In this cluster randomized clinical trial, a cocreated preschool physical activity policy did not increase children's physical activity beyond usual practice after 6 months.
The cocreated preschool PA policy did not change moderate to vigorous physical activity (MVPA) during preschool hours more than usual practice.
The policy did not change total physical activity during preschool hours relative to usual practice.
The policy did not change daily step counts during preschool hours relative to usual practice.
Physical activity rose similarly in both groups over the 6-month period regardless of the intervention.
The trial was large, with all randomized preschools completing follow-up.
No participants withdrew because of adverse events.
The authors conclude that adopting a PA policy does not readily translate into measurable behavior change in preschool children.
This study tested whether giving preschools a physical activity policy, developed together with the people who work in them, would get children moving more. Researchers in Stockholm randomly assigned 124 public preschools either to put the policy into practice for 6 months or to carry on as usual. Over 3,700 children aged 3 to 5 wore activity monitors during preschool hours before and after the 6 months. Children in both groups became more active over time, but the increases were almost identical. Children in policy preschools and in usual-practice preschools gained about 5.5 minutes of moderate-to-vigorous activity per day, and their total activity and step counts rose by similar amounts. The differences between groups were tiny and not statistically meaningful. No children left the study because of harm from the intervention. This research suggests that simply putting a physical activity policy in place at the preschool level may not be enough to measurably increase how much young children move during the day. The authors point out that turning a policy into real changes in behavior is complex, and that such changes can be hard to detect in preschool settings. Other approaches or stronger implementation support may be needed to boost children's activity.
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Upload Your LabsChen C, Migueles J, Ahlqvist V, Campos-Garzón P, Henriksson P, Neovius M, et al.. (2026). Preschool Physical Activity Policy and Children's Physical Activity: A Pragmatic Cluster Randomized Clinical Trial.. JAMA network open. https://doi.org/10.1001/jamanetworkopen.2026.40617