Sze Lin Yoong, Nicole Pearson, Luke Giles, Hannah Lamont, Luke Wolfenden, Jannah Jones, Christophe Lecathelinais, Patti-Jean Naylor, Anthony Okely, Nicole Nathan, Kathryn Reilly, Rebecca Lorch, John Wiggers, Jacklyn Jackson, Melanie Lum, Karen Gillham, Alice Grady
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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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Trial registration: </strong>This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000987864).</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"51"},"PeriodicalIF":5.5000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046965/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of a multi-component implementation strategy to increase outdoor free play opportunities in early childhood education and care (ECEC) services: the get outside get active (GOGA) randomised controlled trial.\",\"authors\":\"Sze Lin Yoong, Nicole Pearson, Luke Giles, Hannah Lamont, Luke Wolfenden, Jannah Jones, Christophe Lecathelinais, Patti-Jean Naylor, Anthony Okely, Nicole Nathan, Kathryn Reilly, Rebecca Lorch, John Wiggers, Jacklyn Jackson, Melanie Lum, Karen Gillham, Alice Grady\",\"doi\":\"10.1186/s12966-025-01749-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Increased outdoor free play is associated with health and developmental benefits for preschool-aged children. 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引用次数: 0
摘要
背景：增加户外自由玩耍对学龄前儿童的健康和发展有益。因此，建议幼儿教育和护理（ECEC）服务提供更多的户外自由玩耍的时间。本研究旨在了解多组件实施策略（Get Outside Get Active）对ECEC服务提供户外自由游戏机会的影响。方法：这是一项平行组随机对照试验，涉及位于澳大利亚新南威尔士州一个地区的84家ECEC服务。41项服务被随机分配到6个月的多成分实施策略或常规护理组（n = 43）。为增加总安排的户外自由游戏时间，政府支持服务机构修改常规，以增加提供户外自由游戏及/或室内外自由游戏的机会（让儿童在室内外空间自由活动）。主要试验结果是在基线、6个月（主要终点）和18个月时测量ECEC服务提供的平均每天户外自由玩耍时间。次要结果是仅在室内-室外自由玩耍的平均时间，以及全天在室内-室外自由玩耍的比例。仅在6个月时对30个ecec的运动环境质量进行直接观察。结果：6个月时，干预组儿童平均每日户外自由玩耍时间显著增加(61.3分钟；95% CI 2.5 ~ 120.01；P = 0.041)和室内外自由玩耍(59.1 min；95% CI 9.1 ~ 109.1；P = 0.021)。然而，在18个月时，组间无显著差异。实施全天室内外活动的比例(OR 1.97；95% CI 0.81 ~ 4.78；P = 0.196)， 6个月时各组运动环境质量无显著差异。结论：实施策略显著增加了干预后ECEC服务的户外自由游戏机会，尽管组间效应在18个月后没有持续。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。试验注册：该试验已在澳大利亚新西兰临床试验注册中心（ACTRN12621000987864）前瞻性注册。
Impact of a multi-component implementation strategy to increase outdoor free play opportunities in early childhood education and care (ECEC) services: the get outside get active (GOGA) randomised controlled trial.
Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
Trial registration: This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000987864).
期刊介绍：
International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain.
IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.
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