JMIR Publications

ABSTRACT

Background:

Outdoor play has always been a fundamental part of childhood. Children’s participation in outdoor play connects them to nature, the land and supports their role in the natural world. Early learning and child care (ELCC) centres provide important opportunities for outdoor play, however, barriers towards the provision of outdoor play opportunities exist, including educator attitudes, existing policies and procedures, outdoor space limitations and adverse weather conditions.

Objective:

The PROmoting Early Childhood Outside (PRO-ECO) 2.0 study is a community-based research partnership with Indigenous Knowledge Keepers and Elders, Indigenous and early childhood organizations, early childhood education faculty, ELCC centres and families, aiming to expand outdoor play in ELCC centres. This paper provides a detailed overview of the community-based design process, guided by the 5 R’s – Respect, Relevance, Responsibility, Reciprocity and Relationship – and the resulting study protocol for the mixed methods wait-list control cluster randomized trial.

Methods:

The PRO-ECO program and study protocol are implemented in partnership with 10 ELCC centres delivering licensed full-day, year-round care to children aged 2.5-6 years in rural and urban areas of British Columbia, Canada. The PRO-ECO program includes four components to address the common barriers to outdoor play in ELCC settings. Primary outcome measures include the proportion and diversity of observed nature play behaviour during dedicated outdoor times at ELCC centres as measured through observational behaviour mapping. Secondary outcomes include changes in educator attitudes, quality of ELCC outdoor play space, and children’s perspectives of their experiences at ELCC centres. Outcome data are collected at baseline, and 6-months and 12-months post-baseline. The community’s perspectives (educators, children, families) of the project are assessed qualitatively to understand the acceptability and effect of the PRO-ECO program. Mixed-effect models will test the effect of the PRO-ECO program on quantitative outcomes. Qualitative data will support interpretation of quantitative findings and provide evidence on project acceptability.

Results:

Participant recruitment for this study began in August 2023 and data collection was completed at participating ELCC centres in March 2025. A total of 227 children, 90 early childhood educators and 40 family members were recruited to participate in this study.

Conclusions:

The PRO-ECO 2.0 study ruses a rigorous and robust experimental design within a community-based research project. The 5 R’s approach grounded our work in shared values, disrupting traditional academic power relations and weaving together Indigenous and Western worldviews in the context of academic research. Clinical Trial: NCT05626595