Movement skills and physical activity in obese children: randomized controlled trial
Purpose: To evaluate the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS) physical activity program in overweight children.Methods: A multi-site randomized controlled trial (RCT) was conducted with three intervention arms: (1) child-centered physical activity skill development program (Activity); (2) parent-centered dietary modification program (Diet); or (3) both programs combined (Activity+Diet). Movement skill proficiency, perceived athletic competence, accelerometer-assessed physical activity and parent-reported time spent in screen behaviors were assessed at baseline, 6 and 12 months in 165 pre-pubertal children aged 5.5-9 years (59% girls, 78% obese). Differences in changes in outcomes between groups were assessed using linear mixed models. Results: Compared to the Diet group, the Activity (mean [95% confidence interval]) (+7.7 [3.8 to 11.6] units) and Activity+Diet (+6.7 [2.9 to 10.5] units) groups displayed 11-13% greater improvement in overall movement skill proficiency (gross motor quotient) at 6 months. Perceived athletic competence increased across groups at follow-ups (across groups: 6 months = +0.21 [0.11 to 0.31] units, 12 months = +0.21 [0.07 to 0.35] units). Groups did not differ statistically for change in physical activity outcomes. Total screen time (min week-1) decreased in all groups at 6 months (across groups: -385.4 [-501.0 to -269.8]) and in the Activity (-261.8 [-470.5 to -53.1]) and Activity+Diet groups (-340.5 [-534.6 to -146.4]) at 12 months. The Diet group reported greater reductions in TV/DVD viewing time at 6 months compared to the Activity group (248.6 [24.0 to 473.3]). Conclusion: The Activity and Activity+Diet programs were efficacious in improving overweight childrens movement skill proficiency. All programs were efficacious in reducing time spent in screen behaviors. Other correlates may need to be targeted, in addition to movement skills, to increase physical activity among overweight children.