Evaluating the scale-up of the Play Active programme for children's physical activity in early childhood education and care services: a national type III hybrid effectiveness-implementation trial protocol

Hayley Christian; Carol Maher; Stewart G Trost; Jasper Schipperijn; Kevin Murray; Ian Li; Andrea Nathan; Alana Papageorgiou; Matthew Mclaughlin; Adrian Bauman

doi:10.1136/bmjopen-2025-103968

Evaluating the scale-up of the Play Active programme for children's physical activity in early childhood education and care services: a national type III hybrid effectiveness-implementation trial protocol

BMJ Open. 2025 Oct 23;15(10):e103968. doi: 10.1136/bmjopen-2025-103968.

Authors

Hayley Christian^{1

2}, Carol Maher³, Stewart G Trost⁴, Jasper Schipperijn⁵, Kevin Murray², Ian Li⁶, Andrea Nathan⁷, Alana Papageorgiou^{7

2}, Matthew Mclaughlin^{7

8}, Adrian Bauman⁹

Affiliations

¹ The Kids Research Institute Australia, The University of Western Australia, Nedlands, Western Australia, Australia hayley.christian@uwa.edu.au.
² School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.
³ Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia.
⁴ School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia.
⁵ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁶ Office of the Provost, Curtin University, Perth, Western Australia, Australia.
⁷ The Kids Research Institute Australia, The University of Western Australia, Nedlands, Western Australia, Australia.
⁸ School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
⁹ School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Abstract

Introduction: Physical activity is crucial for young children's health and development. Many young children do not meet the recommended 3 hours of daily physical activity, including 60 min of energetic play. Early childhood education and care (ECEC/childcare) is a key setting to intervene to improve children's physical activity. The Play Active programme is a scalable evidence-informed ECEC-specific physical activity policy intervention with implementation support strategies to improve educators' physical activity-related practices.

Methods and analysis: This hybrid type III effectiveness-implementation trial will use a quasi-experimental repeated measures design to assess the real-world effectiveness of Play Active's scalable implementation support strategies in helping ECEC services adopt the practices included in the Play Active policy. Secondary aims will examine changes in educator-reported and device-measured children's physical activity; assess the sustainability of the programme; identify effective dissemination strategies; assess cost-effectiveness; and involve comprehensive process evaluation. All ECEC services in Western Australia (n=776), Queensland (n=1744) and South Australia (n=445) will be invited to participate. Data will be collected at baseline, 6, 12, 18, 24 and 30 months.

Ethics and dissemination: Ethics approval has been provided by The University of Western Australia Human Research Ethics Committee (HREC) (2023/ET000187), the University of Queensland HREC (2024/HE000076) and the University of South Australia HREC (206023). This real-world trial of Play Active is vital for understanding its implementation in practice and to generate evidence for further scale-up and roll-out nationally. Key findings will be disseminated to stakeholders, collaborators, policy-makers as well as families and practitioners in the ECEC sector.

Trial registration number: ACTRN12624000406505.

Keywords: Behavior; Child; Community child health; Exercise; PUBLIC HEALTH.

Publication types

Clinical Trial Protocol

MeSH terms

Australia
Child, Preschool
Clinical Trials as Topic
Cost-Benefit Analysis
Exercise*
Health Promotion* / methods
Humans
Play and Playthings*
Program Evaluation