A Policy-Based Intervention for Physical Activity and Screen Time in Childcare Outside School Hours

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.

Corresponding Author: Carol Maher, PhD, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide University, 108 N Terrace, Adelaide, SA, Australia (carol.maher@adelaide.edu.au).

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