The "great live and move challenge": a program to promote physical activity among children aged 7-11 years. Design and implementation of a cluster-randomized controlled trial.

BACKGROUND: Recent population-based surveys have reported that large majorities of children in France, Europe and in the US are not complying with international physical activity (PA) guidelines. There is, therefore, a need to find programs that will improve children's PA habits from an early age. Theory-based interventions that include school, family, and community involvement have the potential to generate a considerable increase in the PA level of children. The theory of planned behavior (TPB) is one of the most widely tested models of the factors influencing health-related behaviors. The Great Live and Move Challenge (GLMC) is an extended TPB-based intervention designed to promote PA in French primary school children aged 7-11 years. The objective of this paper is to describe the protocol of a randomized controlled trial to evaluate the effectiveness of the GLMC on the PA level of children. METHODS: This is a two-year cluster-randomized controlled trial comparing an intervention group to a control group, randomized into clusters (community of communes) and stratified by department (Hérault, Gard, Aude) and residential environment (urban, rural). The goal is to recruit 4000 children. The GLMC involves children and their parents, and multiple local grassroots partners, such as school teachers, municipal officials and policy stakeholders. The intervention will be delivered over 3.5 months per year for a two-year period. Pre- and post-intervention, children and parents will be asked to fulfill a questionnaire concerning current PA level, TPB variables (i.e., intentions, attitudes, subjective norms, perceived behavioral control) and other psychosocial variables (e.g., perceptions of activity opportunities). A subsample of 400 children will be proposed to wear an accelerometer (i.e., the Actigraph GT3X+). The primary hypothesis is that the GLMC intervention will increase the proportion of children achieving the World Health Organization's recommended 60 min of moderate to vigorous PA per day by 15%. DISCUSSION: This study will evaluate the effectiveness of a multilevel, theory-based PA program and potentially provide valuable information for schools and public health officers looking for innovative PA programs. TRIAL REGISTRATION: ISRCTN:61116221 , 19/06/2018.

Predicting Physical Activity Among Children: Investigating Interaction Effects in the Theory of Planned Behavior.

PURPOSE: The theory of planned behavior (TPB) has been criticized for not including interactions between the variables assumed to predict behavior. This study sought to test how TPB variables interact to predict physical activity (PA) in children. METHOD: Four hundred thirty-eight children (Mage = 8.6 years, SD = 1.6 years) completed a TPB questionnaire and a PA questionnaire at Time 1. The PA measure was repeated 2 months later. Path analyses were performed to test the hypothesized model including interaction terms between TPB variables. Simple slopes analyses were also carried out to examine the statistically significant interaction terms. RESULTS: Path analyses confirmed the classical hypotheses of TPB (R2 for intentions = .39, R2 for PA = .12) and also demonstrated only statistically significant Attitudes × Perceived Behavioral Control and Subjective Norms × Attitudes interactions (R2 change for intentions = .01, p = .009). Simple slopes analyses revealed that the strength of the association between perceived behavioral control and intentions was only statistically significantly higher (t = 2.18, p = .05, d = 0.34, 95% CI  [0.03, 0.65]) when attitudes were high compared with when attitudes were low. The link between attitudes and intentions was only statistically significant at a low level of subjective norms but not at a high level. CONCLUSION: The integration of interaction effects between TPB variables did not increase for the variance of PA explained by the model. More research appears to be necessary to explore how the TPB could be augmented to better predict PA in children.

Impact and Moderating Variables of an Intervention Promoting Physical Activity Among Children: Results From a Pilot Study.

This pilot study pursued three objectives: to assess the effect of a 1-month multilevel intervention on the PA of children, to assess the impact of the intervention on the theory of planned behavior (TPB) variables, and to evaluate the extent to which the impact of the intervention on PA and TPB variables varied according to personal (i.e., gender and age) and situational (i.e., class and school) moderating variables. Children were aged 7 to 11 years ( n = 306). Analyses revealed a significant increase of PA practice and TPB variables ( ps < .001). Age (i.e., being a younger child) was associated with a higher increase on attitude and perceived control ( ps < .01). The class or the school levels explained a meaningful variance in the evolution of PA or TPB variables (intraclass correlation coefficients > .10). The present study reports the interest and feasibility of a multilevel intervention to increase PA and TPB variables in children.

Promoting Physical Activity among Children: The "Great Live and Move Challenge" / Promouvoir l'activité physique des enfants : Le « Grand Défi Vivez Bougez ¼.

Objective: The "Great Live and Move Challenge" (GLMC) is an intervention designed to promote physical activity (PA) in schools and the community among 6- to 11-year-old schoolchildren and their families.Method: This project, implemented in the Montpellier and Pays Coeur d'Hérault regions since 2013, encourages children to quantify their daily PA level by illustrating each 15 minutes of exercise by an "energy cube". Based on collaboration between pilots, teachers and policymakers, this project is implemented over a 6-week period in schools, municipalities and recreation centres. "Great Challenge" events are organized to promote PA. The GLMC is also a theory-based intervention based on the tenets of the planned behaviour theory.Results: Since the 2014-2015 edition, 2,243 children have taken part in the GLMC and have accumulated 391,102 "energy cubes". In addition, more than 30 "Great Challenge" events have been organized. Since its launch during the 2012-2013 school year, the numbers of children who have taken part in the GLMC have been multiplied by 5.58. The mean number of daily "energy cubes" accumulated by children has increased from 4.04 in the first year to 6.22 in 2014-2015.Conclusion: The "energy cube" can provide a measure of the commitment of children and their surrounding community in a comprehensive approach to PA promotion.