Author(s): AU, W.Y., LIN, S., LEUNG, C., FONG, D., WONG, S., CHAN, D., CAPIO, C., YU, C., WONG, S., CHEN, Y., THOMPSON, W., SIU, P., Institution: THE UNIVERSITY OF HONG KONG, Country: CHINA, Abstract-ID: 261

INTRODUCTION:
Health-related quality of life (HRQOL) is an important indicator of overall wellbeing by measuring one’s perception towards his/her physical and mental state despite objective functioning. While the World Health Organization (WHO) recommends children and adolescents aged 5-17 to engage in 60-minute moderate-to-vigorous physical activity (PA) daily for health, physical inactivity is highly prevalent in this population, including preschoolers. Social isolation policies during COVID-19 pandemic not only accelerated physical inactivity, but worsened HRQOL in children. Effective interventions to curb physical inactivity and improve HRQOL are urgently needed. Positive relationship between PA and HRQOL is profound in older populations, but few rigorously-designed studies with clear intervention methodology and adequate PA dose examined the effect of PA on improving HRQOL in young children. Limited evidence in preschoolers suggested no effect of PA on HRQOL, but reliance on parent-report to assess HRQOL, and parents’ role to motivate children PA might have diminished certainty of findings, and none of them specifically investigated effectiveness during COVID-19 pandemic. Given that improving HRQOL of preschoolers has significant impact on their overall wellbeing, this study evaluated the effect of a school-based PA intervention with exercise dose benchmarked with the WHO PA guidelines, on improving self-reported HRQOL in preschoolers grown during the pandemic period of COVID-19.
METHODS:
This is an on-going cluster randomized controlled trial involving 3300 children aged 4-6 from 110 Hong Kong preschools. The first-year batch was conducted under social isolation policies of COVID-19 (9/2022-6/2023). Children were randomized into intervention or control groups according to attended schools. Control preschools continued with the usual curriculum with 2.5 hours PA/week. Intervention schools received an additional twice weekly 75-minute game-based PA class (+2.5 hours), making up to 5 hours PA/week, meeting the WHO-recommended PA levels on weekdays. HRQOL was assessed by the Kiddy-KINDL instrument in 6 aspects: 1) physical & 2) psychological well-being; 3) self-esteem; 4) family; 5) friends, and 6) daily functioning. Generalized estimating equations adjusted for baseline values was used to assess treatment effects.
RESULTS:
The first-year batch included 207 children from 10 schools [116 intervention, 91 control; mean age=5.27 years (SD 0.38); 103 girls]. Significant intervention effect was found on HRQOL over a school year (intervention +0.5%; control -4.6%; p=0.004).
CONCLUSION:
These preliminary findings suggested that kindergarten-based PA intervention might have attenuated the general decline in HRQOL during COVID-19 pandemic, showing the importance and potential of PA to improve preschoolers’ overall wellbeing. Results in the coming years will substantiate whether positive effect of PA on HRQOL can be sustained in post-COVID years.