Yoong Sze Lin, Pearson Nicole, Giles Luke, Lamont Hannah, Wolfenden Luke, Jones Jannah, Lecathelinais Christophe, Naylor Patti-Jean, Okely Anthony, Nathan Nicole, Reilly Kathryn, Lorch Rebecca, Wiggers John, Jackson Jacklyn, Lum Melanie, Gillham Karen, Grady Alice
Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
Int J Behav Nutr Phys Act. 2025 May 1;22(1):51. doi: 10.1186/s12966-025-01749-0.
Increased outdoor free play is associated with health and developmental benefits for preschool-aged children. It is therefore recommended that early childhood education and care (ECEC) services provide increased time for outdoor free play. This study seeks to understand the impact of a multi-component implementation strategy (Get Outside Get Active) on ECEC service provision of opportunities for outdoor free play.
This was a parallel-group randomised controlled trial involving 84 ECEC services located in one region of New South Wales, Australia. Forty-one services were randomised to a 6-month multi-component implementation strategy or to a usual care group (n = 43). To increase total scheduled outdoor free play time, services were supported to modify their routines to increase provision of outdoor free play and/or indoor-outdoor free play opportunities (whereby children are allowed to move freely between indoor and outdoor spaces). The primary trial outcome, mean minutes per day of outdoor free play opportunities provided in ECEC services, was measured at baseline, 6-months (primary endpoint), and 18-months. Secondary outcomes were mean minutes of indoor-outdoor free play only and proportion implementing indoor-outdoor free play for the full day. The quality of the movement environment was assessed using direct observations in 30 ECECs at 6 months only.
At 6 months, the intervention group showed a significant increase in mean daily minutes of outdoor free play (61.3 min; 95% CI 2.5 to 120.01; p = 0.041) and indoor-outdoor free play (59.1 min; 95% CI 9.1 to 109.1; p = 0.021) relative to the control group. However, no significant between-group differences were observed at 18 months. The proportion implementing a full-day indoor-outdoor program (OR 1.97; 95% CI 0.81 to 4.78; p = 0.196) and the quality of movement environments did not differ between groups at 6 months.
The implementation strategy significantly increased outdoor free play opportunities in ECEC services post-intervention, though the between group effects were not sustained at 18 months. Future research should focus on ensuring the long-term impact of implementation strategies and understanding the factors driving changes in control group behaviour.
This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000987864).
增加户外自由活动时间对学龄前儿童的健康和发育有益。因此，建议幼儿教育与保育（ECEC）服务机构增加户外自由活动时间。本研究旨在了解多组分实施策略（“走出去，动起来”）对ECEC服务机构提供户外自由活动机会的影响。
这是一项平行组随机对照试验，涉及澳大利亚新南威尔士州一个地区的84家ECEC服务机构。41家服务机构被随机分配到为期6个月的多组分实施策略组或常规护理组（n = 43）。为了增加预定的户外自由活动总时间，支持各服务机构调整日常安排，以增加户外自由活动和/或室内外自由活动机会（即允许儿童在室内和室外空间之间自由活动）。主要试验结果为ECEC服务机构每天提供的户外自由活动机会的平均分钟数，在基线、6个月（主要终点）和18个月时进行测量。次要结果为仅室内外自由活动的平均分钟数以及全天实施室内外自由活动的比例。仅在6个月时，通过对30家ECEC机构进行直接观察来评估运动环境质量。
在6个月时，干预组相对于对照组，户外自由活动的平均每日分钟数（61.3分钟；95%置信区间2.5至120.01；p = 0.041）和室内外自由活动的平均每日分钟数（59.1分钟；95%置信区间9.1至109.1；p = 0.021）显著增加。然而，在18个月时未观察到组间显著差异。在6个月时，实施全天室内外项目的比例（比值比1.97；95%置信区间0.81至4.78；p = 0.196）和运动环境质量在两组之间没有差异。
该实施策略在干预后显著增加了ECEC服务机构的户外自由活动机会，尽管组间效应在18个月时未持续。未来的研究应侧重于确保实施策略的长期影响，并了解驱动对照组行为变化的因素。
本试验已在澳大利亚新西兰临床试验注册中心（ACTRN12621000987864）进行前瞻性注册。
