title: Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial.
abstract: OBJECTIVE
  To assess the effect of a governmentally-led center based child care physical activity program (Youp'là Bouge) on child motor skills.
  
  
  METHODS
  We conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed.
  
  
  RESULTS
  At baseline, 648 children present on the motor test day were included (age 3.3 ± 0.6, BMI 16.3 ± 1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n = 201), children in the intervention group (n = 187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (-0.8 to 0.3), p = 0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: (1) free-access to a movement space and parental information session for motor skills (2) highly motivated and trained educators for BMI (3) free-access to a movement space and purchase of mobile equipment for physical activity (all p < 0.05).
  
  
  CONCLUSIONS
  This "real-life" physical activity program in child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs.
  
  
  BACKGROUND
  Clinical trials.gov NCT00967460.
authors.forename: Antoine
authors.initials: A
authors.lastname: Bonvin
authors.forename: Jérôme
authors.initials: J
authors.lastname: Barral
authors.forename: Tanja H
authors.initials: TH
authors.lastname: Kakebeeke
authors.forename: Susi
authors.initials: S
authors.lastname: Kriemler
authors.forename: Anouk
authors.initials: A
authors.lastname: Longchamp
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Jardena J
authors.initials: JJ
authors.lastname: Puder
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002656:Child Day Care Centers; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D016015:Logistic Models; D008297:Male; D009042:Motivation; D009043:Motor Activity; D009048:Motor Skills; D050177:Overweight / Q000628:therapy; D015397:Program Evaluation; D011788:Quality of Life; D016037:Single-Blind Method; D013557:Switzerland; D016896:Treatment Outcome