Formation of the Regional Economic Areas in Japan：Economic Base of a System of RegionalAdministrative Units composed of Several Prefectures

OBJECTIVE: The objective of this study was to systematically review the evidence of motor skill intervention programs on typically developing children's fine motor development aged birth to 6 years. METHODS: Six electronic databases were searched with no date restrictions. Inclusion criteria were any school-, community-, or home-based intervention targeting the development of fine motor skills of children aged birth to 6 years; randomized controlled trials using quasiexperimental, experimental, or single group prepost designs with a minimum sample size of 15 participants per group; and statistical analyses of fine motor skill development at both preintervention and postintervention or addressing the intervention effects on fine motor skill development. Data were extracted on design, participants, intervention components, methodological quality, and efficacy. RESULTS: Twenty-five of the total 31 studies reported positive intervention effects on fine motor skills. The meta-analyses included 19 studies and revealed moderate effect sizes of motor skill programs on fine motor, visual motor, and manual dexterity outcomes. There were substantial differences between intervention settings, facilitators, length, and content with most studies implemented in school settings and facilitated by teachers. CONCLUSION: Fine motor skill development in the early years is an extensive upcoming field of interest for many international researchers. This review study presents evidence on the positive effects of intervention programs that aim to enhance fine motor skills for young children. The findings are promising but need to be interpreted with caution because of the high risk of bias in many of the studies

Cross-sectional examination of 24-hour movement behaviours among 3-and 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries : the SUNRISE study protocol

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.Peer reviewe

A Ball Skills Intervention in Preschoolers: The CHAMP Randomized Controlled Trial

Purpose: Fundamental motor skills (FMS) contribute to positive health trajectories. A high level of competence in ball skills (a subset of FMS) is a predictor for time spent in moderate- to vigorous-intensity physical activity during adolescence. This study examined the effects of a ball skills intervention on ball skill competence among preschool-aged boys and girls. Methods: This is a two-armed randomized controlled trial. A total of 124 preschoolers (Mage ± SD = 48.14 ± 6.62 months) were randomly assigned to one of two groups, the Children\u27s Health Activity Motor Program (CHAMP; n = 81) or control (n = 43). FMS were measured before, after (9 wk), and at retention (18 wk) using the object control subscale of the Test of Gross Motor Development, Second Edition. Changes in ball skill scores were calculated (pretest-posttest, pretest-retention, posttest-retention) and were compared using one-way ANOVAs with post hoc Scheffe analysis. Results: Findings support that groups demonstrated significantly different rates of change from pretest to posttest (F3,117 = 179.45, P \u3c 0.001), pretest to retention (F3,113 = 95.8, P \u3c 0.001), and posttest to retention (F3,113 = 189.89, P \u3c 0.001). Compared with their control group peers, CHAMP boys and girls had greater positive rates of change from pretest to posttest and pretest to retention as well as greater negative rates of change from posttest to retention. Conclusions: CHAMP was effective in improving and maintaining ball skills in preschool-age boys and girls. Findings support that providing a high-quality motor skill program in early childhood settings could potentially be a sustainable public health approach to promoting FMS and positive developmental trajectories for health

A Ball Skills Intervention in Preschoolers: The CHAMP Randomized Controlled Trial

PURPOSE: Fundamental motor skills (FMS) contribute to positive health trajectories. A high level of competence in ball skills (a subset of FMS) is a predictor for time spent in moderate- to vigorous-intensity physical activity during adolescence. This study examined the effects of a ball skills intervention on ball skill competence among preschool-aged boys and girls. METHODS: This is a two-armed randomized controlled trial. A total of 124 preschoolers (Mage ± SD = 48.14 ± 6.62 months) were randomly assigned to one of two groups, the Children's Health Activity Motor Program (CHAMP; n = 81) or control (n = 43). FMS were measured before, after (9 wk), and at retention (18 wk) using the object control subscale of the Test of Gross Motor Development, Second Edition. Changes in ball skill scores were calculated (pretest-posttest, pretest-retention, posttest-retention) and were compared using one-way ANOVAs with post hoc Scheffe analysis. RESULTS: Findings support that groups demonstrated significantly different rates of change from pretest to posttest (F3,117 = 179.45, P < 0.001), pretest to retention (F3,113 = 95.8, P < 0.001), and posttest to retention (F3,113 = 189.89, P < 0.001). Compared with their control group peers, CHAMP boys and girls had greater positive rates of change from pretest to posttest and pretest to retention as well as greater negative rates of change from posttest to retention. CONCLUSIONS: CHAMP was effective in improving and maintaining ball skills in preschool-age boys and girls. Findings support that providing a high-quality motor skill program in early childhood settings could potentially be a sustainable public health approach to promoting FMS and positive developmental trajectories for health

Physical activity and prospective associations with indicators of health and development in children aged <5 years: a systematic review

Background: Early childhood is a critical period for growth and development, yet the association with physical activity during this important period is unknown. The aim of this review is to critically summarize the evidence on the prospective associations between physical activity and health and development in children aged < 5 years. Methods: A systematic search in three electronic databases (Pubmed, PsycINFO, and Sportdiscus) was conducted to identify prospective studies examining the associations between physical activity (all types; specified by quantity) and health indicators (body composition, cardiometabolic health, bone health and risks/harm) or development (motor, cognitive and social-emotional development) in young children (mean age < 5 years at baseline). Two independent researchers assessed the methodological quality using the ‘Quality Assessment Tool for Quantitative Studies’ (EPHPP). This tool covers eight quality criteria: selection bias, study design, confounders, blinding, data collection methods, withdrawals and drop-outs, intervention integrity and data-analysis. Results: Thirty-nine studies, predominantly conducted in preschoolers (ages 3–5 years), were included of which nine were rated as high methodological quality. There was moderate evidence for a positive association between physical activity and motor (n = 11 studies) and cognitive development (n = 10 studies) based on consistent findings from studies having low-to-moderate methodological quality. There was insufficient evidence for an association between physical activity and body composition (n = 15 studies), cardiometabolic health indicators (n = 7 studies), social-emotional development (n = 2 studies) and bone health (n = 2 studies) based on inconsistent findings from studies having weak-to-high methodological quality. Conclusions: There is a need for more high-quality research in order to determine the dose-response relationship between physical activity and health and development in early childhood. Special attention should be paid to studies in children below the age of 3 years

Promoting ball skills in preschool-age girls

Objectives: Evidence supports that girls are less proficient than boys at performing ball skills. This study examined the immediate and long-term effects of a ball skill intervention on preschool-age girls\u27 ball skill performance. Design: Randomized controlled trial. Methods: Girls (Mage = 47.24 ± 7.38 months) were randomly assigned to a high autonomy, mastery-based 9-week motor skill intervention (the Children\u27s Health Activity Motor Program; CHAMP, 540 min; n = 38) or a control group (free-play; n = 16). Ball skill proficiency was assessed at pretest, posttest, and retention test(after 9 weeks)using the object control subscale ofthe Test of GrossMotor Development - 2ndEdition. Treatment efficacy was examined using linear mixed models. Two models were fit: one for short-term changes (pretest to posttest) and one for long-term changes (pretest to retention). Results: Linear mixed models revealed a significantly time*treatment interaction for both models. Post hoc analysis confirmed that girls in CHAMP experienced significant gains in ball skills from pretest to posttest (p \u3c .001) and pretest to retention (p \u3c .001). Moreover, girls in CHAMP were no different from the control group at pretest(p \u3e .05) but had significantly higher ball skills scores at both posttest(p \u3c .001) and retention (p \u3c .001). Conclusions: This study demonstrates the positive effects of a ball skill intervention (i.e., CHAMP) on improving girls\u27 ball skills both short- and long-term. Findings suggest that early childhood interventions that focus on the development of ball skills in young girls might be an avenue to improve girls\u27 ball skill performance

Associations of gross motor skills with self-regulation and executive function in preschool-aged children

This study aimed to examine associations between gross motor skills and executive functions (EF) in a large sample of Australian preschool-aged children. Of 566 children (mean age = 3.2 ± 0.4 years, 51.2% girls), locomotor, object control, and total skill competence were significantly associated with visual spatial working memory and inhibition (p < 0.05). Total skill competence was associated with shifting and locomotor skills were significantly associated with self-regulation (p < 0.05). Static balance was significantly associated with inhibition and shifting (p < 0.05). In boys, an association between object control skills and visual spatial working memory was observed. In girls, an association between static balance and visual spatial working memory, phonological working memory, and shifting was observed. The identification of significant associations between gross motor skills and different EFs is an important contribution to the growing evidence on the relationship between motor skills and EFs in early childhood

Associations between gross motor skills and physical activity in Australian toddlers

Objectives: Physical activity can be promoted by high levels of gross motor skills. A systematic review found a positive relationship in children (3–18 years) but only few studies examined this in younger children. The aim of this study was to examine the association between gross motor skills and physical activity in children aged 11–29 months. Design: Cross-sectional study. Methods: This study involved 284 children from 30 childcare services in NSW, Australia (Mean age = 19.77 ± 4.18 months, 53.2% boys). Physical activity was measured using accelerometers (Actigraph GT3X+). Gross motor skills were assessed using the Peabody Developmental Motor Scales Second Edition (PDMS-2). Multilevel linear regression analyses were computed to assess associations between gross motor skills and physical activity, adjusting for sex, age and BMI. Results: Children spent 53.08% of their time in physical activity and 10.39% in moderate to vigorous physical activity (MVPA). Boys had higher total physical activity (p < 0.01) and MVPA (p < 0.01) than girls. The average gross motor skills score was 96.16. Boys scored higher than girls in object manipulation (p < 0.001). There was no association between gross motor skills and total physical activity or MVPA. Conclusions: Although gross motor skills were not associated with physical activity in this sample, stronger associations are apparent in older children. This study therefore highlights a potential important age to promote gross motor skills

Protocol for a cluster randomized clinical trial of a mastery-climate motor skills intervention, Children's Health Activity and Motor Program (CHAMP), on self-regulation in preschoolers.

IntroductionSelf-regulation (SR) is critical to healthy development in children, and intervention approaches (i.e., professional training, classroom-based curricula, parent-focused intervention) have shown to support or enhance SR. However, to our knowledge, none have tested whether changes in children's SR across an intervention relate to changes in children's health behavior and outcomes. This study, the Promoting Activity and Trajectories of Health (PATH) for Children-SR Study uses a cluster-randomized control trial to examine the immediate effects of a mastery-climate motor skills intervention on SR. Secondly, this study examines the associations between changes in SR and changes in children's health behaviors (i.e., motor competence, physical activity, and perceived competence) and outcomes (i.e., body mass index and waist circumference) (ClinicalTrials.gov Identifier, NCT03189862).Methods and analysisThe PATH-SR study will be a cluster-randomized clinical trial. A total of 120 children between the ages of 3.5 to 5 years of age will be randomized to a mastery-climate motor skills intervention (n = 70) or control (n = 50) condition. SR will be assessed using measures that evaluate cognitive SR (cognitive flexibility and working memory), behavioral SR (behavioral inhibition), and emotional SR (emotional regulation). Health behaviors will be assessed with motor skills, physical activity, and perceived competence (motor and physical) and health outcomes will be waist circumference and body mass index. SR, health behaviors, and health outcomes will be assessed before and after the intervention (pre-test and post-test). Given the randomization design, 70 children in the intervention group and 50 in the control group, we have 80% power to detect an effect size of 0.52, at a Type I error level of 0.05. With the data collected, we will test the intervention effect on SR with a two-sample t-test comparing the intervention group and the control group. We will further evaluate the associations between changes in SR and changes in children's health behaviors and health outcomes, using mixed effect regression models, with a random effect to account for within-subject correlations. The PATH-SR study addresses gaps in pediatric exercise science and child development research. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development during the early years.Ethics and disseminationEthical approval for this study was obtained through the Health Sciences and Behavioral Sciences Institutional Review Board, University of Michigan (HUM00133319). The PATH-SR study is funded by the National Institutes of Health Common Fund. Findings will be disseminated via print, online media, dissemination events and practitioner and/or research journals.Trial registration numberClinicalTrials.gov Identifier, NCT03189862

Protocol for a cluster randomized clinical trial of a mastery-climate motor skills intervention, Children’s Health Activity and Motor Program (CHAMP), on self-regulation in preschoolers

Introduction Self-regulation (SR) is critical to healthy development in children, and intervention approaches (i.e., professional training, classroom-based curricula, parent-focused intervention) have shown to support or enhance SR. However, to our knowledge, none have tested whether changes in children’s SR across an intervention relate to changes in children’s health behavior and outcomes. This study, the Promoting Activity and Trajectories of Health (PATH) for Children-SR Study uses a cluster-randomized control trial to examine the immediate effects of a mastery-climate motor skills intervention on SR. Secondly, this study examines the associations between changes in SR and changes in children’s health behaviors (i.e., motor competence, physical activity, and perceived competence) and outcomes (i.e., body mass index and waist circumference) (ClinicalTrials.gov Identifier, NCT03189862). Methods and analysis The PATH—SR study will be a cluster-randomized clinical trial. A total of 120 children between the ages of 3.5 to 5 years of age will be randomized to a mastery-climate motor skills intervention (n = 70) or control (n = 50) condition. SR will be assessed using measures that evaluate cognitive SR (cognitive flexibility and working memory), behavioral SR (behavioral inhibition), and emotional SR (emotional regulation). Health behaviors will be assessed with motor skills, physical activity, and perceived competence (motor and physical) and health outcomes will be waist circumference and body mass index. SR, health behaviors, and health outcomes will be assessed before and after the intervention (pre-test and post-test). Given the randomization design, 70 children in the intervention group and 50 in the control group, we have 80% power to detect an effect size of 0.52, at a Type I error level of 0.05. With the data collected, we will test the intervention effect on SR with a two-sample t-test comparing the intervention group and the control group. We will further evaluate the associations between changes in SR and changes in children’s health behaviors and health outcomes, using mixed effect regression models, with a random effect to account for within-subject correlations. The PATH-SR study addresses gaps in pediatric exercise science and child development research. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development during the early years. Ethics and dissemination Ethical approval for this study was obtained through the Health Sciences and Behavioral Sciences Institutional Review Board, University of Michigan (HUM00133319). The PATH-SR study is funded by the National Institutes of Health Common Fund. Findings will be disseminated via print, online media, dissemination events and practitioner and/or research journals