Evidence map›Paper›PMID 42832201›Full record

Trial reportJAMA network open2026

A Policy-Based Intervention for Physical Activity and Screen Time in Childcare Outside School Hours: A Cluster Randomized Clinical Trial.

Carol Maher, Luke Wolfenden, Nicole Nathan, Jacinta Brinsley, Ty Ferguson, Rachel Curtis, Rosa Virgara, Alyce Barnes, Svetlana Bogomolova, Kylie Brannelly and 13 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Carol MaherAlliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, South Australia, Australia.
Luke WolfendenSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.
Nicole NathanSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.
Jacinta BrinsleyAlliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, South Australia, Australia.
Ty FergusonAlliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, South Australia, Australia.
Rachel CurtisAlliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, South Australia, Australia.
Rosa VirgaraAlliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, South Australia, Australia.
Alyce BarnesSchool of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.
Svetlana BogomolovaCentre for Social Impact, Flinders Business School, Flinders University, Adelaide, South Australia, Australia.
Kylie BrannellyQueensland Children's Activities Network, Woodend, Queensland, Australia.
Dylan P CliffEarly Start, School of Education, University of Wollongong, Wollongong, New South Wales, Australia.
Perry CampbellAustralian Children's Education and Care Quality Authority (ACECQA), Darlinghurst, New South Wales, Australia.
Adrian EstermanAlliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, South Australia, Australia.
Lucy K LewisCaring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
Rachel K MilteCaring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
Michael NoetelSchool of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
Anthony D OkelySchool of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
Mandy RichardsonDepartment for Education, Adelaide, South Australia, Australia.
Richard R RosenkranzDepartment of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas.
Natasha SchranzPreventive Health SA, Adelaide, South Australia, Australia.
Rebecca M StanleySchool of Social Sciences, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.
R Glenn WeaverDepartment of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
Hayley ChristianThe Kids Research Institute Australia, The University of Western Australia, Perth, Western Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Extended education programs reach tens of millions of children globally during discretionary hours when physical activity competes with screen use, yet scalable strategies to improve movement behaviors are limited. Objective: To evaluate the effectiveness of Activated Outside School Hours Care (OSHC), a policy-based intervention to improve physical activity and screen time practices in extended education settings. Design, Setting, and Participants: This cluster randomized clinical trial was conducted in Australia's system of organized before- and after-school care in 3 Australian states (South Australia, New South Wales, and Western Australia) between August 1, 2022, and December 31, 2024, with assessments at baseline, 3 months, and 12 months. Intervention: Activated OSHC is a web-based intervention offering voluntary accreditation to services aligning their policies with national physical activity and screen time guidelines through staff training. Services were randomized 1:1 to intervention or usual practice, in which services continued their typical programming. Main Outcomes and Measures: The primary outcome was service-level adherence to OSHC sector physical activity and screen time guidelines. Secondary outcomes included staff physical activity-enabling behaviors, children's moderate-to-vigorous physical activity and recreational screen time, and availability of physical activity equipment, assessed through direct observation. Intention-to-treat and per-protocol analyses were performed. Results: Of 197 services (101 in the intervention group and 96 in the control group), 182 (92%; 90 in the intervention group and 92 in the control group) completed the 12-month follow-up. Of the 101 services in the intervention group, 48 (48%) achieved accreditation within 12 months. Intention-to-treat analyses showed no significant effects for guideline adherence or children's activity levels. However, the services in the intervention group demonstrated greater staff physical activity-promoting behaviors during before-school care (odds ratio [OR], 1.72; 95% CI, 1.27-2.33) and greater availability of physical activity equipment during before- (OR, 1.21; 95% CI, 1.00-1.46) and after-school care (OR, 1.16; 95% CI, 1.04-1.30). In per-protocol analyses, accredited services were more likely than controls to meet all guidelines (OR, 7.35; 95% CI, 1.39-38.86), with improved after-school screen time adherence (OR, 5.63; 95% CI, 1.16-27.22). In per-protocol analyses, accredited services showed greater staff physical activity-enabling behaviors (OR, 3.00; 95% CI, 2.10-4.28), and children engaged in more physical activity during before-school care (incidence rate ratio, 1.23; 95% CI, 1.05-1.43) compared with controls. Conclusions and Relevance: This randomized clinical trial found few population-level changes in intention-to-treat analyses. However, services achieving accreditation demonstrated consistent improvements in guideline adherence, staff behaviors relating to physical activity, and children's physical activity. The intervention was effective when implemented, but limited uptake constrained population-level impact. The accreditation model is viable for practice improvement, but policy- or system-level strategies may be needed to drive widespread adoption. Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12622000393752.

Indexed as

Child CareExerciseHealth PromotionScreen TimeAustraliaChildChild, PreschoolFemaleHumansMaleNew South Wales

Identifiers

PMID42832201
PMCPMC13639758

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.