Active Play in After-school Programmes: development of an intervention and description of a matched-pair cluster-randomised trial assessing physical activity play in after-school programmes

Kirsti Riiser, Sølvi Helseth, Hanna Ellingsen, Bjørg Fallang, Knut Løndal, Kirsti Riiser, Sølvi Helseth, Hanna Ellingsen, Bjørg Fallang, Knut Løndal

Abstract

Introduction: Interventions delivered in after-school programmes (ASPs) have the potential to become a means of ensuring adequate physical activity among schoolchildren. This requires a motivational climate, allowing for self-determined play. If trained, ASP staff may represent a valuable resource for supporting such play. Increasing knowledge and supportive skills among ASP staff may also potentially increase their motivation for work. The purpose of this article is to describe the development of the 'Active Play in ASP' intervention, which aims to promote physical activity among first graders attending ASP, and to present a protocol for a matched-pair cluster-randomised trial to evaluate the intervention.

Methods and analysis: Informed by experiences from practice, evidence-based knowledge and theory, the intervention was developed in a stepwise process including focus group meetings and a small-scale pilot test. The intervention contains a course programme for ASP staff to increase their skills in how to support physical activity through play. In a cluster randomised controlled trial, the ASPs will be matched and randomly allocated to receive the 7-month intervention or to a control group. Outcomes will be assessed at baseline, after 7 and 19 months. First graders attending the ASPs included are eligible. The primary outcome will be accelerometer-determined minutes in moderate to vigorous physical activity in the ASP. The study uses a mixed methods approach including observations and interviews to provide rich descriptions of the concept of children's physical activity in ASP. Moreover, the trial will assess whether the ASP staff benefits from participation in the intervention in terms of increased work motivation. Lastly, process evaluations of programme fidelity, satisfaction and suggestions on improvement will be performed.

Ethics and dissemination: The study is approved by the Data Protection Official for Research (reference no 46008). Results will be presented in conferences and peer-reviewed journals.

Trial registration number: Clinical Trials (NCT02954614), pre-results.

Keywords: after school programs; children; intervention; physical activity; play.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Process of development of Active Play in ASP. ASP, after-school programme.
Figure 2
Figure 2
Flowchart of the study design. ASPs, after-school programmes.

References

    1. Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010;7:40 10.1186/1479-5868-7-40
    1. Biddle SJ, Gorely T, Stensel DJ. Health-enhancing physical activity and sedentary behaviour in children and adolescents. J Sports Sci 2004;22:679–701. 10.1080/02640410410001712412
    1. Biddle SJ, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med 2011;45:886–95. 10.1136/bjsports-2011-090185
    1. Fedewa AL, Ahn S. The effects of physical activity and physical fitness on children's achievement and cognitive outcomes: a meta-analysis. Res Q Exerc Sport 2011;82:521–35. 10.1080/02701367.2011.10599785
    1. Ommundsen Y, Løndal K, Loland S, . et al. . Sport, children and well-being : Ben-Arieh A, Casas F, Frønes I, Korbin JE, . Handbook of child well-being. Dordrecht: Springer Reference, 2014.
    1. Waters E, de Silva-Sanigorski A, Hall BJ, et al. . Interventions for preventing obesity in children. Cochrane database of systematic reviews 2011;12:CD001871.
    1. Gadamer H. Truth and method. London: Sheed and Ward, 1989.
    1. Pellegrini AD, Smith PK. Physical activity play: the nature and function of a neglected aspect of playing. Child Dev 1998;69:577–98. 10.1111/j.1467-8624.1998.tb06226.x
    1. Gallahue DL, Ozmun JC. Understanding motor development: infants, children, adolescents, adults. . 6th ed Boston: London: McGraw Hill, 2006:xix.
    1. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985;100:126–31.
    1. Warren JM, Ekelund U, Besson H, et al. . Assessment of physical activity - a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 2010;17:127–39. 10.1097/HJR.0b013e32832ed875
    1. Dobbins M, Husson H, DeCorby K, et al. . School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2013;2:CD007651 10.1002/14651858.CD007651.pub2
    1. The Norwegian Directorate of Health. Anbefalinger om kosthold, ernæring og fysisk aktivitet (Norwegian guidelines on diet, nutrition and physical activity). Oslo: The Norwegian Directorate of Health, 2014.
    1. Beets MW, Beighle A, Erwin HE, et al. . After-school program impact on physical activity and fitness: a meta-analysis. Am J Prev Med 2009;36:527–37. 10.1016/j.amepre.2009.01.033
    1. Beets MW, Weaver RG, Turner-McGrievy G, et al. . Making policy practice in afterschool programs: a randomized controlled trial on physical activity changes. Am J Prev Med 2015;48:694–706. 10.1016/j.amepre.2015.01.012
    1. Cradock AL, Barrett JL, Giles CM, et al. . Promoting physical activity with the out of School Nutrition and physical activity (OSNAP) Initiative: a Cluster-Randomized Controlled Trial. JAMA Pediatr 2016;170:155–62. 10.1001/jamapediatrics.2015.3406
    1. Gortmaker SL, Lee RM, Mozaffarian RS, et al. . Effect of an after-school intervention on increases in children's physical activity. Med Sci Sports Exerc 2012;44:450–7. 10.1249/MSS.0b013e3182300128
    1. Hughey SM, Weaver RG, Saunders R, et al. . Process evaluation of an intervention to increase child activity levels in afterschool programs. Eval Program Plann 2014;45:164–70. 10.1016/j.evalprogplan.2014.04.004
    1. Green K. Understanding physical education. . London: Sage, 2008:280.
    1. Løndal K. Revelations in bodily play. A study among children in an after-school programme. Oslo, 2010. Phd Dissertation.
    1. Løndal K, Bergsjø C. Fysisk aktivitet i skolefritidsordningen: En undersøkelse i fire skolefritidsordninger i Oslo. (Physical activity in after-school programmes. A study of four after-school programmes in Oslo). Oslo: Oslo Univeristy College, 2005.
    1. Løndal K. Children's lived experience and their sense of coherence: Bodily play in a Norwegian after-school programme. Child Care in Practice 2010;16:391–407. 10.1080/13575279.2010.498414
    1. Løndal K, Lund S, Bergsjø CH. Tilrettelegging for fysisk aktivitet i skolefritidsordningen i Oslo. (Facilitating physical activity in after-school programmes in Oslo). Tidsskriftet FoU i praksis 2016;10:43–61.
    1. Dowda M, Pate RR, Trost SG, et al. . Influences of preschool policies and practices on children's physical activity. J Community Health 2004;29:183–96. 10.1023/B:
    1. Constantinides P, Montalvo R, Silverman S. Teaching processes in elementary physical education classes taught by specialists and nonspecialists. Teach Teach Educ 2013;36:68–76. 10.1016/j.tate.2013.07.004
    1. Løndal K, Greve A. Didactic approaches to Child-Managed Play: analyses of Teacher?s interaction styles in kindergartens and After-School Programmes in Norway. International Journal of Early Childhood 2015;47:461–79. 10.1007/s13158-015-0142-0
    1. Cheon SH, Reeve J, Yu TH, et al. . The teacher benefits from giving autonomy support during physical education instruction. J Sport Exerc Psychol 2014;36:331–46. 10.1123/jsep.2013-0231
    1. The Norwegian Directorate of Health. . Utviklingsstrategi for helsestasjons- og skolehelsetjenesten. (Strategy for the public health center- and the school health service). Rapport IS-1798. Oslo: The Norwegian Directorate of Health 2010.
    1. Craig P, Dieppe P, Macintyre S, et al. . Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655 10.1136/bmj.a1655
    1. Øygardslia H. Tiltak for økt fysisk aktivitetsnivå i skolefritidsordninger: En forskningsoppsummering. (Interventions to increase physical activity in after-school programmes; a systematic review). Master thesis. ODA Open Digital Archive: Oslo and Akershus University College of Applied Sciences, 2016.
    1. Huberty JL, Dinkel DM, Beets MW. Evaluation of GoGirlGo!; A practitioner based program to improve physical activity. BMC Public Health 2014;14:118 10.1186/1471-2458-14-118
    1. Iversen CS, Nigg C, Titchenal CA. The impact of an elementary after-school nutrition and physical activity program on children's fruit and vegetable intake, physical activity, and body mass index: Fun 5. Hawaii Med J 2011;70(7 Suppl 1):37–41.
    1. Thaw JM, Villa M, Reitman D, et al. . Evidence-based fitness promotion in an afterschool setting: implementation fidelity and its policy implications. New Dir Youth Dev 2014;2014:103–31. 10.1002/yd.20106
    1. Ryan RM, Deci EL. Active human nature : Hagger MS, Chatzisarantis NL, Intrinsic motivation and self-determination in exercise and sport. Champaign: Human Kinetics, 2007:1–21.
    1. Standage M, Gillison F, Treasure D. Self-determination and motivation in physical education : Hagger MS, Chatzisarantis NLD, Intrinsic motivation and self-determination in exercise and sports. Champaign; IL: Human Kinetics, 2007:71–87.
    1. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000;55:68–78. 10.1037/0003-066X.55.1.68
    1. Ryan RM, Patrick H, Deci EL, et al. . Facilitating health behaviour change and its maintenance: interventions based on Self-Determination Theory. The European Helath Psychologist 2008;10:2–5.
    1. Edmunds J, Ntoumanis N, Duda JL. Testing a self-determination theory-based teaching style intervention in the exercise domain. Eur J Soc Psychol 2008;38:375–88. 10.1002/ejsp.463
    1. Broström S. SFO som arena for læring. Ankerstjerne IT, . SO- og fritidspedagogik -før, nu og i fremtiden. Fredrikshavn: Dafolo, 2010.
    1. Fortier MS, Duda JL, Guerin E, et al. . Promoting physical activity: development and testing of self-determination theory-based interventions. Int J Behav Nutr Phys Act 2012;9:20 10.1186/1479-5868-9-20
    1. Edmunds JK, Ntoumanis N. Perceived autonomy support and psychological need satisfaction in exercise : Hagger MS, Chatzisarantis NLD, Intrisic motivation and self-determination in exercise and sport. Champaign, IL: Human Kinetics, 2007.
    1. Reeve J. Self-determination theory applied to educational settings : Deci EL, Ryan RM, Handbook of self-determination research. Rochester, NY: University of Rochester Press, 2002.
    1. The Norwegian Directorate of Health, , , . Fysisk aktivitet blant 6-, 9- og 15-åringer i Norge. Resultater fra en kartlegging i 2011. (Physical activity among 6-,9- and 15 year olds in Norway 2011). IS-2002 Oslo; Helsedirektoratet, 2012.
    1. Samdal O, Leversen I, Torsheim T, et al. . Trender i helse og livsstil bant barn og unge 1985-2005. (Trends in health and lifestyle among children and adolescents 1985-2005. Norwegian results from the study "Health behavior among school children. A WHO study in several countries"). Bergen: HEMIL-senteret, University of Bergen, 2009.
    1. The KIDSCREEN Group Europe. The KIDSCREEN questionnaires Quality of life questionnaires for children and adolescents Lengerich. Germany: Pabst Science Publishers, 2006.
    1. Cole TJ, Bellizzi MC, Flegal KM, et al. . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–3. 10.1136/bmj.320.7244.1240
    1. Broeck A, Vansteenkiste M, Witte H, et al. . Capturing autonomy, competence, and relatedness at work: construction and initial validation of the Work-related basic need satisfaction scale. J Occup Organ Psychol 2010;83:981–1002. 10.1348/096317909X481382
    1. Gagné M, Forest J, Vansteenkiste M, et al. . The multidimensional work motivation Scale: validation evidence in seven languages and nine countries. European Journal of Work and Organizational Psychology 2015;24:178–96 . 10.1080/1359432X.2013.877892
    1. Andersen IA, Andersen JR. Validering av eit måleinstrument for jobbtilfredsheit. (Validation of an instrument to measure job satisfaction). Sykepleien Forskning 2012;7:334–40.
    1. Pavot W, Diener E. Review of the satisfaction with Life Scale. Psychol Assess 1993;5:164–72. 10.1037/1040-3590.5.2.164
    1. Atkins S, Odendaal W, Leon N, et al. . Qualitative process evaluation for complex interventions Hallberg IR DAR, ed Complex interventions in health; An overview of resarch methods. New York: Routhledge, 2015.
    1. Kvale S, Rygge J, Brinkmann S, et al. . Det kvalitative forskningsintervju. 2. utg. ed. Oslo: Gyldendal akademisk, 2009.
    1. Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health 2012;40:795–805. 10.1177/1403494812465030
    1. Schreier M. Qualitative Content analysis in practice. Thousand Oaks, CA: Sage Publications LTD, 2012.
    1. Hallberg IR. Knowledge for health care practice : Richards DA, Hallberg IR, Complex interventions in health: an overview of research methods. New York: Routhledge, 2015.

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