Early Childhood Outside (ECO) - Randomized Controlled Trial Study

NCT04624932 | Completed Results

• 1 other identifier: H19-03644
• Study Type: interventional
• Target: 563
• Locations: 1 country
• Sites: 1

Brief Summary

Outdoor play is important for children as it can promote healthy social and physical development, emotional well-being, self-confidence, risk management and overall physical activity. Yet, opportunities for outdoor play have been decreasing across generations due to perceptions that it is dangerous and unnecessary. Early childhood educators (ECEs) and administrators are struggling to provide children with high quality and stimulating outdoor play time. To help ECEs and administrators, the investigators have developed a Risk Reframing (RR) digital tool, https://outsideplay.ca, which is underpinned by social cognitive theory (SCT) and health behaviour change techniques. The aim of the current study is to test the efficacy of the RR digital tool in: 1) increasing ECEs/administrators' tolerance of risk in play; and, 2) attaining their behavior change goal in promoting children's outdoor play at their early childcare center. The investigators will conduct a single-blind (researchers and outcome assessors) randomized controlled trial and will obtain complete data on at least 206 early childhood educators and administrators currently working in Canada. The RR digital tool is designed for a one-time visit and includes three chapters of self-reflection and experiential learning tasks. The control condition consists of reading the Position Statement on Active Outdoor Play, a 2-page information sheet on children's active outdoor play. Primary outcome is increased tolerance of risk in play, as measured by the Tolerance of Risk in Play Scale - teacher version. Secondary outcome is self-reported attainment of a behaviour change goal that participants set for themselves. The investigators will test the hypothesis that there will be differences between the intervention and control conditions with respect to tolerance of risk in play and goal attainment.

Conditions

Risk Assessment; Online Intervention; Child Development

Keywords

Risk reframing tool; Children's outdoor play; Children's outdoor risky play; Early childhood education

Outcome Measures

Primary Outcomes (1)

• Change in Tolerance of Risk in Play Across Baseline, 1-week Post-intervention and 3-months Post-intervention

  This scale measures participants' tolerance of risk in outside play. Teacher Tolerance of Risk in Play Scale has 26 items of yes/no (coded as 1 and 0, respectively) survey questions of risk tolerance. To account for item difficulty and respondent trait, we convert respondents' responses to a psychometric measure that is standardized to z-scores. We standardized the measure to z-scores at each measurement time point. For example, at baseline, all respondents' (including those from control and intervention group) psychometric measures have a population mean of zero/0 and standard deviation of 1. A higher z-score means a higher tolerance of risk in play (in the case of our study, a higher score means a more favorable outcome). In this table, we present the outcome measures as absolute z-score values, rather than change from two time points. We do not consider clinically relevant threshold for this outcome measure as there is no established literature.

  Baseline, 1-week post-intervention, and 3-months post-intervention

Secondary Outcomes (1)

• Change in Attainment of a Behavior Change Goal

  1-week post-intervention, and 3-months post-intervention

Study Arms (2)

Risk Reframing (RR) Digital Tool

EXPERIMENTAL

Participants proceed through three chapters in the tool: https://outsideplay.ca. Chapter 1: reflecting on their own childhood play activities; what they got out of these experiences; outdoor play activities of the children at their center; what they do to promote children's outdoor play; what gets in the way in promoting children outdoor play. Chapter 2: imagining themselves in six video segments where they must decide how to communicate with parents; and, whether they allow children to engage in rough and tumble play, play at heights, play with tools, play at speed/mud play, and resolve conflicts amongst themselves Chapter 3: reflecting on their barriers and things that helped them promote and support the children's outdoor play at their center. Participants to assess whether there is anything they want to change to set a realistic goal, outlining steps for attaining that goal.

Behavioral: RR Digital Tool

Position Statement on Active Outdoor Play

SHAM COMPARATOR

The position statement summarizes the issues and research regarding children's access to outdoor play and provides recommendations for various stakeholders. It states that "access to active play in nature and outdoors - with its risks - is essential for healthy child development" and recommends increasing children's opportunities for self-directed play in all settings. The Position Statement includes recommendations for parents, educators, health professionals, administrators and various level of governments to address the barriers to children's outdoor play. It addresses common misconceptions and encourages that danger be differentiated from risk and outdoor play and fun be valued as much as safety.

Behavioral: Position Statement on Active Outdoor Play

Interventions

RR Digital Tool BEHAVIORAL

This is the intervention condition. Participants in this condition will take the RR digital tool available at https://outsideplay.ca.

Risk Reframing (RR) Digital Tool

Position Statement on Active Outdoor Play BEHAVIORAL

This is the control condition. Participants in this condition will read the position statement that summarizes the issues and research regarding children's access to outdoor play.

Position Statement on Active Outdoor Play

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being 19 years of age or older;
• Currently working or training in the early childhood education field in Canada; and,
• Being able to speak, read, and understand English.
• Having access to the internet

You may not qualify if:

• n/a

Sponsors & Collaborators

• University of British Columbia: lead
• The Lawson Foundation: collaborator

Study Sites (1)

British Columbia Children's Hospital Research Institute

Vancouver, British Columbia, V6H 3V4, Canada

Location

Related Publications (5)

• Tremblay MS, Gray C, Babcock S, Barnes J, Bradstreet CC, Carr D, Chabot G, Choquette L, Chorney D, Collyer C, Herrington S, Janson K, Janssen I, Larouche R, Pickett W, Power M, Sandseter EB, Simon B, Brussoni M. Position Statement on Active Outdoor Play. Int J Environ Res Public Health. 2015 Jun 8;12(6):6475-505. doi: 10.3390/ijerph120606475.

  PMID: 26062040 BACKGROUND

• ParticipACTION. The Biggest Risk Is Keeping Kids Indoors: ParticipACTION Report Card on Physical Activity for Children and Youth. Toronto, Ontario; 2015

  BACKGROUND

• Ihrig KM. Teacher tolerance of risk in play scale (T-TRiPS): Evaluating the psychometric properties of a new measure. (Unpublished master thesis). Colorado State University, Fort Collins, Colorado, USA; 2020.

  BACKGROUND

• Brussoni M, Han CS, Lin Y, Jacob J, Munday F, Zeni M, Walters M, Oberle E. Evaluation of the Web-Based OutsidePlay-ECE Intervention to Influence Early Childhood Educators' Attitudes and Supportive Behaviors Toward Outdoor Play: Randomized Controlled Trial. J Med Internet Res. 2022 Jun 10;24(6):e36826. doi: 10.2196/36826.

  PMID: 35687394 DERIVED

• Brussoni M, Han CS, Jacob J, Munday F, Zeni M, Walters M, Cheng T, Schneeberg A, Fox E, Oberle E. A Web-Based Risk-Reframing Intervention to Influence Early Childhood Educators' Attitudes and Supportive Behaviors Toward Outdoor Play: Protocol for the OutsidePlay Study Randomized Controlled Trial. JMIR Res Protoc. 2021 Nov 18;10(11):e31041. doi: 10.2196/31041.

  PMID: 34792479 DERIVED

Limitations and Caveats

Given the nature of the interventions, it was not possible to blind participants to their allocation, thus potentially introducing sources of bias.

Results Point of Contact

• Title: Dr. Mariana Brussoni
• Organization: University of British Columbia

mbrussoni@bcchr.ubc.ca

604-875-3712

Study Officials

• Mariana Brussoni

  University of British Columbia / BC Children's Hospital

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Allocations will be concealed to the researchers at participant assignment and data analysis.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: October 30, 2020
• First Posted: November 12, 2020
• Study Start: December 1, 2020
• Primary Completion: June 30, 2021
• Study Completion: June 30, 2021
• Last Updated: July 11, 2023
• Results First Posted: July 11, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Starting upon publication of the RCT results until five years after publication.
• Access Criteria: Dr. Brussoni will review requests and share supporting information as indicated above with researchers and students going similar research.

Locations

CA (1)