Effects of a staff physical activity professional development intervention on preschoolers' mental health and self-regulation: The active learning Norwegian Preschool(er)s (ACTNOW) cluster randomised controlled trial.

ABSTRACT

BACKGROUND AND AIM: Physical activity may have positive effects on preschoolers' mental health and self-regulation. The preschool setting provides children with opportunities to meet physical activity guidelines and could improve with staff training in delivering physical activity. This study examined the effect of physical activity professional development for preschool staff on preschoolers' proxy-measured mental health and self-regulation. METHODS: In total, 1265 children from 46 preschools were cluster randomised to either the intervention or the control group. The intervention was nested within two levels implemented concurrently the preschool level, formed as a professional development where preschools conducted development work, and the child level, with whom the staff implemented physical activity with four core components. Data were analysed using an ANCOVA model through structural equation modelling with latent outcome factors of emotional problems, peer problems, hyperactivity, and prosocial behaviour from the Strength and Difficulties Questionnaire; and cognitive, emotional, and behavioural self-regulation from the Child Self-regulation and Behaviour Questionnaire. RESULTS: No effects of the intervention (standardised effect sizes -0.195-0.145, p-values 0.118-0.893) were observed. Secondary analysis showed that children with initially high prosocial behaviour and behavioural self-regulation positively benefited from the intervention (p = 0.035 and p = 0.047, respectively). CONCLUSION: The ACTNOW intervention had no effects on preschoolers' mental health or self-regulation after 18 months, besides effects for children with initially the highest prosocial behaviour and behavioural self-regulation. Although the professional development was more extensive than previous studies it may have been insufficient to change the preschools physical activity practices. CLINICAL TRIAL REGISTRATION www. CLINICALTRIALS gov identifier NCT04048967.