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Interventions to support healthy movement behaviours among preschool children in early childhood education and care settings: A realist synthesis protocol
Miller H, John J, Pesce C, Henderson M, Bardid F ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a protocol document describing plans for a systematic review of interventions that support healthy movement behaviours (physical activity, sedentary behaviour, and sleep) among preschool children in early childhood education and care settings. The review will use realist synthesis methods to understand what works, for whom, and under what circumstances, rather than just measuring whether interventions are effective. The findings are intended to inform the development and implementation of future interventions to help preschool children meet World Health Organisation movement guidelines. No results are yet available as the work is still in planning stages.
Key points
- Many preschool children worldwide do not meet WHO 24-hour movement behaviour guidelines
- Movement behaviours (physical activity, sedentary time, sleep) are interdependent and influenced by multiple contextual factors
- Current evidence on intervention effectiveness is inconsistent
- The review will use realist synthesis to develop programme theory about context-mechanism-outcome configurations
- Results are planned for submission by 2027
Limitations
This is a protocol document describing planned work, not a completed study, so no empirical findings or results are available. The review will not be completed until 2027, limiting any immediate application of its findings.
Abstract
Background: A paradigm shift towards a broader view of movement behaviours emphasises the importance of physical activity, sedentary behaviour, and sleep across the 24-hr day. Despite these behaviours being positively associated with important health and development outcomes, research suggests many preschool children worldwide fail to meet the World Health Organisation 24-hr movement behaviour guidelines. In order to improve adherence, interventions have often targeted Early Childhood Education and Care (ECEC) settings, a key environment where children spend a substantial proportion of their day. However, evidence regarding the effectiveness of these interventions and their components is inconsistent. These inconsistencies highlight the complexity of movement behaviour interventions, as movement behaviours are interdependent and influenced by multiple contextual factors. Considering this, a theory-driven approach is best suited to develop a deeper understanding for what works for whom, under which circumstances, and how, to ultimately improve policy development. Objectives: The aim of this protocol is to investigate under which contextual circumstances do interventions most effectively improve preschool children’s 24-hr movement behaviours in ECEC setting through developing and an evidence-informed initial programme theory which outline for whom these interventions work, under what contexts, and through which mechanisms. Methods: Findings of the synthesis will be reported following the RAMESES (Realist and Meta-Narrative Evidence Synthesis: Evolving Standards) publication standards. A literature search will be conducted to identify relevant peer-reviewed movement behaviour intervention studies. Identified studies will be considered for inclusion based on pre-determined inclusion criteria. Study screening, data extraction, and quality assessment will be independently conducted by two reviewers. The realist synthesis will apply a combined conceptual framework to develop potential Context-Mechanism-Outcome configurations and develop and initial programme theory which will be developed and refined–by means of piecemeal confirmation and/or disconfirmation–throughout the evidence synthesis. Results: This protocol was registered in PROSPERO (CRD420261449684). Duplicate screening, quality assessment, data extraction, relevance and rigour appraisal, and iterative programme theory testing is planned for mid-2026. The primary review manuscript is targeted for submission by 2027. Conclusions: This review moves away from current literature focus on intervention effectiveness and instead develops a more nuanced understanding of intervention implementation and effectiveness through applying theory-driven processes. Results of the synthesis intends to identify appropriate strategies to promote healthy 24-hr movement behaviours in the early years to inform the development, adaptation, and implementation of current and future interventions.