title: Intervention fidelity in a teacher-led program to promote physical activity in preschool-age children.
abstract: OBJECTIVE
  To examine protocol fidelity among teachers involved in a six-month cluster-randomized physical activity (PA) intervention.
  
  
  METHODS
  In 2011, preschools in Springfield, MA were randomized to short bouts of structured PA (SBS-PA, n=5) or unstructured playtime (UPA, n=5). SBS-PA provided structured PA in the classroom during the first 10 min of gross-motor playtime followed by 20 min of unstructured playtime. UPA consisted of 30 min of unstructured playtime. All teachers (SBS-PA and UPA) received a written study protocol and 1.5h of training. SBS-PA also received videos to use to lead structured PA and 1.5 additional hours of training. Study fidelity and process evaluation were assessed twice weekly via semi-structured questionnaire.
  
  
  RESULTS
  Only 56.6% of SBS-PA and 75.2% of UPA free playtimes lasted for 30 min; 86.3% of SBS-PA teachers implemented structured PA during the first 10 min of gross-motor playtime but only 67.2% delivered the intervention as instructed. Only 68.5% of SBS-PA teachers implemented the 20-minute unstructured playtime. SBS-PA teachers reported that time limitations was a major barrier in implementing the designed intervention. Pre-post changes in PA did not differ between groups.
  
  
  CONCLUSIONS
  Limited fidelity to intervention protocol likely impacted study findings. Future studies should focus on strategies to improve adherence among intervention leaders.
authors: Department of Kinesiology, University of Massachusetts Amherst, 110 Totman Building, 30 Eastman Lane, Amherst, MA 01003, USA. Electronic address: alhassan@kin.umass.edu.
authors: Sofiya
authors: S
authors: Alhassan
authors: Gramercy Research Group, 500 West 4th Street, Suite 203, Winston-Salem, NC 27101, USA. Electronic address: mwhittglover@gramercyresearch.com.
authors: Melicia C
authors: MC
authors: Whitt-Glover
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D016000:Cluster Analysis; D015444:Exercise; D005178:Faculty; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008404:Massachusetts; D009043:Motor Activity; D009146:Music; D010988:Play and Playthings; D011203:Poverty; D015397:Program Evaluation; D012572:School Health Services; D011795:Surveys and Questionnaires; D013997:Time Factors; D014743:Videotape Recording
keywords: Classroom; Intervention; Physical activity; Preschool; Study fidelity; Teacher