Increasing Children's Physical Activity by Policy (CAP)
2021年8月31日 更新者：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.
研究概览
详细说明
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.
研究类型
介入性
注册 (预期的)
4000
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
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Stockholm、瑞典、10431
- Karolinska Institutet
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
3年 至 5年 (孩子)
接受健康志愿者
是的
有资格学习的性别
全部
描述
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
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：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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无干预：Regular practice
The control preschool will continue their regular practice.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change in physical activity levels of children
大体时间：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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change in sedentary time of children
大体时间：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
大体时间：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)
|
|
Change in anthropometry (weight in kg) of children
大体时间：Change from baseline to 6 months follow-up in anthropometry
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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
大体时间：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
大体时间：Change from baseline to 6 months follow-up in anthropometry
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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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change in preschool policy and environmental characteristics (process outcome)
大体时间：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)
大体时间：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)
大体时间：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)
大体时间：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
大体时间：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
大体时间：Measured at 6 months ((questionnaires and interviews)
|
How preschool teachers perceive and evaluate the intervention measured through questionnaire and interview.
|
Measured at 6 months ((questionnaires and interviews)
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Daniel Berglind, Associate Professor、Karolinska Institutet
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
有用的网址
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2020年9月23日
初级完成 (实际的)
2021年7月2日
研究完成 (预期的)
2021年12月31日
研究注册日期
首次提交
2020年9月16日
首先提交符合 QC 标准的
2020年9月23日
首次发布 (实际的)
2020年9月30日
研究记录更新
最后更新发布 (实际的)
2021年9月1日
上次提交的符合 QC 标准的更新
2021年8月31日
最后验证
2021年8月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.