Effects of Sustainability via Active Garden Education on preschool-aged children’s locomotor skills

Background: Physical activity and locomotor skills influence children’s current and future health trajectories. Purpose: To (i) assess the effect of Sustainability via Active Garden Education (SAGE) intervention on locomotor skills in children, and (ii) test whether changes were related to the fidelity and dose of the program. Methods: SAGE installed a garden in early care and education (ECE) facilities and implemented a curriculum consisting of 12 one-hour sessions to promote healthy eating and physical activity. Quantitative locomotor skills were assessed by the number of laps completed on the progressive aerobic cardiovascular endurance run (PACER), while qualitative assessment was conducted using the CHAMPS protocol. Fidelity was the number of active games completed, while dose was the number of gross motor skills implemented. Two-level linear mixed models adjusted by sex and age examined the effects of SAGE on locomotor outcomes. Fidelity and dose were tested as moderators. Results: A total of 173 children [50.90% boys; mean age 4.43 years (SD: 0.38)] participated in the study. Significant improvements over time were observed on overall qualitative locomotor score [β=2.51; 95% confidence interval (CI): 1.32; 3.70], and the subscores of slide (β=1.04; 95% CI: 0.54; 1.55) and hop (β=1.16; 95% CI: 0.61; 1.72). There was a significant effect of SAGE on the hop skill score in the intervention group compared to control (β=1.14; 95% CI: 0.41; 2.24). Fidelity and dose delivered did not moderate changes. Conclusions: Children’s overall qualitative locomotor score, hop, and slide skills increased across both groups. Participation in SAGE improved the hop locomotor skill. The Clinical Trials Registration The study clinical trials registration is NCT03261492.