The feasibility of an early-years motor skill school-based intervention research project in a low-resourced area of South Africa

Early Abstract:

Introduction: Innovative, inclusive and resource-efficient screening and intervention methods are essential to address motor skill impairment among preschool children and prevent long-term consequences. This study explores the feasibility of implementing a unique motor skill program for preschool children in low-resourced rural areas of South Africa, addressing the heightened risk of motor skill impairment in this demographic. 
Methods: Employing a quantitative pre-post quasi-experimental design with convenience sampling, the research involved assessing children using the Movement Assessment Battery for Children – second edition (MABC-2) to evaluate their motor skills. Key objectives included assessing the program's recruitment, consent, attrition, adherence, and attendance rates, alongside determining its effect on motor skills. Children who scored below the 5th percentile of the MABC-2 total score were included in the study and schools were randomly assigned to an intervention and control group. The Hopscotch program was facilitated by an occupational therapist over 8 weeks. Two weekly group sessions focused on gross and fine motor skills through obstacle courses, ball games, and craft activities. All participants in the  groups were re-assessed following the intervention. The control group received the same intervention following the post-assessment.
Quantitative attendance checklists were analysed to determine consent, assent, attrition and attendance rates. The feasibility of the MABC-2 as a data collection instrument and outcome measure was reported according to test completion rate and cost.
The initial effect of the program was determined through analysis of the pre-and post-intervention MABC-2 scores using descriptive statistics while independent samples t-test were used to determine statistically significance of between-group differences. The Minimal Important Difference (MID) for MABC-2 scores was considered to determine the clinical significance of the results. 
Results: The results revealed a high consent rate (98.08%) and a 0% attrition rate, with significant attendance at program sessions (93.75%). While independent samples t-tests indicated no statistically significant differences in motor skill improvements between the intervention and control groups, analysis considering the Minimal Important Difference (MID) demonstrated clinically significant improvements in overall motor skill proficiency and balance for the experimental group. The cost of the MABC-2 exceeded the planned budget and amounted to 77% of the total study cost. The duration for testing was one school morning for each pre- and post-test when done by five researchers.
Conclusions: The study highlights the feasibility of conducting intervention research in low-resourced settings. It notes the challenges of using the MABC-2 due to its cost and time requirements and reports on the initial effect of the program on the motor skills of the participants. Statistical significance of positive results was affected by the small sample size, however the MID was useful in indicating clinical significance of progress made in general motor skill proficiency and balance.
The feasibility study provides valuable insights to effectively plan and conduct a research project and implement a school-based motor skill intervention program in a low-resourced area. 
Keywords: feasibility, low-resourced areas, motor skill assessment, motor skill impairment, motor skill program, preschool children, rural areas, school-based intervention.