Development, Child, Fundamental Motor Skills, Physical Activity, Self-regulation
Conditions
Brief summary
The goal of PLAY is to adapt and test a developmentally appropriate intervention delivered on a mobile app to parents, with the goal of teaching fundamental motor skill (FMS) proficiency to their preschool-aged children (ages 3 to 5 y). Seventy-two children (3 to 5 y of age) were randomized. Of these children, 36 parents were randomized to use the FMS app and 36 were randomized to use a version of the app that promotes unstructured PA as a comparator group. Parents in the FMS condition accessed instructional lessons, peer modeling videos, and activity breaks to deliver 720 minutes of targeted, structured FMS instruction time to their child over a 12-week period. Parents in the comparator arm used a version of the app that provides instructional lessons to promote the equivalent amount of unstructured PA for their child. Parents were asked to guide the intervention, as parental support, modeling, and co-participation predict children's engagement in PA.
Detailed description
Preschoolers spend 4 hours/day in front of a screen, while fewer than one-quarter engage in the recommended two hours of daily physical activity (PA). The decline in PA, increase in screen-based behaviors, and onset of obesity during preschool years have been linked to lifetime risk of obesity and related comorbidities. However, emerging evidence indicates that screen time can actually be leveraged as a tool to increase children's PA and promote healthy weight. Specifically, PA interventions delivered over digital devices can provide real-time encouragement for children to be physically active. Prior interventions delivered over mobile devices were effective in increasing PA levels, including our own P-Mobile study that provided behavioral strategies to parents of children aged 6 to 10 years. When considering how to support and motivate parents whose children are preschool-aged, teaching and modeling fundamental motor skills (FMS) are critical to enable children's PA. FMS like running, jumping, or throwing a ball, are basic, goal-directed movement patterns developed in early childhood that provide a foundation for children to be physically active and competent movers. These skills enable a child to function independently in their surrounding environment, engage with peers, and contribute to their ability to be physically active. Evidence has shown that children must establish a minimal level of FMS proficiency to continue participating in PA opportunities as they age. FMS and PA behaviors have a dynamic and reciprocal relationship. Children with higher levels of FMS are more physically active both during childhood and into adolescence. Therefore, a PA intervention for preschoolers should focus on developing FMS competence.
Interventions
Lessons will be provided over the app each week with notifications sent 5 days/week over 12 weeks specific to randomized experimental group.
Lessons will be provided over the app each week with notifications sent 5 days/week over 12 weeks specific to randomized active comparator group.
Sponsors
Study design
Eligibility
Inclusion criteria
* 3-5 years of age * Physically capable of exercise * Has no parent-reported mobility limitations that impairs performance of fundamental motor skills
Exclusion criteria
• Gross Motor Quotient at gifted or very advanced based on the Test of Gross Motor Development (TGMD-3)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| App Adherence | From date of randomization until completion of the 12 weeks of intervention | Adherence to the app intervention based on number of activity breaks completed over the 12 week intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Test of Gross Motor Development (TGMD-3) Percentile Rank Between Baseline and Week 12 | baseline and 12 weeks (primary outcome) | A validated, reliable observation assessment to evaluate fundamental motor skills performance. Percentile ranks range from 1st (lowest) to 99th (highest/best). |
Countries
United States
Participant flow
Recruitment details
A convenience sample was recruited using flyers at local childcare centers, email listserv, social media, and community health fairs.
Participants by arm
| Arm | Count |
|---|---|
| Fundamental Motor Skills (FMS) The FMS group will utilize the PLAY FMS app that provides instructional lessons, peer modeling videos, and activity breaks to deliver 720 minutes of targeted, structured FMS instruction time to the child over a 12 week period.
Fundamental Motor Skills App: Lessons will be provided over the app each week with notifications sent 5 days/week over 12 weeks specific to randomized experimental group. | 35 |
| Unstructured Physical Activity The active comparator group will use a version of the PLAY app that provides instructional lessons to promote the equivalent dosage of unstructured physical activity for the child.
Unstructured Physical Activity App: Lessons will be provided over the app each week with notifications sent 5 days/week over 12 weeks specific to randomized active comparator group. | 37 |
| Total | 72 |
Baseline characteristics
| Characteristic | Fundamental Motor Skills (FMS) | Unstructured Physical Activity | Total |
|---|---|---|---|
| Age, Continuous | 3.8 years STANDARD_DEVIATION 0.8 | 4.1 years STANDARD_DEVIATION 0.8 | 4.0 years STANDARD_DEVIATION 0.8 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 1 Participants | 3 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 33 Participants | 36 Participants | 69 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Fundamental Motor Skills (TGMD-3 Total Percentile Rank) | 18.6 percentile STANDARD_DEVIATION 2.3 | 14.9 percentile STANDARD_DEVIATION 2.1 | 16.7 percentile STANDARD_DEVIATION 2.2 |
| Race/Ethnicity, Customized Race African American | 8 Participants | 11 Participants | 19 Participants |
| Race/Ethnicity, Customized Race Other | 6 Participants | 2 Participants | 8 Participants |
| Race/Ethnicity, Customized Race White | 21 Participants | 24 Participants | 45 Participants |
| Region of Enrollment United States | 35 participants | 37 participants | 72 participants |
| Sex: Female, Male Female | 15 Participants | 16 Participants | 31 Participants |
| Sex: Female, Male Male | 20 Participants | 21 Participants | 41 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 35 | 0 / 37 |
| other Total, other adverse events | 0 / 35 | 0 / 37 |
| serious Total, serious adverse events | 0 / 35 | 0 / 37 |
Outcome results
App Adherence
Adherence to the app intervention based on number of activity breaks completed over the 12 week intervention
Time frame: From date of randomization until completion of the 12 weeks of intervention
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Fundamental Motor Skills (FMS) | App Adherence | 71 percentage of activity breaks |
| Unstructured Physical Activity | App Adherence | 87 percentage of activity breaks |
Change in Test of Gross Motor Development (TGMD-3) Percentile Rank Between Baseline and Week 12
A validated, reliable observation assessment to evaluate fundamental motor skills performance. Percentile ranks range from 1st (lowest) to 99th (highest/best).
Time frame: baseline and 12 weeks (primary outcome)
Population: Delta in TGMD-3 Total Percentile Rank between baseline to Week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Fundamental Motor Skills (FMS) | Change in Test of Gross Motor Development (TGMD-3) Percentile Rank Between Baseline and Week 12 | 7.1 percentile | Standard Deviation 1.4 |
| Unstructured Physical Activity | Change in Test of Gross Motor Development (TGMD-3) Percentile Rank Between Baseline and Week 12 | -5.5 percentile | Standard Deviation 1.3 |