.au/theses/3399
The preschool years (3 – 5 years of age) are an important time to influence key health behaviours such as physical activity. Engaging in sufficient physical activity during the preschool years has the potential to decrease the risk of health consequences later in life. However, a large proportion of preschool-aged children do not meet current physical activity recommendations.
Preschool-aged children’s participation in physical activity is influenced by a number of factors, one of which is fundamental movement skill proficiency. Fundamental movement skills are the foundation for physical activity with mastery requiring practice, feedback and encouragement. Australian preschool children currently demonstrate low levels of fundamental movement skill proficiency.
Child care settings are an ideal place to promote physical activity and fundamental movement skill development. Approximately 84% of Australian children are enrolled in formal child care (e.g. long day care centres) the year before starting school, which means that a large proportion of the preschool population could be targeted. Additionally, child care settings are required to support physical development and they generally have the resources to promote physical activity and to support fundamental movement skill development (e.g. space and equipment).
This thesis reports on two trials that informed the development, implementation and evaluation of a fundamental movement skill development intervention (Jump Start), targeting three- to five-year old children enrolled in long day care centres: a Proof-of- Concept trial followed by a pilot Randomised Controlled Trial (pilot RCT). The aim of both studies was to test the feasibility (screening, recruitment and retention and collection of useable data), acceptability (implementation of planned professional development, structured lessons and unstructured activities, and staff acceptability), and potential efficacy (changes in physical activity and fundamental movement skill development) of Jump Start. Physical activity levels and fundamental movement skill proficiency were encouraged through structured lessons and unstructured activities delivered by setting staff in long day care settings. Both trials were underpinned by Social Cognitive Theory, and attempted to influence behaviour change through modifying the child care environment, and targeting cognitive and personal factors (e.g. teaching that fundamental movement skills are mastered through practice) and behaviour (e.g. practicing fundamental movement skills through regular and enjoyable games).
The Proof-of-Concept trial was a single group design involving 37 three- to five-year old children attending one long day care centre (mean age 4.8y, SD = 0.45). Measures were collected at pre-intervention and at post-intervention (8-weeks). The intervention had three components: professional development (1 day workshop), structured lessons (20min, 3 x per week) and unstructured activities (3 per week). Results showed that the intervention was feasible and acceptable, however a small number of issues were identified for modification for the pilot RCT, including: unsatisfactory implementation of lessons by staff, low return of staff lesson evaluations, and barriers to collection of objective data (such as fear of instruments and regular absences).
The pilot RCT was a 20-week, 2-arm parallel group trial involving 97 three- to five-year old children who were randomly assigned at the centre level to either the intervention (n = 52) or comparison group (n = 45). The intervention comprised three components: 1) Professional development which consisted of 4 x 30 minute workshops delivered in staff meetings, 15 demonstration structured lessons, and 14 demonstration unstructured activities; 2) 43 staff-implemented structured lessons; and 3) 44 staff-implemented unstructured activities. Three structured lessons and three unstructured activities were delivered each week, with five focus skills covered during the intervention period (run, jump, hop, catch, kick).
The pilot RCT confirmed that the Jump Start program was feasible, acceptable, and potentially efficacious. All feasibility and acceptability targets were met with the exception of implementation of unstructured activities. All potential efficacy hypotheses were met, with the exception of physical activity levels at post-intervention. A significantly greater increase for total physical activity was found for the intervention group, compared with the comparison group, during the intervention (adjusted diff = 110.48, 95% CI = 33.62, 187.33, p = 0.01), however this was not maintained at postintervention. At post-intervention a greater increase was found for all fundamental movement skills in the intervention group compared with the comparison group, with statistically significant differences found for jump (adjusted diff = 1.41, 95% CI = 0.69, 2.13, p < 0.001) and total fundamental movement skill score (adjusted diff = 2.08, 95% CI = 0.76, 3.40, p < 0.001), Additionally a greater decrease was found in the intervention group, compared with the comparison group, for body mass index (adjusted diff = -0.08, 95% CI = -0.33, 0.17, p = 0.53).
This study’s findings reinforce the potential that child care settings (e.g. long day care) hold for promoting physical activity and fundamental movement skill proficiency among preschool-aged children. Future efficacy studies that are adequately powered to detect statistically significant differences between groups are now needed to confirm these results.