JMIR Publications

ABSTRACT

Background:

Outdoor risky play, such as climbing, racing and independent exploration, is an important part of childhood and is associated with various positive physical, mental and developmental outcomes for children. Parental attitudes and fears, particularly mothers’, are a major deterrent to children’s opportunities for outdoor risky play.

Objective:

To evaluate the efficacy of two versions of an intervention to reframe mothers’ perceptions of risk and change parenting behaviours: web-based intervention or an in-person workshop, compared to the control condition.

Methods:

The Go Play Outside! randomized controlled trial was conducted in Canada in 2017 to 2018. Participants were recruited through social media, snowball sampling, and community notices. Mothers of children aged 6-12 years were self-assessed through eligibility questions, and those eligible and consented to participate in the study were randomized into a fully automated web-based intervention, the in-person workshop or the control condition. The intervention was underpinned by social cognitive theory, incorporating behaviour change techniques. Participants progressed through a series of self-reflection exercises and developed a goal for change. Control participants received the Position Statement on Active Outdoor Play. The primary outcome was increase in tolerance of risky play and the secondary outcome was goal attainment. Data were collected online via REDCap at baseline, 1-week and 3-months post-intervention. Randomization was conducted using sealedenvelope.com. Allocations were concealed to researchers at assignment and data analysis. We conducted mediation analyses to examine whether the intervention influenced elements of social cognitive theory, as hypothesized.

Results:

A total of 451 mothers were randomized and completed baseline socio-demographic assessments: 150 in the web-based intervention, 153 in the in-person workshop, and 148 in the control condition; of which a total of 351 mothers completed the intervention. At 1-week post-intervention, 121, 85, and 135 mothers completed assessments for each condition, respectively, and at 3-months post-intervention, 105, 84 and 123 completed the assessments, respectively. Compared to mothers in the control condition, mothers in the web-based intervention had significantly higher tolerance of risky play at 1-week, and 3-months post-intervention; and mothers in the in-person workshop had significantly higher tolerance of risky play at 1-week post-intervention. No other significant outcomes were found. None of the potential mediators were found to significantly mediate the outcomes.

Conclusions:

The trial demonstrates that the web-based intervention was effective in increasing mothers’ tolerance for risk in play. Clinical Trial: ClinicalTrials.gov, NCT03374683. Retrospectively registered on December 15, 2017.