PDF(Pubmed)
Abstract：
Families face a range of barriers in supporting their children\'s active play in nature including family circumstances, environmental constraints, and behavioral factors. Evidence-based strategies to address these barriers are needed. We aimed to develop and pilot test a primary care-based family-centered behavioral intervention to promote active outdoor play in 4-10 year-old children.
Project Nature, a provider-delivered intervention that provides informational resources and an age-appropriate toy for nature play, was initially developed for children ages 0-3. With stakeholder input, we adapted existing materials for 4-10 year-olds and conducted usability testing at an urban clinic serving families from diverse backgrounds. Subsequently, we conducted a mix-methods pilot study to evaluate intervention feasibility and acceptability. Parents of 4-10 year-olds completed pre- and post-surveys (n = 22), and a purposive subset (n = 10) completed qualitative interviews. Post-intervention, pediatric providers (n = 4) were interviewed about their implementation experiences.
The majority (82%) of parents liked the information provided and the remaining (18%) were neutral. Qualitatively, parents reported that: the toy provided a tangible element to help children and parents be active, they did not use the website, and they wished the intervention emphasized strategies for physical activity during cold and wet seasons. Providers felt the materials facilitated discussion about behavior change with families. There were no statistically significant changes in PA and outdoor time pre- and post-intervention.
Project Nature was welcomed by providers and families and may be a practical intervention to promote outdoor active play during well-child visits. Providing an age-appropriate nature toy seemed to be a critical component of the intervention, and may be worth the additional cost, time and storage space required by clinics. Building from these results, Project Nature should be revised to better support active outdoor play during suboptimal weather and evaluated to test its efficacy in a fully-powered trial.
Project Nature, a provider-delivered intervention that provides informational resources and an age-appropriate toy for nature play, was initially developed for children ages 0-3. With stakeholder input, we adapted existing materials for 4-10 year-olds and conducted usability testing at an urban clinic serving families from diverse backgrounds. Subsequently, we conducted a mix-methods pilot study to evaluate intervention feasibility and acceptability. Parents of 4-10 year-olds completed pre- and post-surveys (n = 22), and a purposive subset (n = 10) completed qualitative interviews. Post-intervention, pediatric providers (n = 4) were interviewed about their implementation experiences.
The majority (82%) of parents liked the information provided and the remaining (18%) were neutral. Qualitatively, parents reported that: the toy provided a tangible element to help children and parents be active, they did not use the website, and they wished the intervention emphasized strategies for physical activity during cold and wet seasons. Providers felt the materials facilitated discussion about behavior change with families. There were no statistically significant changes in PA and outdoor time pre- and post-intervention.
Project Nature was welcomed by providers and families and may be a practical intervention to promote outdoor active play during well-child visits. Providing an age-appropriate nature toy seemed to be a critical component of the intervention, and may be worth the additional cost, time and storage space required by clinics. Building from these results, Project Nature should be revised to better support active outdoor play during suboptimal weather and evaluated to test its efficacy in a fully-powered trial.
摘要：
背景：家庭在支持孩子在自然界中的积极游戏方面面临一系列障碍，包括家庭环境，环境限制,和行为因素。需要采取基于证据的策略来解决这些障碍。我们旨在开发和试点测试一种基于初级保健的以家庭为中心的行为干预措施，以促进4-10岁儿童的活跃户外游戏。
方法：项目性质，提供者提供的干预措施，为自然游戏提供信息资源和适合年龄的玩具，最初是为0-3岁的儿童开发的。有了利益相关者的投入，我们为4-10岁儿童调整了现有材料，并在为不同背景的家庭提供服务的城市诊所进行了可用性测试。随后，我们进行了一项混合方法试验研究,以评估干预的可行性和可接受性.4-10岁儿童的父母完成了前后调查（n=22），一个有目的的子集(n=10)完成了定性访谈。干预后，儿科提供者(n=4)接受了关于其实施经验的访谈.
结果：大多数（82％）的父母喜欢提供的信息，其余（18％）是中性的。定性,家长报告说：玩具提供了一个有形的元素，以帮助孩子和父母是积极的，他们没有使用这个网站，他们希望干预措施强调寒冷和潮湿季节的体育锻炼策略。提供者认为这些材料促进了与家庭有关行为改变的讨论。干预前后PA和室外时间无统计学意义的变化。
结论：自然项目受到提供者和家庭的欢迎，可能是促进儿童访视期间户外活跃游戏的实际干预措施。提供适合年龄的自然玩具似乎是干预的关键组成部分，并且可能值得额外的成本，诊所所需的时间和存储空间。根据这些结果，应修改“自然项目”，以更好地支持不良天气下的活跃户外游戏，并进行评估以在全功率试验中测试其功效。
方法：项目性质，提供者提供的干预措施，为自然游戏提供信息资源和适合年龄的玩具，最初是为0-3岁的儿童开发的。有了利益相关者的投入，我们为4-10岁儿童调整了现有材料，并在为不同背景的家庭提供服务的城市诊所进行了可用性测试。随后，我们进行了一项混合方法试验研究,以评估干预的可行性和可接受性.4-10岁儿童的父母完成了前后调查（n=22），一个有目的的子集(n=10)完成了定性访谈。干预后，儿科提供者(n=4)接受了关于其实施经验的访谈.
结果：大多数（82％）的父母喜欢提供的信息，其余（18％）是中性的。定性,家长报告说：玩具提供了一个有形的元素，以帮助孩子和父母是积极的，他们没有使用这个网站，他们希望干预措施强调寒冷和潮湿季节的体育锻炼策略。提供者认为这些材料促进了与家庭有关行为改变的讨论。干预前后PA和室外时间无统计学意义的变化。
结论：自然项目受到提供者和家庭的欢迎，可能是促进儿童访视期间户外活跃游戏的实际干预措施。提供适合年龄的自然玩具似乎是干预的关键组成部分，并且可能值得额外的成本，诊所所需的时间和存储空间。根据这些结果，应修改“自然项目”，以更好地支持不良天气下的活跃户外游戏，并进行评估以在全功率试验中测试其功效。
