JMIR Publications

ABSTRACT

Background:

Participation in outdoor play has been extensively documented as beneficial for the health, well-being and development of children. Canadian early childhood education centres (ECECs) are important settings in young children’s lives and provide opportunities to participate in outdoor play. However, there are barriers to the provision of outdoor play opportunities at ECECs, such as adverse weather conditions, poorly designed outdoor spaces, outdoor time policies and early childhood educators (ECEs) comfort levels.

Objective:

The PROmoting Early Childhood Outside (PRO-ECO) Study is a wait-list control cluster randomized trial that evaluates the impact of the PRO-ECO intervention, an innovative outdoor play intervention, on children’s outdoor play behaviour. The purpose of this paper is to provide a detailed overview of the pilot study protocol and the methods that will be used to develop, implement and evaluate the PRO-ECO intervention.

Methods:

Eight ECECs delivering licensed care to children aged 2.5 – 6 years in the Greater Vancouver region of British Columbia, Canada and operated by the Young Men’s Christian Association of Greater Vancouver (YMCA GV) are included in this study. Using a wait-list control cluster randomized trial design, we randomly allocated ECECs to either the PRO-ECO intervention arm (n = 4) or the wait-list control arm (n = 4). Primary outcome measures include changes in the proportion and diversity of observed outdoor play behavior during dedicated outdoor times at the ECECs as measured through observational behaviour mapping. Secondary outcome measures include changes in educator attitudes, quality of ECECs’ outdoor play space, and children’s psychosocial strengths, physical activity levels, and social behaviours. A process evaluation on the acceptability of the PRO-ECO intervention in the eight YMCA GV ECECs will also be assessed. Outcome data are collected at baseline, 6-month follow-up and 12-month follow-up. Mixed-effect models will test the effect of the PRO-ECO intervention on quantitative outcomes. Baseline and post-intervention data will be included in the analysis, controlling for the cluster design. Qualitative data will support quantitative findings and provide evidence on the acceptability of implementation.

Results:

Participant recruitment for this study began in August 2021 and baseline data collection was completed at all eight ECECs in November 2021. As of April 2022, 130 children have been recruited to participate in this study.

Conclusions:

The PRO-ECO pilot study will develop, implement, and evaluate the PRO-ECO intervention within eight YMCA GV ECECs in the Vancouver region of Canada. The findings of this work will be useful for ECEs, ECEC providers, and policy makers to consider means for enhancing outdoor play provision and assessing sustainability of the intervention in ECEC settings. Clinical Trial: NCT05075580