Active Fundament - Fundamentally Better (AF)

An Active Fundament, Fundamentally Better: From an Early Age, Moving Well and Moving Enough as the Basis for a Lifetime of Physical Activity.

The objective of this longitudinal, quasi-experimental study is to improve children's fundamental motor skills and physical activity levels. In addition, the study aims to support pedagogical staff and educators in implementing physical activity during the workday, with the intention of facilitating a more supportive and enjoyable working environment that aligns with children's needs for physical activity.

The study is conducted in 18 child centers, combining childcare and preschool settings. Participants include children aged 2-6 years and their pedagogical staff and teachers.

The primary research questions addressed are:

• Can pedagogical staff and teachers be supported in increasing physical activity levels among children aged 2-6 years?
• Can a scalable intervention for child centers be developed that can be implemented in other regions following completion of the study? A total of nine intervention centers will be compared with nine control centers to determine whether observed effects can be attributed to the intervention.

Children will participate in assessments of motor skills, wear accelerometers to measure physical activity levels, and take part in walk-along interviews and a draw-and-tell method. Parents will complete questionnaires. Pedagogical staff and teachers will complete questionnaires and participate in observational assessments. Management representatives of the child centers (both preschool and childcare) will participate in interviews and complete a questionnaire to construct an echogram.

Study Overview

• Status: Recruiting
• Conditions: Physical Inactivity in Early Childhood and Care; Delayed Fundamental Motor Skill Development; Early Childhood & Care Physical Activity Behavior; Motor Development in Children Aged 2-6 Years; Physical Activity-Supportive Early Childhood Education and Care (ECEC) Environment
• Intervention / Treatment: Behavioral: Actief Fundament

• Study Type: Interventional
• Enrollment (Estimated): 1000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jasper de Graef, Master of Arts; Phone Number: +31623635013; Email: j.degraef@fontys.nl
• Study Contact Backup: Name: Dave van Kann, PhD; Phone Number: +31627349611; Email: d.vankann@fontys.nl

Study Locations

• Netherlands
  • Limburg
    • Maastricht, Limburg, Netherlands, 6211 LK
      • Recruiting
      • Maastricht University
      • Contact: Jessica Gubbels, Associate Professor; Phone Number: +31 6 36501281; Email: jessica.gubbels@maastrichtuniversity.nl
  • North Brabant
    • Eindhoven, North Brabant, Netherlands, 5644HZ
      • Recruiting
      • Fontys Sport en Bewegen
      • Contact: Dave van Kann, PhD; Phone Number: +31 6 27349611; Email: d.vankann@fontys.nl
  • North Holland
    • Amsterdam, North Holland, Netherlands, 1067SM
      • Recruiting
      • Hogeschool van Amsterdam
      • Contact: Mirka Janssen, PhD; Phone Number: +31 6 21158173; Email: m.janssen@hva.nl

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Children must be in the child center in the recruitment period(s)
• Professionals in ECEC and management must be working at the child center during the recruitment period.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Childeren in ECEC settings; 2-6 year olds	Behavioral: Actief Fundament; In procesmeetings with the intervention centers we will discuss possible changes to improve physical activity levels of children. Activities and changes will be based on the measurement outcomes.
Experimental: Professionals in ECEC settings; Pedagogical and educational staff including management	Behavioral: Actief Fundament; In procesmeetings with the intervention centers we will discuss possible changes to improve physical activity levels of children. Activities and changes will be based on the measurement outcomes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average daily light physical activity, moderate-to-vigorous physical activity (MVPA), and sedentary behavior in minutes, assessed by accelerometry	Children's physical activity behavior will be objectively assessed using triaxial accelerometers (ActiGraph GT3X+). Accelerometers will be worn during waking hours for seven consecutive days. Physical activity data will be processed using validated pediatric cut-points to derive average daily time spent in light physical activity, moderate-to-vigorous physical activity (MVPA), and sedentary behavior. Outcomes will be reported as mean minutes per day for each activity intensity category per measurement period.	One week of accelerometer measurement, repeated annually in the spring season for four consecutive years
Pedagogical support for physical activity assessed by the Movement Environment Rating Scale (MOVERS)	Pedagogical actions of teachers and caretakers that support children's physical activity will be assessed using the Movement Environment Rating Scale (MOVERS). MOVERS is an observational instrument designed for early childhood education and care settings and evaluates the extent to which pedagogical practices and environmental characteristics promote physical activity and motor development. The scale consists of four domains and yields a total score ranging from 1 to 7, with higher scores indicating a more supportive physical activity environment and higher-quality pedagogical practices. Observations will be conducted during a full day in childcare and preschool settings by trained observers.	Assessed at baseline, mid-intervention, and at study completion (approximately 3 years)
Self-reported pedagogical physical activity practices assessed by questionnaire	Pedagogical staff's self-reported practices related to promoting physical activity and fundamental motor skills will be assessed using a structured questionnaire. The questionnaire captures frequency and type of physical activity-related pedagogical actions during the workday. Outcomes will be summarized as mean scores per domain, with higher scores indicating greater engagement in physical activity-supportive practices.	Assessed at baseline and annually thereafter during the spring season, through study completion (up to 4 years)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Motor competence assessed by the Athletic Skills Track (AST)	Motor competence will be assessed using the Athletic Skills Track (AST), a standardized motor competence assessment for children. The AST consists of a sequence of age-appropriate motor tasks assessing balance, coordination, agility, jumping, and running skills. Performance is expressed as total completion time in seconds, with lower times indicating better motor skill performance. Only children aged 4 years and older will be assessed.	Assessed at baseline and annually thereafter during the spring season, through study completion (up to 4 years)
Motor competence assessed by the 4 Skills Scan (4SS) test	Motor competence will be assessed using the 4 Skills Scan (4SS) test, a validated motor skill assessment for children. The 4SS evaluates four motor domains: jumping force, jumping coordination, running coordination, and object control. Each domain is scored on a standardized scale, resulting in a total score ranging from 4 to 16, with higher scores indicating better motor skill proficiency. Only children aged 4 years and older will be assessed.	Assessed at baseline and annually thereafter during the spring season, through study completion (up to 4 years)
Parental involvement in the child center and child physical activity assessed by questionnaire	Parental involvement will be assessed using a structured parent questionnaire. The questionnaire measures parental involvement across multiple domains, including involvement in the child center, support for the child's physical activity, and perceived child well-being. Domain-specific mean scores will be calculated, with higher scores indicating greater parental involvement and support. The questionnaire will be administered to parents of participating children.	Assessed at baseline and annually thereafter during the spring season, through study completion (up to 4 years)

Collaborators and Investigators

• Sponsor: Fontys University of Applied Sciences
• Investigators: Study Director: Dave van Kann, PhD, Fontys University of Applied Sciences; Study Director: Jessica Gubbels, Associate Professor, Maastricht University

Publications and helpful links

Helpful Links

• Study project website
• Project funding

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2024
• Primary Completion (Estimated): August 31, 2027
• Study Completion (Estimated): December 31, 2027

Study Registration Dates

• First Submitted: December 4, 2025
• First Submitted That Met QC Criteria: December 18, 2025
• First Posted (Estimated): January 2, 2026

Study Record Updates

• Last Update Posted (Estimated): January 2, 2026
• Last Update Submitted That Met QC Criteria: December 18, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: preschool; motor skills; childcare; physical activity levels; Child center
• Other Study ID Numbers: FHML-REC/2024/032; RAAK.PRO05.034 (Other Grant/Funding Number: Nation agency of applied research (Regieorgaan SIA))

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No