PMID- 35687394 OWN - NLM STAT- MEDLINE DCOM- 20220614 LR - 20220809 IS - 1438-8871 (Electronic) IS - 1439-4456 (Print) IS - 1438-8871 (Linking) VI - 24 IP - 6 DP - 2022 Jun 10 TI - Evaluation of the Web-Based OutsidePlay-ECE Intervention to Influence Early Childhood Educators' Attitudes and Supportive Behaviors Toward Outdoor Play: Randomized Controlled Trial. PG - e36826 LID - 10.2196/36826 [doi] LID - e36826 AB - BACKGROUND: Outdoor play is critical to children's healthy development and well-being. Early learning and childcare centers (ELCCs) are important venues for increasing children's outdoor play opportunities, and early childhood educators' (ECE) perception of outdoor play can be a major barrier to outdoor play. The OutsidePlay-ECE risk-reframing intervention is a fully automated and open access web-based intervention to reframe ECEs' perceptions of the importance of outdoor play and risk in play and to promote a change in their practice in supporting it in ELCC settings. We grounded the intervention in social cognitive theory and behavior change techniques. OBJECTIVE: The aim of this study is to evaluate the effectiveness of the OutsidePlay-ECE web-based risk-reframing intervention. METHODS: We conducted a single-blind randomized controlled trial in Canada between December 2020 and June 2021 to test the OutsidePlay-ECE risk-reframing intervention for ECEs. We recruited participants using social media and mass emails through our partner and professional networks. We invited ECEs and administrators working in an ELCC, who can speak, read, and understand English. We randomized consented participants to the intervention or control condition. The participants allocated to the intervention condition received a link to the OutsidePlay-ECE intervention. Participants allocated to the control condition read the Position Statement on Active Outdoor Play, a 4-page document on research and recommendations for action in addressing barriers to outdoor play. The primary outcome was a change in tolerance of risk in play. The secondary outcome was goal attainment. We collected data on the web via REDCap (Vanderbilt University) at baseline and 1 week and 3 months after intervention. RESULTS: A total of 563 participants completed the baseline survey, which assessed their demographics and tolerance of risk in play. They were then randomized: 281 (49.9%) to the intervention and 282 (50.1%) to the control condition. Of these, 136 (48.4%) and 220 (78%) participants completed the baseline requirements for the intervention and control conditions, respectively. At 1 week after intervention, 126 (44.8%) and 209 (74.1%) participants completed follow-up assessments, respectively, and at 3 months after intervention, 119 (42.3%) and 195 (69.1%) participants completed the assessments, respectively. Compared with participants in the control condition, participants in the intervention group had significantly higher tolerance of risk in play at 1 week (beta=.320; P=.001) and 3 months after intervention (beta=.251; P=.009). Intention-to-treat analyses replicated these findings (beta=.335; P<.001 and beta=.271; P=.004, respectively). No significant intervention effect was found for goal attainment outcomes (odds ratio 1.124, 95% CI 0.335-3.774; P=.85). CONCLUSIONS: The results of this randomized controlled trial demonstrated that the OutsidePlay-ECE intervention was effective and had a sustained effect in increasing ECEs' and administrators' tolerance of risk in play. It was not effective in increasing goal attainment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04624932; https://clinicaltrials.gov/ct2/show/NCT04624932. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/31041. CI - (c)Mariana Brussoni, Christina S Han, Yingyi Lin, John Jacob, Fritha Munday, Megan Zeni, Melanie Walters, Eva Oberle. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 10.06.2022. FAU - Brussoni, Mariana AU - Brussoni M AUID- ORCID: 0000-0002-1495-816X AD - Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. AD - British Columbia Injury Research & Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada. AD - Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. AD - BC Children's Hospital Research Institute, Vancouver, BC, Canada. AD - School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. FAU - Han, Christina S AU - Han CS AUID- ORCID: 0000-0003-0090-4627 AD - Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. AD - BC Children's Hospital Research Institute, Vancouver, BC, Canada. FAU - Lin, Yingyi AU - Lin Y AUID- ORCID: 0000-0001-9485-7811 AD - Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States. FAU - Jacob, John AU - Jacob J AUID- ORCID: 0000-0002-2212-3250 AD - Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. FAU - Munday, Fritha AU - Munday F AUID- ORCID: 0000-0002-8370-9175 AD - School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. FAU - Zeni, Megan AU - Zeni M AUID- ORCID: 0000-0001-9621-6276 AD - Faculty of Education, University of British Columbia, Vancouver, BC, Canada. FAU - Walters, Melanie AU - Walters M AUID- ORCID: 0000-0002-1238-473X AD - Child Care Services, University of British Columbia, Vancouver, BC, Canada. FAU - Oberle, Eva AU - Oberle E AUID- ORCID: 0000-0001-7815-2563 AD - Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. AD - School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. LA - eng SI - ClinicalTrials.gov/NCT04624932 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220610 PL - Canada TA - J Med Internet Res JT - Journal of medical Internet research JID - 100959882 SB - IM MH - Attitude MH - Child MH - Child Day Care Centers MH - Child, Preschool MH - Humans MH - *Internet-Based Intervention MH - Single-Blind Method MH - Surveys and Questionnaires PMC - PMC9233267 OTO - NOTNLM OT - child care OT - early childhood education OT - outside play OT - preschool OT - risk perception OT - risk reframing OT - risky play OT - tolerance of risk in play COIS- Conflicts of Interest: The authors declare that they are both the developers and evaluators of the intervention. EDAT- 2022/06/11 06:00 MHDA- 2022/06/15 06:00 PMCR- 2022/06/10 CRDT- 2022/06/10 11:53 PHST- 2022/01/27 00:00 [received] PHST- 2022/05/10 00:00 [accepted] PHST- 2022/05/09 00:00 [revised] PHST- 2022/06/10 11:53 [entrez] PHST- 2022/06/11 06:00 [pubmed] PHST- 2022/06/15 06:00 [medline] PHST- 2022/06/10 00:00 [pmc-release] AID - v24i6e36826 [pii] AID - 10.2196/36826 [doi] PST - epublish SO - J Med Internet Res. 2022 Jun 10;24(6):e36826. doi: 10.2196/36826.