PROmoting Early Childhood Outside 2.0

NCT05626595 | Completed

• 1 other identifier: H20-01362
• Study Type: interventional
• Target: 307
• Locations: 1 country
• Sites: 10

Brief Summary

Licensed early learning and childcare centres (ELCCs) can provide children with rich opportunities for outdoor play that they may not otherwise experience in their home or community. However, many ELCCs struggle to provide high quality and stimulating outdoor play time. The primary aim of this study is to develop, implement and test a comprehensive multi-component project, the PROmoting Early Childhood Outside (PRO-ECO), to build capacity for, and address the complexities of building support for outdoor play in early childcare centre settings. This is to ultimately increase children's access to engaging outdoor spaces for play. The overarching goal of this project is to develop and evaluate a comprehensive multi- component project, called the PROmoting Early Childhood Outside (PRO- ECO). This project is to increase children's outdoor play and the diversity of outdoor play behaviour in Canadian ELCC settings providing full-day licensed care for preschoolers. PRO-ECO integrates development of policies and procedure, early childhood educator (ECE) training and mentorship, outdoor space modifications and, parent/caregiver engagement. The PRO-ECO project will be co-developed, implemented and evaluated in partnership with provincial childcare organizations and ten ELCCs. A wait-list control cluster randomised trial design (RCT) will evaluate the effectiveness of the project and how it can be modified to tackle barriers in diverse settings. This project is an extension of the PRO-ECO pilot study (protocol ID H20-03912-A001, Clinicaltrials.gov ID NCT05073380).

Conditions

Child Development

Keywords

Children's outdoor play; Children's outdoor risky play; Early childhood education

Outcome Measures

Primary Outcomes (1)

• Assessing children's time spent in bio play

  To assess children's participation play that includes interaction with natural environment elements at ELCCs, an observational behavior mapping (OBM) methodology will be used. OBM involves understanding how an environment supports movement through mapping, recording, and analyzing geographically located data.

  Project Group - Change of prevalence of bio play at 5-months and 10-months post-project implementation (Spring 2024 and Fall 2024); Wait List Control Group - Change of prevalence of bio play at 5-months post-project implementation (Fall 2024)

Secondary Outcomes (5)

• Assessing the diversity of play types children engage in

  Project Group - Change in play diversity at 5-months and 10-months post-project implementation (Spring 2024 and Fall 2024); Wait List Control Group - Change in play diversity at 5-months post-project implementation (Fall 2024)

• Quality of early childhood education centres' outdoor play spaces

  Project and Wait-list Control Group - Change in Seven C's Score at 5-months post-project implementation (Spring 2024; Fall 2024)

• Early childhood educators' attitudes towards outdoor risky play

  Project and Wait-list Control Group - Change in educators' attitudes at 5-months post-project implementation (Spring 2024; Fall 2024)

• Acceptability and feasibility of PRO-ECO project

  Project and Wait-list Control Group - Change in educator and parent perspectives at 5-months post-project implementation (Spring 2024; Fall 2024)

• Assessing children's time spent in outdoor play

  Project Group - Change of prevalence of play at 5-months and 10-months post-project implementation (Spring 2024 and Fall 2024); Wait List Control Group - Change of prevalence of play at 5-months post-project implementation (Fall 2024)

Study Arms (2)

Control

EXPERIMENTAL

Outdoor play is an essential component of childhood development, including supporting children's cognitive, physical, emotional, and social growth. Currently, the early learning and childcare centres (ELCCs) host children within childcare settings, with outdoor playtime governed by institutional regulations.

Behavioral: Wait List Group - Normal Daily Practice

Project

SHAM COMPARATOR

The PRO-ECO project to increase the quality of outdoor play involves four primary components: 1. Modifying ELCC's outdoor play policies: the ELCC policy on outdoor play requirements and procedures will be modified in conjunction with ELCC management. 2. ECE training and mentorship: ECEs will undergo the Learning Outside Together (LOT) program, which incorporates traditional wisdom into training on Indigenous ways of knowing, learning and experiencing the land as teacher. 3. ELCC outdoor space modification: This includes designing and implementing tailored modifications for each centre's outdoor play space developed by landscape architecture students. 4. Parent engagement: ELCCs will host parent-engagement events and opportunities to increase knowledge of the importance of outdoor play.

Behavioral: Project Group - PRO-ECO Project

Interventions

Project Group - PRO-ECO Project BEHAVIORAL

The PRO-ECO project will be tailored to individual sites. Through collection of focus group and baseline data, the project will be further refined to provide site-specific adjustments, such as specific materials in the built environment design modification or targeted training. Identified features of effective projects outlined in the literature have informed the development of the project foundation and potential tailoring.

Project

Wait List Group - Normal Daily Practice BEHAVIORAL

ELCCs that are randomly assigned to the waitlist group will participate in their normal daily practice, including standard curriculum and outdoor play time. Once post-data collection is complete, wait list sites will be given the PRO-ECO project.

Control

Eligibility Criteria

• Age: 30 Months - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may not qualify if:

• We will select ELCCs providing full day care to preschool children to include in the study in consideration of readiness of program to participate and perceived need for the program, and time spent.
• Being early childhood educators (ECEs) or staff (e.g., administrators, directors and supervisors) at the participating ELCCs.
• Being between the ages of 2.5 to 6 years;
• Currently enrolled in one of the participating ELCCs;
• Obtained parental consent for their participation in the study.

Sponsors & Collaborators

• University of British Columbia: lead
• Government of Canada: collaborator

Study Sites (10)

Curious Minds

Canal Flats, British Columbia, Canada

Location

Outdoor Paradise

Cariboo, British Columbia, Canada

Location

Turtle Island

Chetwynd, British Columbia, Canada

Location

Kinnikinnick

Cranbrook, British Columbia, Canada

Location

NW

Fort St. James, British Columbia, Canada

Location

Ogopogo

Grand Forks, British Columbia, Canada

Location

Bird's Nest

Lytton, British Columbia, Canada

Location

Lily of the Valley

Surrey, British Columbia, Canada

Location

The Nest

Victoria, British Columbia, Canada

Location

Kulilu

Windermere, British Columbia, Canada

Location

Related Publications (1)

• Brussoni M, Ramsden R, Grieve S, Mount D, Fox E, Herrington S, Lin Y, Johnson SE, Lloyd J, Elliot E, Mlieczko E, Lemire A, Scott L, Barrett A, Cottier E, Rice A. The 5 R's of Indigenous Research as a Framework to Co-Design and Evaluate an Outdoor Play Program in Early Learning and Child Care Centers: Protocol for the Promoting Early Childhood Outside (PRO-ECO) 2.0 Wait-List Control Cluster Randomized Trial. JMIR Res Protoc. 2025 Dec 12;14:e77956. doi: 10.2196/77956.

  PMID: 41385788 DERIVED

Study Officials

• Mariana Brussoni

  University of British Columbia

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: November 7, 2022
• First Posted: November 25, 2022
• Study Start: September 1, 2023
• Primary Completion: October 24, 2024
• Study Completion: March 20, 2025
• Last Updated: April 6, 2025

Record last verified: 2025-04

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: The data requests will be reviewed by the PRO-ECO Project Steering Committee, ELCC partners and Dr. Brussoni.

Locations

CA (10)