Increasing Children's Physical Activity by Policy (CAP)
31 août 2021 mis à jour par: Daniel Berglind, Karolinska Institutet
Increasing Children's Physical Activity by Policy (CAP): a Cluster Randomized Controlled Trial in the Stockholm Region Preschools
Levels of physical activity (PA) and physical fitness in children are low and declining, both globally and in Sweden.
Preschools are important settings with the potential to influence the majority (>93%) of Swedish children's PA behaviors in early stage of life (<5 years).
Preschool policy is an organizational level factor associated with children's PA but the casual link remains unclear.
A cluster randomized controlled trial will be conducted to explore the feasibility and effectiveness of implementing a policy package for children's PA levels and other relevant health indicators.
Aperçu de l'étude
Statut
Actif, ne recrute pas
Les conditions
Intervention / Traitement
Description détaillée
The overarching aim of the proposed project is to examine the effects of implementing physical activity (PA) policies in preschools on PA and indicators of health in young children. The proposed project is a unique collaboration between the applicants and Stockholm stad which will result in PA policies, that will be implemented in all 658 public preschools within the Stockholm region, having the possibility to affect more than 38 000 children.
The current study is designed as a cluster randomized controlled trial with 2 conditions (intervention vs. control) and preschools serving as the unit of randomization. Measures of primary and secondary outcomes will be obtained at baseline and at 6-months on an individual level.
This study will provide robust evidence of the effect of structural changes, at the organizational level of preschools, on children's PA and indicators of health. Notably, such robust evidence is urgently warranted as Swedish preschool children's PA levels are low which will have long-lasting effects on their lives. Finally, as the intervention has been developed in co-creation with Stockholm stad it has the possibility to, if proven effective, be implemented rapidly within preschools.
Type d'étude
Interventionnel
Inscription (Anticipé)
4000
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Stockholm, Suède, 10431
- Karolinska Institutet
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
3 ans à 5 ans (Enfant)
Accepte les volontaires sains
Oui
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
On preschool level:
- Located in Stockholm county
- Public preschool
- At least 60 children enrolled in preschool
- Chief of the preschool accepted the invitation for participation
On individual level-preschool children
- Enrolled in participating preschool
- 3-5 years old at the time of study start
- Parents signed informed consent
- Can participate in regular physical activity
On individual level-preschool teachers
- Full-time employee at the participating preschool
- Teachers responsible for participating children
Exclusion Criteria:
On preschool level:
- Located outside Stockholm county
- Private preschool
- Less than 60 children enrolled in preschool
- Chief of the preschool not willing to participate
On individual level-preschool children
- Not enrolled in participating preschool
- Outside 3-5 years old age range at study start
- Parents declined informed consent
- Cannot participate in regular physical activity due to mobility disability etc.
On individual level-preschool teachers
- Not full-time employee at the participating preschool
- Not responsible for any participating children
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Policy
The policy will be implemented on preschool level.
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The intervention will include: i. Formalized physical activity policies implemented in preschools including the following:
ii. A study website with an activity bank also serving as a platform for inter-professional education that preschool teachers can share and communicate about engaging activities and experience iii. Weekly follow-up and feedback by web-based questionnaires |
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Aucune intervention: Regular practice
The control preschool will continue their regular practice.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in physical activity levels of children
Délai: Change from baseline 6 months follow-up in physical activity levels (daily minutes in moderate to vigorous physical activity)
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Physical activity levels in terms of daily minutes in moderate to vigorous physical activity, total physical activity and daily steps measured objectively by Actigraph GT3X+ accelerometers
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Change from baseline 6 months follow-up in physical activity levels (daily minutes in moderate to vigorous physical activity)
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in sedentary time of children
Délai: Change from baseline to 6 months follow-up in daily minutes in sedentary time
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Daily sedentary time in minutes assessed by the Actigraph GT3X+
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Change from baseline to 6 months follow-up in daily minutes in sedentary time
|
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Change in musculoskeletal fitness of children
Délai: Change from baseline to 6 months follow-up in musculoskeletal fitness (handgrip strength)
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Musculoskeletal fitness, in terms of handgrip strength ,will be measured by an analogue dynamometer (TKK 5825, Grip-A, Takei, Tokyo, Japan).
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Change from baseline to 6 months follow-up in musculoskeletal fitness (handgrip strength)
|
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Change in anthropometry (weight in kg) of children
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Weight will be measured by validated scales (calibrated scale: VB2-200-EC, Vetek AB, Väddö, Sweden)
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Change from baseline to 6 months follow-up in anthropometry
|
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Change in anthropometry (height in cm) of children
Délai: Change from baseline to 6 months follow-up in anthropometry
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Height will be measured by validated scales (portable stadiometer: Seca 213, Seca, Chino, CA, USA)
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Change from baseline to 6 months follow-up in anthropometry
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Change in anthropometry (waist circumference in cm) of children
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Waist circumference will be measured at the level of the navel directly on the skin
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Change from baseline to 6 months follow-up in anthropometry
|
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Change in anthropometry (BMI) of children
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Weight and height will be combined to report BMI in kg/m^2
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Change from baseline to 6 months follow-up in anthropometry
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Change in psychosocial functioning of children
Délai: Change from baseline to 6 months follow-up in psychosocial functioning
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Psychosocial functioning of children will be assessed by a parental proxy report of the Strength and Difficulty Questionnaire.
Total difficulties score is generated by summing scores from all the scales except the prosocial scale and ranges from 0 to 40, higher score means worse outcome.
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Change from baseline to 6 months follow-up in psychosocial functioning
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Change in sleep of children
Délai: Change from baseline to 6 months follow-up in sleep
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Sleep will be measured objectively by the GT3X+ accelerometer combined with a sleep time diary documented by parents during the days when the child is wearing the accelerometer.
In addition, parents will answer questions about children's sleep duration and quality in the last 6 months in the sleep questionnaire.
These sleep questions are adapted from the validated Ages and Stages Questionnaire.
The sleep quality score ranges from 0-12 and higher score means better outcome.
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Change from baseline to 6 months follow-up in sleep
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Sick leave duration of children
Délai: From 12 months prior the intervention starts and during the 6 months intervention period
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Sick leave duration in terms of total days of leave will be collected from the Stockholm City smartphone application "Anmäl frånvaro".
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From 12 months prior the intervention starts and during the 6 months intervention period
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Sick leave frequency of children
Délai: From 12 months prior the intervention starts and during the 6 months intervention period
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Sick leave frequency in terms of total occasions of leave will be collected from the Stockholm City smartphone application "Anmäl frånvaro".
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From 12 months prior the intervention starts and during the 6 months intervention period
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Change in compliance with the World Health Organization (WHO) guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age
Délai: Change from baseline to 6 months follow-up in compliance with The WHO guidelines.
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World Health Organization (WHO) has published guidelines recommending more than 180 minutes of total physical activity with at least 60 minutes of moderate to vigorous physical activity, less than one hour of screen time and 10-13 hours of sleep across 24 hours
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Change from baseline to 6 months follow-up in compliance with The WHO guidelines.
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Change in physical activity levels of teachers
Délai: Change from baseline to 6 months follow-up in physical activity levels
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Physical activity levels in terms of daily minutes in moderate to vigorous physical activity measured by Actigraph GT3X+
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Change from baseline to 6 months follow-up in physical activity levels
|
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Change in steps of teachers
Délai: Change from baseline to 6 months follow-up in steps
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Steps measured by Actigraph GT3X+
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Change from baseline to 6 months follow-up in steps
|
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Change in sedentary time of teachers
Délai: Change from baseline to 6 months follow-up in daily minutes in sedentary time
|
Daily sedentary time in minutes assessed by the Actigraph GT3X+
|
Change from baseline to 6 months follow-up in daily minutes in sedentary time
|
|
Change in musculoskeletal fitness of teachers
Délai: Change from baseline to 6 months follow-up in musculoskeletal fitness (handgrip strength)
|
Musculoskeletal fitness, in terms of handgrip strength ,will be measured by an analogue dynamometer (TKK 5825, Grip-A, Takei, Tokyo, Japan).
|
Change from baseline to 6 months follow-up in musculoskeletal fitness (handgrip strength)
|
|
Change in anthropometry (weight in kg) of teachers
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Weight validated scales (calibrated scale: VB2-200-EC, Vetek AB, Väddö, Sweden)
|
Change from baseline to 6 months follow-up in anthropometry
|
|
Change in anthropometry (height in cm) of teachers
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Height will be measured by validated scales (portable stadiometer: Seca 213, Seca, Chino, CA, USA)
|
Change from baseline to 6 months follow-up in anthropometry
|
|
Change in anthropometry (waist circumference in cm) of teachers
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Waist circumference will be measured at the level of the navel directly on the skin
|
Change from baseline to 6 months follow-up in anthropometry
|
|
Change in anthropometry (BMI) of teachers
Délai: Change from baseline to 6 months follow-up in anthropometry
|
Weight and height will be combined to report BMI in kg/m^2
|
Change from baseline to 6 months follow-up in anthropometry
|
|
Sick leave duration of teachers
Délai: From 12 months prior the intervention starts and during the 6 months intervention period
|
Sick leave duration in terms of total days of leave will be collected from the Stockholm City smartphone application "Anmäl frånvaro".
|
From 12 months prior the intervention starts and during the 6 months intervention period
|
|
Sick leave frequency of teachers
Délai: From 12 months prior the intervention starts and during the 6 months intervention period
|
Sick leave frequency in terms of total occasions of leave will be collected from the Stockholm City smartphone application "Anmäl frånvaro".
|
From 12 months prior the intervention starts and during the 6 months intervention period
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in preschool policy and environmental characteristics (process outcome)
Délai: Change from baseline preschool policy and environmental characteristics at 3 months and at 6 months
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Preschool environmental characteristic such as available paly equipment, playground characteristic, policy, working practices will be assessed by validated Environment and Policy Evaluation and Observation as a Self-Report Instrument (EPAO-SR).
The preschool playground characteristics and size will be double checked using google maps.
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Change from baseline preschool policy and environmental characteristics at 3 months and at 6 months
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Implementation of the policy package (process outcome)
Délai: Measured weekly throughout 6 months only in intervention preschools
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Fidelity and dose of the implementation of the policy package will be documented through weekly feedback questionnaires throughout the intervention.
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Measured weekly throughout 6 months only in intervention preschools
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Normalization of the policy package into preschool teachers' regular practice (process outcome)
Délai: Measured at 6 months only in intervention preschools
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The extent to which the intervention can be normalized into preschool staff's regular practice will be assessed through No-MAD: Implementation measure based on Normalization Process Theory.
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Measured at 6 months only in intervention preschools
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Change in children's physical activity opportunities outside preschool time (process outcome)
Délai: Change from baseline to 6 months follow-up in children's physical activity opportunities outside preschool time
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Children's PA opportunities in terms of active transport and participation in organized sports will be assessed via a questionnaire (daily during the period that children are wearing the accelerometers) where parents answer time, duration and type of organized sports and mode of transportation to and from preschool.
In addition, several parental practices (outdoor time during the weekend, parental perception of physical activity, parental physical activity, and active play with parents) which could potentially influence children daily physical activity levels will also be assessed by questionnaire.
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Change from baseline to 6 months follow-up in children's physical activity opportunities outside preschool time
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Project evaluation from parents
Délai: Measured at 6 months (questionnaires and interviews)
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How parents perceive and evaluate the intervention measured through questionnaire and interview.
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Measured at 6 months (questionnaires and interviews)
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Project evaluation from preschool teachers
Délai: Measured at 6 months ((questionnaires and interviews)
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How preschool teachers perceive and evaluate the intervention measured through questionnaire and interview.
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Measured at 6 months ((questionnaires and interviews)
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Daniel Berglind, Associate Professor, Karolinska Institutet
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Liens utiles
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
23 septembre 2020
Achèvement primaire (Réel)
2 juillet 2021
Achèvement de l'étude (Anticipé)
31 décembre 2021
Dates d'inscription aux études
Première soumission
16 septembre 2020
Première soumission répondant aux critères de contrôle qualité
23 septembre 2020
Première publication (Réel)
30 septembre 2020
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
1 septembre 2021
Dernière mise à jour soumise répondant aux critères de contrôle qualité
31 août 2021
Dernière vérification
1 août 2021
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- CAP2020
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
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Étudie un produit d'appareil réglementé par la FDA américaine
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