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

Not Applicable

Completed

• Conditions: Social Skills; Physical Inactivity; Behavior, Child
• Interventions: Behavioral: PlayOn! playground curriculum

• Registration Number: NCT05470621
• Lead Sponsor: Arizona State University

Brief 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.

Detailed 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.

Study Timeline

• Study First Submitted: 2022-07-18
• Study First Submitted QC: 2022-07-20
• Study First Posted: 2022-07-22
• Study Start: 2022-08-22
• Primary Completion: 2023-12-30
• Study Completion: 2023-12-30
• Status Verified: 2024-02
• Last Update Submitted: 2024-02-01
• Last Update Posted: 2024-02-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 294

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Playground Curriculum Arm	PlayOn! playground curriculum	Staff (after-school staff, recess aides, and physical education teachers) receive training to implement a playground curriculum in an after-school program; children receive a training to use the curriculum during recess

Primary Outcome Measures

Name	Time	Method
Mean change in student-reported personal (self-efficacy) health from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 12 months)	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Metacognitive Process in Physical Education Questionnaire.
Change in number of school-reported behavioral incidents from baseline to 6 months	Baseline (month 0) and Post-intervention (approximately 6 months)	School-reported number of children referred to administrators for behavioral incidents
Mean change in student-reported personal (emotional) health from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 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).
Mean change in accelerometer-derived physical activity from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 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.
Mean change in student-reported personal (emotional) health from baseline to 6 months	Baseline (month 0) and Post-intervention (approximately 6 months)	Child-reported personal health (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Discrete Emotions in Physical Education Scale (DEPES).
Mean change in student-reported personal (social) health from baseline to 6 months	Baseline (month 0) and Post-intervention (approximately 6 months)	Child-reported personal health (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Saunders psychosocial influences on physical activity scale.
Mean change in student-reported personal (social) health from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 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.
Mean change in student-reported environmental health from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 12 months)	Child-reported environmental health (peer relationships) will be collected through questionnaire with the ECLS-K peer relationship scale.
Mean change in accelerometer-derived physical activity from baseline to six months	Baseline (month 0) and Post-intervention (approximately 6 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.
Mean change in student-reported personal (self-efficacy) health from baseline to 6 months	Baseline (month 0) and Post-intervention (approximately 6 months)	Child-reported personal health (enjoyment, knowledge, and self-efficacy) will be collected through questionnaire with Metacognitive Process in Physical Education Questionnaire.
Mean change in student-reported environmental health from baseline to 6 months	Baseline (month 0) and Post-intervention (approximately 6 months)	Child-reported environmental health (peer relationships) will be collected through questionnaire with the ECLS-K peer relationship scale.
Mean change in student-reported personal (self-efficacy) health from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 18 months)	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) collected through questionnaire with Metacognitive Process in Physical Education Questionnaire.
Mean change in accelerometer-derived physical activity from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 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.
Mean change in student-reported behavioral health from baseline to 6 months	Baseline (month 0) and Post-intervention (approximately 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.
Mean change in student-reported personal (emotional) health from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 18 months)	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) collected through questionnaire with Discrete Emotions in Physical Education Scale (DEPES).
Mean change in student-reported behavioral health from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 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.
Change in number of school-reported behavioral incidents from baseline to 12 months	Baseline (month 0) and Post-intervention (approximately 12 months)	School-reported number of children referred to administrators for behavioral incidents
Mean change in student-reported personal (social) health from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 18 months)	Child-reported personal health indicators (enjoyment, knowledge, and self-efficacy) collected through questionnaire with Saunders psychosocial influences on physical activity scale.
Mean change in student-reported environmental health from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 18 months)	Child-reported environmental health (peer relationships) will be collected through questionnaire with the ECLS-K peer relationship scale.
Change in number of school-reported behavioral incidents from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 18 months)	School-reported number of children referred to administrators for behavioral incidents
Mean change in student-reported behavioral health from baseline to 18 months	Baseline (month 0) and Post-intervention (approximately 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.

Secondary Outcome Measures

Name	Time	Method
Mean observed implementation sustainability	Post-intervention (approximately 18 months)	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.
Mean perceived implementation feasibility	Post-intervention (approximately 6 months)	Staff-reported appropriateness and feasibility of intervention collected through questionnaire with Feasibility of Intervention Measure (FIM).
Mean perceived implementation appropriateness	Post-intervention (approximately 6 months)	Staff-reported appropriateness and feasibility of intervention collected through questionnaire with Intervention Appropriateness Measure (IAM).
Mean observed implementation fidelity	Monthly post-intervention through end of school year	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.

Trial Locations

Locations (1)

Mesa Public Schools; 🇺🇸 Mesa, Arizona, United States