A multi-site guideline implementation randomised controlled trial to improve physical activity and screen time in Out of School Hours Care

Children’s activity patterns, including their physical activity and screen time behaviours, have wide-ranging impacts on their physical and psychosocial health, school performance, and wellbeing. Around 10% of Australian 5-12-year-old schoolchildren – nearly half a million children - attend Outside School Hours Care (OSHC) every week. Thus OSHC represents an ideal opportunity to positively influence the daily activity patterns of a vast number of children, at a formative stage in their lives.
At present, physical activity and screen time practices in Australian OSHC services are not guided by clear policy. As a result, practice varies enormously, with instances of OSHC services allowing unrestricted recreational screen time for over 5 hours per day, and providing no opportunity for physically active play.
Guidelines are systematically developed statements used to translate health research and expert opinion into recommendations for daily practice. They set out to decrease the gap between research and practice, and reduce inappropriate variability in practice. Our team has recently led an extensive national stakeholder consultation process to co-design evidence-based Australian OSHC sector guidelines for physical activity and screen time.
However, development of guidelines alone will not lead to changes in practice; concerted implementation efforts are required. We have worked closely with end-users, peak bodies and policy makers to develop a multi-level implementation intervention, aimed at improving uptake and adherence to the OSHC sector physical activity and screen time guidelines. We will test the effectiveness and cost-effectiveness of the multi-level implementation intervention by undertaking a randomised controlled trial in n=162 OSHC services across three states: SA, NSW and WA. Thorough process evaluation including a discrete choice experiment will provide critical information to guide national implementation.