A Playground Training to Improve Children's Health After-school and During Recess: The PLAYground Project

Physical Inactivity Clinical Trial

Official title:

A Cluster Randomized Controlled Trial of an After-school Playground Intervention to Improve Children's Physical, Social, and Emotional Health: The PLAYground Project

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05470621
• Other study ID #: STUDY00015985
• Status: Completed
• Phase: N/A
• Start date: August 22, 2022
• Est. completion date: December 30, 2023

Study information

• Verified date: February 2024
• Source: Arizona State University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Schools are critical settings to foster children's health. The purpose of this two-year cluster-randomized trial is to enhance both the after-school and recess settings to provide children with knowledge and skills to facilitate active and inclusive play. The primary aim of the project is to assess the impact of a playground curriculum intervention on children's physical, social, emotional, and behavioral health. The secondary aim of the project to understand the appropriateness, feasibility, fidelity, and sustainability of implementing a playground curriculum in after-school and recess settings.

Description:

Physical, social, and emotional health are critical for children and predict good health later in life. Schools are essential settings to foster children's health as they provide access to the majority of children during crucial stages of development. In particular, recess and before/after school programming are critical sources of children's health and well-being, and core components of a whole school approach to health and wellness. The purpose of this two-year cluster-randomized trial is to enhance the quality of these existing settings through the integration of a playground curriculum designed to promote active and inclusive play.

Based on Social Cognitive Theory aligned with the Theory of Expanded, Extended, and Enhanced Opportunities, it is hypothesized that active and inclusive play through a playground curriculum intervention will improve enjoyment, knowledge, and self-efficacy (personal conditions), social and emotional learning (behavioral conditions), and the development of peer relationships (environmental conditions) among children, leading to increased physical activity and reduced behavioral incidents. The implementation (appropriateness, feasibility, fidelity, and sustainability) of the playground curriculum intervention to improve children's health will be assessed as a secondary outcome.

Participants will be recruited from elementary schools in Mesa Public Schools (Arizona) that offer after-school programming (N=14). The intervention includes the delivery of a curriculum aimed at providing students with knowledge and skills to initiate activities using playground structures. Trainings will be delivered to staff (after-school staff, recess aides, and Physical Education teachers) and students in the after-school setting. Students attending the after-school program will become Play Leaders to transfer the knowledge and skills they learn from PlayOn! to the recess setting.

The impact of the playground curriculum intervention on children's physical, social, emotional, and behavioral health after school and during recess will be measured using surveys, observations, interviews, physical activity devices, and de-identified school behavioral information. Data will be collected at all 14 school sites each fall and spring semester. In year one, seven schools will receive the intervention. Schools will be stratified to either the intervention or control group by Title 1 status - an indicator of school-level income. In year two, the seven control schools will receive the intervention to allow all schools the opportunity to benefit from the project.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 294
• Est. completion date: December 30, 2023
• Est. primary completion date: December 30, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 7 Years to 13 Years

Eligibility

Inclusion Criteria:

• Students enrolled an after-school program in Mesa Public Schools

Exclusion Criteria:

• Students in grades kindergarten or first grade will be excluded due to their young age.

Related Conditions & MeSH terms

• Behavior, Child
• Physical Inactivity
• Social Skills

Intervention

Behavioral:
• PlayOn! playground curriculum
A staff and student training to implement a playground curriculum in after-school and recess settings

Locations

Country	Name	City	State
United States	Mesa Public Schools	Mesa	Arizona

Sponsors (1)

Lead Sponsor	Collaborator
Arizona State University

Country where clinical trial is conducted

United States, 

References & Publications (3)

Jackson SL, Cunningham SA. Social Competence and Obesity in Elementary School. Am J Public Health. 2015 Jan;105(1):153-158. doi: 10.2105/AJPH.2014.302208. — View Citation

Saunders RP, Pate RR, Felton G, Dowda M, Weinrich MC, Ward DS, Parsons MA, Baranowski T. Development of questionnaires to measure psychosocial influences on children's physical activity. Prev Med. 1997 Mar-Apr;26(2):241-7. doi: 10.1006/pmed.1996.0134. — View Citation

Simonton KL, Garn AC, Mercier KJ. Expanding the Discrete Emotions in Physical Education Scale (DEPES): Evaluating Emotions With Behavior and Learning. Res Q Exerc Sport. 2023 Mar;94(1):35-44. doi: 10.1080/02701367.2021.1935434. Epub 2021 Dec 14. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Mean change in accelerometer-derived physical activity from baseline to six months	Accelerometer counts of sedentary, light-, and moderate-to-vigorous physical activity levels will be segmented and processed separately to determine physical activity during recess, during school, during after-school programming, out of school, and on weekends.	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Mean change in accelerometer-derived physical activity from baseline to 12 months	Accelerometer counts of sedentary, light-, and moderate-to-vigorous physical activity levels will be segmented and processed separately to determine physical activity during recess, during school, during after-school programming, out of school, and on weekends.	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Mean change in accelerometer-derived physical activity from baseline to 18 months	Accelerometer counts of sedentary, light-, and moderate-to-vigorous physical activity levels will be segmented and processed separately to determine physical activity during recess, during school, during after-school programming, out of school, and on weekends.	Baseline (month 0) and Post-intervention (approximately 18 months)
Primary	Mean change in student-reported personal (emotional) health from baseline to 6 months	Child-reported personal health (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Discrete Emotions in Physical Education Scale (DEPES).	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Mean change in student-reported personal (self-efficacy) health from baseline to 6 months	Child-reported personal health (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Metacognitive Process in Physical Education Questionnaire.	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Mean change in student-reported personal (social) health from baseline to 6 months	Child-reported personal health (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Saunders psychosocial influences on physical activity scale.	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Mean change in student-reported environmental health from baseline to 6 months	Child-reported environmental health (peer relationships) will be collected through questionnaire with the ECLS-K peer relationship scale.	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Mean change in student-reported behavioral health from baseline to 6 months	Child-reported behavioral health (social and emotional learning) will be collected through questionnaire with the Social and Emotional Learning module of the California Healthy Kids Survey.	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Mean change in student-reported personal (emotional) health from baseline to 12 months	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Discrete Emotions in Physical Education Scale (DEPES).	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Mean change in student-reported personal (self-efficacy) health from baseline to 12 months	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Metacognitive Process in Physical Education Questionnaire.	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Mean change in student-reported personal (social) health from baseline to 12 months	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Saunders psychosocial influences on physical activity scale.	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Mean change in student-reported environmental health from baseline to 12 months	Child-reported environmental health (peer relationships) will be collected through questionnaire with the ECLS-K peer relationship scale.	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Mean change in student-reported behavioral health from baseline to 12 months	Child-reported behavioral health (social and emotional learning) will be collected through questionnaire with the Social and Emotional Learning module of the California Healthy Kids Survey.	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Mean change in student-reported personal (emotional) health from baseline to 18 months	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) collected through questionnaire with Discrete Emotions in Physical Education Scale (DEPES).	Baseline (month 0) and Post-intervention (approximately 18 months)
Primary	Mean change in student-reported personal (self-efficacy) health from baseline to 18 months	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) collected through questionnaire with Metacognitive Process in Physical Education Questionnaire.	Baseline (month 0) and Post-intervention (approximately 18 months)
Primary	Mean change in student-reported personal (social) health from baseline to 18 months	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) collected through questionnaire with Saunders psychosocial influences on physical activity scale.	Baseline (month 0) and Post-intervention (approximately 18 months)
Primary	Mean change in student-reported environmental health from baseline to 18 months	Child-reported environmental health (peer relationships) will be collected through questionnaire with the ECLS-K peer relationship scale.	Baseline (month 0) and Post-intervention (approximately 18 months)
Primary	Mean change in student-reported behavioral health from baseline to 18 months	Child-reported behavioral health (social and emotional learning) will be collected through questionnaire with the Social and Emotional Learning module of the California Healthy Kids Survey.	Baseline (month 0) and Post-intervention (approximately 18 months)
Primary	Change in number of school-reported behavioral incidents from baseline to 6 months	School-reported number of children referred to administrators for behavioral incidents	Baseline (month 0) and Post-intervention (approximately 6 months)
Primary	Change in number of school-reported behavioral incidents from baseline to 12 months	School-reported number of children referred to administrators for behavioral incidents	Baseline (month 0) and Post-intervention (approximately 12 months)
Primary	Change in number of school-reported behavioral incidents from baseline to 18 months	School-reported number of children referred to administrators for behavioral incidents	Baseline (month 0) and Post-intervention (approximately 18 months)
Secondary	Mean perceived implementation appropriateness	Staff-reported appropriateness and feasibility of intervention collected through questionnaire with Intervention Appropriateness Measure (IAM).	Post-intervention (approximately 6 months)
Secondary	Mean perceived implementation feasibility	Staff-reported appropriateness and feasibility of intervention collected through questionnaire with Feasibility of Intervention Measure (FIM).	Post-intervention (approximately 6 months)
Secondary	Mean observed implementation fidelity	Researcher-reported fidelity of intervention (adherence, exposure/dose, quality of delivery, component differentiation, and participant involvement) collected using researcher-developed protocol for monthly systematic observations.	Monthly post-intervention through end of school year
Secondary	Mean observed implementation sustainability	Researcher-reported fidelity of intervention (adherence, exposure/dose, quality of delivery, component differentiation, and participant involvement) collected using researcher-developed protocol for monthly systematic observations.	Post-intervention (approximately 12 months)
Secondary	Mean observed implementation sustainability	Researcher-reported fidelity of intervention (adherence, exposure/dose, quality of delivery, component differentiation, and participant involvement) collected using researcher-developed protocol for monthly systematic observations.	Post-intervention (approximately 18 months)

External Links

•   WestEd, California Department of Education. Using CALSCHLS to assess social-emotional learning and health [Internet]. San Francisco, CA: WestEd; 2015.