Open Access Open Badges Study protocol

Activity Begins in Childhood (ABC) – inspiring healthy active behaviour in preschoolers: study protocol for a cluster randomized controlled trial

Kristi B Adamo124*, Nick Barrowman1, Patti Jean Naylor3, Sanni Yaya5, Alysha Harvey12, Kimberly P Grattan12 and Gary S Goldfield124

Author Affiliations

1 Children’s Hospital of Eastern Ontario Research Institute (CHEO-RI), 401 Smyth Road, Ottawa, ON K1H 8 L1, Canada

2 Healthy Active Living and Obesity Research Group (HALO), 401 Smyth Road, Ottawa, ON K1H 8 L1, Canada

3 School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015 STN CSC, Victoria, BC V8W 3P1, Canada

4 Faculty of Medicine, Pediatrics, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada

5 Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 7 K4, Canada

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Trials 2014, 15:305  doi:10.1186/1745-6215-15-305

Published: 29 July 2014



Today’s children are more overweight than previous generations and physical inactivity is a contributing factor. Modelling and promoting positive behaviour in the early years is imperative for the development of lifelong health habits. The social and physical environments where children spend their time have a powerful influence on behaviour. Since the majority of preschool children spend time in care outside of the home, this provides an ideal setting to examine the ability of an intervention to enhance movement skills and modify physical activity behaviour. This study aims to evaluate the efficacy of the Activity Begins in Childhood (ABC) intervention delivered in licensed daycare settings alone or in combination with a parent-driven home physical activity-promotion component to increase preschoolers’ overall physical activity levels and, specifically, the time spent in moderate to vigorous physical activity.


This study is a single site, three-arm, cluster-randomized controlled trial design with a daycare centre as the unit of measurement (clusters). All daycare centres in the National Capital region that serve children between the ages of 3 and 5, expressing an interest in receiving the ABC intervention will be invited to participate. Those who agree will be randomly assigned to one of three groups: i) ABC program delivered at a daycare centre only, ii) ABC program delivered at daycare with a home/parental education component, or iii) regular daycare curriculum. This study will recruit 18 daycare centres, 6 in each of the three groups. The intervention will last approximately 6 months, with baseline assessment prior to ABC implementation and follow-up assessments at 3 and 6 months.


Physical activity is an acknowledged component of a healthy lifestyle and childhood experiences as it has an important impact on lifelong behaviour and health. Opportunities for physical activity and motor development in early childhood may, over the lifespan, influence the maintenance of a healthy body weight and reduce cardiovascular disease risk. If successful, the ABC program may be implemented in daycare centres as an effective way of increasing healthy activity behaviours of preschoolers.

Trial registration

Current Controlled Trials: ISRCTN94022291. Registered in December 2012, first cluster randomized in April 2013.

Childcare; Daycare environment; Intervention; Motor skills; Paediatric health; Physical activity; Preschool; Sedentary behaviour