A peer coach intervention in childcare centres enhances early childhood physical activity: The Active Early Learning (AEL) cluster randomised controlled trial

BACKGROUND: As numbers of children and time spent in childcare centres increase, so does the potential influence of these centres on early childhood physical activity (PA). However, previous reports indicate little success of interventions aimed at improving PA. The Active Early Learning (AEL) program is a multi-component pragmatic intervention designed to imbed PA into the daily curriculum. Delivered by childcare centre staff, it is directed and supported by a peer coach who works across a network of centres. The objective of the study is to investigate the effect of the AEL program on children’s PA. METHODS: Fifteen childcare centres (8 intervention, 7 control centres; 314 children, 180 boys, 4.3y ± 0.4) participated in a 22-week stratified cluster randomised controlled trial. To be eligible to participate, centres needed to have ≥15 preschool children aged 3 to 5-years. The primary outcome was PA measured by accelerometer (Actigraph GT3X) during childcare centre hours over a 3-day period, calculated in min/h of Total PA and moderate-to-vigorous PA (MVPA). The effect of the intervention was evaluated using linear mixed models adjusted for age, sex, accelerometer wear time and centre clustering. RESULTS: There was an intervention effect for Total PA (+ 4.06 min/h, 95% CI [2.66 to 5.47], p < .001) and MVPA (+ 2.33 min/h, 95% CI [1.31 to 3.34] p < .001). On average, a child taking part in the intervention attending a childcare centre from 8 am to 3 pm performed 28 min more Total PA and 16 min more MVPA per day than children receiving usual practice care. CONCLUSION: In contrast with the findings of previous pragmatic trials in early childcare centres, this study shows that a peer-coach facilitated program, focussed on integrating PA into the daily childcare routine, can elicit increases in preschool children’s PA of practical as well as statistical significance. TRIAL REGISTRATION: Australian New Zealand Clinical Trials registry: ACTRN12619000638134. Registered 30/04/2019.