Conducting actigraphy-based studies in Bangladeshi primary schools: lessons from a pilot study

Children’s movement behaviours—including physical activity (PA), sedentary behaviour (SB), sleep, fundamental movement skills (FMS), and active play (AP)—are increasingly recognised as interrelated determinants of health within the 24-h movement paradigm. However, evidence from low- and middle-income countries (LMICs) remains limited, particularly regarding the feasibility of implementing integrated measurement protocols and interventions. This study aimed to assess the feasibility, acceptability, and methodological challenges of implementing an AP intervention alongside the assessment of PA, SB, sleep, and FMS among primary school children in Bangladesh. A pilot cluster feasibility study was conducted in two urban primary schools in Dhaka, Bangladesh. Following school recruitment, one school was allocated to receive a 4-week active play programme and the other continued usual school activities. Feasibility outcomes included recruitment, retention, intervention attendance, acceptability, and compliance with accelerometer protocols. Forty children (aged 6–12 years) completed baseline and post-test assessments, including accelerometer-based measurement, parent-reported questionnaires, and FMS assessment using TGMD-3. Feasibility outcomes included recruitment, retention, compliance, attendance, and implementation barriers. Quantitative findings were supplemented with informal discussions with children, parents, and teachers. Recruitment was challenging, with only two of fifteen schools agreeing to participate. Overall retention was 66.7%, with higher retention in the intervention group (83%). Compliance with accelerometer protocols declined over time, with device-related concerns—including discomfort, perceived surveillance, and parental burden—emerging as key barriers. Environmental constraints, safety concerns, and academic pressures further limited children’s participation in AP. Despite these challenges, among participants who remained in the study, attendance and reported enjoyment of AP sessions were high. Descriptive outcome trends suggested increases in AP participation and FMS in the intervention school; however, these findings should be interpreted cautiously given the small sample and feasibility design. Findings from two urban schools suggest that AP programmes can be implemented and are generally well received by participating children. However, recruitment challenges, attrition, and declining compliance with accelerometer protocols indicate that further protocol refinement is required before a larger multicentre feasibility study. This pilot feasibility study was not prospectively registered.