Associations among Motor Competence, Physical Activity, Perceived Motor Competence, and Aerobic Fitness in 10-15-Year-Old Youth.

(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents' health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence (MC), moderate-to-vigorous physical activity (MVPA), perceived motor competence (PMC), and aerobic fitness in children and adolescents and the mediating and moderating effects of PMC, aerobic fitness, and weight status on the MC-MVPA relationship. (2) Methods: Participants included 47 adolescents (12.2 ± 1.6 y; 55% male) who completed the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (MC), Harter's perceived self-competency questionnaire (PMC), and the PACER test (aerobic fitness) and whose MVPA was measured via accelerometry. The body mass index (BMI) was calculated from measured height and weight. (3) Results: There were positive correlations between MC and fitness [rs(47) = 0.469, p < 0.01], PMC and fitness [rs(47) = 0.682, p < 0.01], and PMC and MC [rs(47) = 0.416, p < 0.01]. There were no associations among MVPA and MC, PMC, or fitness (p > 0.05). There were inverse associations between BMI and both MVPA [rs(44) = -0.410, p < 0.01] and fitness [rs(47) = 0.295, p < 0.05]. The association between MC and MVPA was mediated by fitness (ß = 0.3984; 95% CI (0.0564-0.7985)). (4) Conclusions: The associations among MC, PMC, and fitness highlight the critical role of MC in health and partially support the proposed developmental model concerning the relationships that exist among MC, MVPA, PMC, fitness, and BMI.

The fundamental motor skill proficiency among Polish primary school-aged children: A nationally representative surveillance study.

OBJECTIVES: With the premise that physical education classes should promote physical activity by teaching and learning fundamental motor skills, this study aimed to evaluate the fundamental motor skill proficiency of primary school students and determine the level of achievement of established learning outcomes for fundamental motor skills, as specified in the Polish National Physical Education Curriculum. DESIGN AND METHODS: A cross-sectional design was used for this study. The sample consisted of 2605 children and adolescents enrolled in grades 1-3 (ages 7-9, n = 1165), 4-6 (ages 10-12, n = 837), and 7-8 (ages 13-14, n = 603), including 1353 boys and 1252 girls. The Fundamental Motor Skills in Sport test, a qualitative and process-oriented assessment tool, was used to evaluate fundamental motor skills. The Fundamental Motor Skills in Sport test evaluates the following movement skills: hurdles, jumping rope, forward roll, ball bouncing, ball throwing and catching, and kicking and stopping a ball. RESULTS: The desired level of overall fundamental motor skill proficiency was achieved by only 2 % of students. An elementary level of fundamental motor skill proficiency was demonstrated by an additional 3.5 % of students. Further, the results showed that only 10-30 % of students had achieved mastery or were close to achieving mastery in a given fundamental motor skill. The skill with the lowest level of proficiency was jumping rope, which only 11 % of students had mastered or were near to mastering. CONCLUSIONS: The present study of a large, nationally representative sample of primary school students in Poland indicates that the vast majority (approximately 94 %) of them demonstrated insufficient fundamental motor skill proficiency. This may greatly hinder effective, safe, and healthy participation in lifelong physical activity.

Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries.

BACKGROUND AND OBJECTIVE: One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries. METHODS: Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country. RESULTS: Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards. CONCLUSIONS: Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood.

The fus test: a promising tool for evaluating fundamental motor skills in children and adolescents.

Fundamental motor skills (FMS) are essential for enjoyable, confident and skillful participation in physical activity across the lifespan. Due to the alarming low level of FMS proficiency in children and adolescents worldwide, the development of motor competency is an urgent issue for physical education. The promotion and implementation of a systematic process of teaching and learning FMS should be a physical education priority. Accordingly, effective assessment tools for evaluating FMS should be adopted or developed. Because FMS assessment for both children and adolescents need further effective solutions, the primary aim of this study was to develop the new age-related test of FMS (Fundamental Motor Skills in Sport test, in Polish: Test Fundamentalnych Umiejetnosci Ruchowych w Sporcie, FUS). The secondary aim of this study was to establish validity and inter-rater, intra-rater, test-retest reliabilities and internal consistency of the FUS test. The FUS test involves six sport skill-based tasks: hurdling, jumping rope, forward roll, ball bouncing, throwing and catching a ball, and kicking and stopping a ball. Two hundred sixty-four Polish students in grades 1-3 (7-9 yrs; n = 81), 4-6 (10-12 yrs; n = 89) and 7-8 (13-14 yrs; n = 94), including 139 girls and 125 boys completed the FUS test. The content validity index for all items was notably high. Both inter-rater and intra-rater reliability showed substantial to almost perfect agreement, with observed agreements for FUS skills between 78.5 and 93.1%. Ball bouncing had a moderate correlation with the forward roll and throwing and catching, while other correlations were low or insignificant. ICC values, ranging from 0.95 to 0.97, confirmed excellent test-retest reliability. The results of our study provide evidence that the FUS test is valid, reliable, and feasible to administer in school settings. Therefore, this tool test has the potential to support deliberate practice and improve motor competence by providing a standardized and structured approach to measuring FMS among school-aged children and adolescents.

Painted playgrounds for preschoolers' physical activity and fundamental motor skill improvement: a randomized controlled pilot trial of effectiveness.

BACKGROUND: Preschool children are not meeting recommended levels of physical activity (PA) nor are they proficient in fundamental motor skills (FMS), which are the foundation for PA. As such, interventions are needed to increase PA and FMS in young children. This trial examined the effects of an environmental ("painted playgrounds") and capacity-building (written toolkit) intervention on child FMS, PA, and sedentary behavior at early childhood education (ECE) centers and examined feasibility. METHODS: In a randomized controlled trial, four ECE centers were randomly assigned to an intervention group or wait-list control. For intervention centers, stencils were spray painted adjacent to playgrounds and teachers were provided material for using stencils for FMS practice. Follow-up assessments were conducted six to eight weeks after baseline. Time spent in PA and sedentary behavior was assessed via accelerometry and FMS were evaluated using the Test of Gross Motor Development (TGMD-3) at baseline and follow-up. A repeated measures linear model was performed to test the effects of the painted playgrounds on the primary outcomes of interest. Feasibility was measured by stencil engagement via direct observation and satisfaction surveys. RESULTS: A total of 51 preschoolers completed baseline assessments (4.3±0.6 years; 43.1% male). There were no significant changes in PA or sedentary behavior (all confidence intervals contain 0) between control and intervention groups. Intervention children significantly improved ball skill, locomotor, and overall TGMD-3 percentile scores at follow-up (all (all confidence intervals contain 0), which was not observed in control group. However, there was no significant change in FMS between the control and intervention groups (confidence intervals contain 0). For stencil use, boys and girls interacted with different stencils during their free play. Directors and teachers reported children incorporated academic concepts and initiated games, and teachers prompted more PA opportunities on the playground. CONCLUSIONS: This intervention did not show statistically significant changes in children's PA, FMS, or sedentary behavior compared to a control group; however, small FMS improvements for the intervention group were found from baseline to follow-up. Further work should examine intervention fidelity as well as inexpensive supplies, teacher training, or other strategies to increase preschool children's PA and improve FMS at ECE centers.

Validation of remote assessment of preschool children's anthropometrics and motor skills.

Introduction: Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and motor skill proficiency measurements collected in a remote-setting to in-person setting among a sample of children ages 3-4 years. Methods: Child anthropometry and motor skill performance were measured in-person by trained assessors and by parents at home with remote supervision via videoconference by trained assessors. The following measures from the National Institutes of Health Toolbox were collected: anthropometry (height and weight), manual dexterity/manipulation (9-hole pegboard), motor coordination and agility (supine timed up and go), lower body strength (standing long jump), and postural stability (one-leg standing balance). Differences in expert and parent-based measurements were assessed using Bland-Altman plots, paired samples t-tests, and Pearson correlations. Results: A total of n = 14 children completed the assessments. No significant differences were observed between measurement locations for weight and motor skills (p > .05). Remote measurement of height (M = 101.1 cm, SD = 5.40) was significantly greater than in-person measurements (M = 98.2 cm, SD = 5.16); p < .0001. Discussion: Remote measurements of motor skills and weight are valid assessments for researchers and clinicians to utilize in young children. Remote assessment with guidance offers comparable and valid estimates as in-person assessment, potentially offering a solution to resource-constricted barriers in research and access to care. There is an opportunity for researchers to fine-tune remote height and individual-level assessment strategies.

Associations of fundamental motor skill competence, isometric plank, and modified pull-ups in 5-year old children: An observational analysis of 2012 NHANES NYFS.

There are purported relationships between fundamental motor skills (FMS), health-related physical fitness, physical activity, and obesity among children. The purpose of this observational, secondary data analysis was to further examine these associations in children from the 2012 National Youth Fitness Survey (NYFS). 121 five-year old children (51% female) from the NYFS database completed the Test of Gross Motor Development, 2nd edition (TGMD-2), muscular fitness measures of plank and modified pull-ups, and weight status based on body mass index (BMI) percentile. Significant positive correlations were identified between TGMD-2 scores and both pull-ups and plank. Linear regression models, controlling for sex, weight status, and Hispanic ethnicity also identified both modified pull-ups completed and plank time as significant predictors of TGMD-2 total raw score. No demographic factors were significant factors in any of the models. This secondary data analysis identified associations between FMS and health-related physical fitness (i.e., muscular fitness), with both modified pull-ups and plank performance, in five-year old children. Results underscored the importance of different facets of health-related physical fitness contributing significantly to FMS performance and the need for more work related to physical fitness in preschool-age children.

mHealth Intervention for Motor Skills: A Randomized Controlled Trial.

BACKGROUND AND OBJECTIVES: Children's motor skills are a critical foundation for physical activity. The objective was to determine the effectiveness and feasibility of a mobile app-based intervention delivered to parents to improve preschoolers' motor skills. METHODS: This randomized controlled trial randomly assigned children to : (1) Motor Skills, including instructional lessons, peer modeling videos, behavioral scaffolding, and structured activities or 2) Free Play. Both groups received a 12-week app-based intervention informed by social cognitive theory to deliver 12 hours (12-minutes per day, 5× per week) of instruction. The children were aged 3 to 5 y; parents and children had no mobility impairments. The primary outcome variables were children's motor skills percentile score assessed with the Test of Gross Motor Development, third edition (TGMD-3) at baseline, end-of-intervention (week 12), and follow-up (week 24); and feasibility and acceptability. RESULTS: Seventy-two children (4.0 ± 0.8 y) participated. Between baseline and week 12, children in the Motor Skills condition significantly improved total TGMD-3 percentile (+13.7 Motor Skills vs -5.3 Free Play, P < .01), locomotor skills percentile (+15.5 Motor Skills vs -4.8 Free Play, P < .01), and ball skills percentile (+8.3 Motor Skills vs -7.3 Free Play, P < .01) compared with children in the comparator group. Significant differences were sustained at follow-up (week 24). Adherence did not significantly differ between conditions (71% for Motor Skills; 87% for Free Play). Parents in both arms reported high scores on satisfaction, helpfulness, and ease of use. CONCLUSIONS: Clinicians and educators may encourage parents to enhance their child's motor skills through structured at-home programs.

Levels and Correlates of Objectively Measured Sedentary Behavior in Young Children: SUNRISE Study Results from 19 Countries.

PURPOSE: There is a paucity of global data on sedentary behavior during early childhood. The purpose of this study was to examine how device-measured sedentary behavior in young children differed across geographically, economically, and sociodemographically diverse populations, in an international sample. METHODS: This multinational, cross-sectional study included data from 1071 children 3-5 yr old from 19 countries, collected between 2018 and 2020 (pre-COVID). Sedentary behavior was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation, and seated transport duration were calculated. Linear mixed models were used to examine the differences in sedentary behavior variables between sex, country-level income groups, urban/rural settings, and population density. RESULTS: Children spent 56% (7.4 h) of their waking time sedentary. The longest average bout duration was 81.1 ± 45.4 min, and an average of 61.1 ± 50.1 min·d-1 was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, compared with children from low-income and lower-middle-income countries. Sex and urban/rural residential setting were not associated with any outcomes. Higher population density was associated with several higher sedentary behavior measures. CONCLUSIONS: These data advance our understanding of young children's sedentary behavior patterns globally. Country income levels and population density appear to be stronger drivers of the observed differences, than sex or rural/urban residential setting.

Through the Looking Glass: A Systematic Review of Longitudinal Evidence, Providing New Insight for Motor Competence and Health.

INTRODUCTION: In 2008, a conceptual model explaining the role of motor competence (MC) in children's physical activity (PA), weight status, perceived MC and health-related fitness was published. OBJECTIVE: The purpose of the current review was to systematically compile mediation, longitudinal and experimental evidence in support of this conceptual model. METHODS: This systematic review (registered with PROSPERO on 28 April 2020) was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Separate searches were undertaken for each pathway of interest (final search 8 November 2019) using CINAHL Complete, ERIC, Medline (OVID), PsycINFO, Web of Science Core Collection, Scopus and SportDiscus. Potential articles were initially identified through abstract and title checking (N = 585) then screened further and combined into one review (n = 152), with 43 articles identified for extraction. Studies needed to be original and peer reviewed, include typically developing children and adolescents first assessed between 2 and 18 years and objective assessment of gross MC and at least one other variable (i.e., PA, weight status, perceived MC, health-related fitness). PA included sport participation, but sport-specific samples were excluded. Longitudinal or experimental designs and cross-sectional mediated models were sought. Strength of evidence was calculated for each pathway in both directions for each domain (i.e., skill composite, object control and locomotor/coordination/stability) by dividing the proportion of studies indicating a significantly positive pathway in the hypothesised direction by the total associations examined for that pathway. Classifications were no association (0-33%), indeterminate/inconsistent (34-59%), or a positive '+' or negative ' - ' association (≥ 60%). The latter category was classified as strong evidence (i.e., ++or --) when four or more studies found an association. If the total number of studies in a domain of interest was three or fewer, this was considered insufficient evidence to make a determination. RESULTS: There was strong evidence in both directions for a negative association between MC and weight status. There was strong positive evidence for a pathway from MC to fitness and indeterminate evidence for the reverse. There was indeterminate evidence for a pathway from MC to PA and no evidence for the reverse pathway. There was insufficient evidence for the MC to perceived MC pathway. There was strong positive evidence for the fitness-mediated MC/PA pathway in both directions. There was indeterminate evidence for the perceived MC-mediated pathway from PA to MC and no evidence for the reverse. CONCLUSION: Bidirectional longitudinal associations of MC with weight status are consistent with the model authored by Stodden et al. (Quest 2008;60(2):290-306, 2008). However, to test the whole model, the field needs robust longitudinal studies across childhood and adolescence that include all variables in the model, have multiple time points and account for potential confounding factors. Furthermore, experimental studies that examine change in MC relative to change in the other constructs are needed. TRIAL REGISTRATIONS: PROSPERO ID# CRD42020155799.

Fundamental Motor Skill Delays in Preschool Children With Disabilities: 2012 National Youth Fitness Survey.

Delays in fundamental motor skill (FMS) competency have been observed in a variety of children with disabilities. However, evidence of FMS delays is largely limited to small, geographically specific, limitedly diverse, and non-representative samples. The purpose of this study was to examine the association between FMS competency and reported disability status among pre-school children, ages 3-5 years, using the 2012 National Youth Fitness Survey (NYFS). In total, 329 preschool children (49% female; 4.00 ± 0.04 years of age) from the 2012 NYFS completed the Test of Gross Motor Development-2, including 43 preschoolers identified with a disability based on parental report (44% female; 4.20 ± 0.16 years). Associations were examined with logistic regression using sampling weights. Poor FMS competency, defined as gross motor quotient scores ≤ 79, was observed in significantly more children with disabilities (29%) than children without disabilities (10%, OR = 3.5, p = 0.04). While not statistically significant, there was a growing disparity in FMS competency at age 5 (41 vs. 11%) compared to age 3 (15 vs. 9%, OR = 1.80, p = 0.30). The results provide additional evidence for poor FMS competency among pre-school children with disabilities. FMS should be an early part of comprehensive assessments for all children suspected of disability or development delay as it is critical to identify and intervene upon FMS delays before discrepancies can widen.

Associations between body composition and fundamental motor skill competency in children.

BACKGROUND: Evidence supports an inverse relationship between weight status and motor competence, but most work utilizes body mass index as the proxy for weight status. Body mass index fails to account for essential components of body composition, which may be critical for motor performance. The purpose of this investigation was to examine the relationship between fundamental motor skills competency and body composition (i.e., fat mass, fat percentage, and fatfree mass) as measured by bio-electrical impedance analysis and body mass index in children. METHODS: Two hundred forty-four children from the Southeastern portion of the United States participated in this project (6.05 ± 2.01 years, 53.3% male). Fundamental motor skills were measured using the Test of Gross Motor Development - 2nd edition and body composition was assessed with the Tanita SC-331S Body Composition Analyzer (bio-electrical impedance analysis). Body mass index was calculated using CDC normative growth charts. RESULTS: Bio-electrical impedance analysis measures accounted for 23.1%, F(3, 241) = 24.10, p < .001 and 2.7%, F(3, 241) = 2.22, p = .086 variance in locomotor and object control subscales, respectively; body mass index accounted for 8.4% (locomotor) and 0.1% (object control) variance. For the Test of Gross Motor Development -2nd edition total score, bio-electrical impedance analysis measures accounted for 24.4% F(3, 241) = 25.90, p < .001 compared to body mass index which accounted for 7.9% F(1, 244) = 20.86, p < .001 of the variance. Only fat free mass (p < .001) was a significant predictor for locomotor skills and total models for the Test of Gross Motor Development - 2nd edition; BMI was also a significant predictor (p < .001) in both the locomotor and total models. CONCLUSIONS: Different components of body composition (i.e., fat free mass) were associated with different aspects of fundamental motor skills competency. Excess body fat may be a morphological constraint to proficient locomotor performance when transporting the body through space. In contrast, body composition did not significantly predict object manipulation performance. More work is needed to understand the causality and directionality of this relationship; however, bio-electrical impedance analysis accounts for more variance in fundamental motor skills performance than body mass index in a field-based setting.

Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries.

BACKGROUND: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children's daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children's movement behaviours before and during the COVID-19 pandemic. METHODS: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined. RESULTS: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9). CONCLUSION: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents' mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

Bifactor structure and model reliability of the Test of Gross Motor Development - 3rd edition.

OBJECTIVES: This study investigated the structure of the Test of Gross Motor Development - 3rd edition (TGMD-3). Specifically, we examine bifactor structure, which simultaneously models a fundamental motor skills (FMS) general factor and specific factors for locomotor skills and ball skills, compared to other models. DESIGN: Cross-sectional design using the TGMD-3 normative sample. METHODS: The sample (N = 862) of children (Mage = 6.51, SD = 2.23) was matched based on United States census data, ensuring appropriate percentages of demographic representation and disability status. Confirmatory factor analyses, exploratory structural equation modeling, model-based reliability estimates including coefficient omega hierarchical, and coefficient omega hierarchical subscale, explained common variance estimates, and relative parameter bias were examined. RESULTS: Findings revealed bifactor structure produced a better model fit compared to both one-factor and two-factor models. Furthermore, model reliability estimates that parceled true score variance for the general FMS factor, locomotor skills factor, and ball skills factor yielded high internal consistency for FMS (.797) but not locomotor skills (.168) and ball skills (.216). Finally, explained common variance (.852-.879) and relative parameter bias (.018-.072) estimates identified the strength of the run, skip, slide, and dribble skills tests to represent the FMS general factor. CONCLUSIONS: Our findings demonstrate the advantages of using bifactor structure to examine the TGMD-3 compared to one-factor and two-factor models. Additionally, these results provide further evidence that using the TGMD-3 to examine an overall FMS general factor may explain more variance in performance and provide a better picture for evaluating children's current FMS levels compared to subscales independently.

Clinical Validity of the Test of Gross Motor Development-3 in Children With Disabilities from the U.S. National Normative Sample.

The Test of Gross Motor Development (TGMD) measures fundamental motor skills competency and is frequently used for eligibility determination of adapted physical education services in children with disabilities. The purpose of this study was to determine if the TGMD-3 is clinically sensitive to detect deficits in the fundamental motor skills of children with disabilities (i.e., intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, language and articulation disorders). Eighty-five children with disabilities and 85 matched controls (i.e., typically developing, individually matched on age, sex, ethnicity, and race) completed the TGMD-3. Mann-Whitney U tests identified significant differences in the total TGMD-3 scores for children with intellectual disability (p < .001), autism spectrum disorder (p < .001), and attention deficit hyperactivity disorder (p = .032). No differences were identified for children with language and articulation disorders. Comparisons of subscales (i.e., locomotor and ball skills) differed across disability groups. This study provides evidence that the TGMD-3 is clinically sensitive to identify deficits in fundamental motor skills competency.

Intervention to Improve Preschool Children's Fundamental Motor Skills: Protocol for a Parent-Focused, Mobile App-Based Comparative Effectiveness Trial.

BACKGROUND: Preschool age is an important time to master fundamental motor skills (FMS) through structured physical activity, yet many young children lag behind in motor skill development. OBJECTIVE: The Promoting Lifelong Activity in Youth (PLAY) study is a pilot comparative effectiveness trial to test the acceptability, feasibility, and preliminary effectiveness of a mobile app delivered to parents to promote FMS development in their preschool children (aged 3-5 years). METHODS: We conducted a 2-arm, parallel-design, randomized comparative effectiveness trial in 72 parent-child dyads from the southeastern United States. Experts in motor development and developmental psychology developed an app designed to deliver a 12-week program to parents of preschoolers using 1 of 2 curricula: an FMS program (intervention) that involved peer modeling, parent engagement, and structured skills-based activities and an unstructured physical activity (comparator) curriculum that provided suggestions for child-led physical activity (ie, free play). Primary outcomes are feasibility and acceptability of the app and child's FMS measured at end of intervention (week 12). Exploratory outcomes are child's objective physical activity, perceived movement competence, and parent report of self-regulation at the end of treatment (week 12) and sustained outcomes at follow-up (week 24). RESULTS: This project was funded in September 2018, with institutional review board approval in August 2018. Data collection took place from May 2019 through February 2020. To date, the project team has completed data collection on 69 preschool-age children, and results are expected to be published by 2021. CONCLUSIONS: The PLAY study examines the feasibility and preliminary effectiveness of a mobile app, parent-led curricula to promote FMS proficiency for preschool children. If found to be effective, the app has the potential for wide-scale dissemination to parents of preschoolers and to provide a model for the utilization of mobile apps to promote young children's motor skill development. TRIAL REGISTRATION: ClinicalTrials.gov NCT03901300; https://clinicaltrials.gov/ct2/show/NCT03901300. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/19943.

Relationship between the 24-Hour Movement Guidelines and fundamental motor skills in preschoolers.

OBJECTIVES: To examine the association among 24-Hour Movement Guidelines and fundamental motor skills (FMS) in preschoolers. DESIGN: Prospective cohort study with one-year follow-up. METHODS: Parents of 3-4-year-old children reported child age, sex, race, and time spent viewing screens (hours/day). Accelerometers measured preschooler physical activity (PA) and sleep. The 24-Hour Movement Guidelines were examined (≥3 h/day total PA including ≥1 h/day of moderate-to-vigorous [MVPA], 10-13 h/day of sleep, and ≤1 h/day of screen-time). Trained researchers administered the Test of Gross Motor Development-Third Edition (TGMD-3) to assess FMS. Linear regression was used to assess guidelines met and raw locomotor, ball skills, and total TGMD-3 scores with adjustment for covariates. RESULTS: One hundred and seven preschoolers provided complete cross-sectional data, and 53 preschoolers provided complete longitudinal data. Of the 107 preschoolers, they were 3.4 ±â€¯0.6 years of age, 44% were male, 50% were White, and the mean age-and-sex adjusted TGMD-3 total score percentile was below average (41 ±â€¯22). Many preschoolers met the PA guideline (91%) and sleep guideline (83%), but few preschoolers met the screen-time guideline (8%) or all three guidelines (6%). MVPA was positively associated with locomotor and total TGMD-3 scores in cross-sectional analysis (p < 0.05 for all). Baseline PA, sleep, and screen-time were associated with total TGMD-3 score at follow-up (p < 0.05 for all). Meeting the screen-time guideline and all three guidelines at baseline were each positively associated with total TGMD-3 score at follow-up (p < 0.05 for all). CONCLUSIONS: Each movement behavior contributed to later FMS. Promotion of adequate movement behaviors is warranted for child health.

A natural experiment of state-level physical activity and screen-time policy changes early childhood education (ECE) centers and child physical activity.

BACKGROUND: Early childhood education (ECE) centers are an important place for preschool-aged children to obtain physical activity (PA). A U.S. state government (Louisiana) recently updated requirements for licensed centers' PA and screen-time policies, which allowed for assessment of 1) ECE center practices, environment, staff behaviors, and policies changes on child-level PA and 2) state level changes on the ECE center. METHODS: ECE centers were assessed at the beginning of state licensing changes and 1-year later. The ECE centers were assessed via the Environmental Policy Assessment and Observation (EPAO) tool. The EPAO Sedentary Opportunities score, which primarily assesses television viewing time, was revised to reflect viewing non-television devices (e.g. tablets). Child-level PA was measured using accelerometry. For Aim 1, mixed models assessed ECE center changes and child PA with adjustment for demographic characteristics (fixed effects), baseline EPAO score (random effects), and clustering for center. For Aim 2, paired t-tests assessed ECE center environment differences between baseline and follow-up. RESULTS: Nine ECE centers participated and 49 preschoolers provided complete measures at both time points. For Aim 1, increases in the EPAO revised-Sedentary Opportunities score (as in less non-television screen-time) resulted in increased child PA (p = 0.02). For Aim 2, ECE centers improved their EPAO Active Opportunities and Staff Behaviors score (p = 0.04 and p = 0.02 respectively). CONCLUSIONS: ECE centers improved their environment after 1-year, resulting in additional child PA. Changes in ECE centers environment, possibly through policy, can positively influence children's PA.

Factors That Influence Participation in Classroom-Based Physical Activity Breaks in Head Start Preschoolers.

BACKGROUND: Activity breaks are an established way physical activity may be incorporated into the preschool day. The purpose of this study was to examine what factors influenced moderate to vigorous physical activity (MVPA) during a teacher-implemented classroom-based activity break (CBAB) in a Head Start population. METHODS: Ten-minute CBAB was conducted over 2 days in a quasi-experimental design; 99 preschoolers (mean age 3.80 [0.65] y; 49.5% male) from a convenience sample participated. Accelerometers measured MVPA, fundamental motor skill competency was assessed using the Test of Gross Motor Development-second edition, and weight classification status used body mass index percentiles. RESULTS: A significant, moderate regression was found (r = .328, P = .001) between fundamental motor skill and MVPA. There was no significant correlation between body mass index percentile and MVPA during the CBAB. In addition, the locomotor subscale was the best predictor for MVPA for children during the CBAB (r = .32, ß = 0.82, P < .001). CONCLUSIONS: CBAB equally elicited MVPA for normal and overweight preschoolers. Fundamental motor skill competency was associated with MVPA during the CBAB; in particular, locomotor skills were the best predictor for physical activity. Structured activity opportunities that focus on locomotor skills may be a useful integration to prompt more MVPA in a preschool-age population.