BACKGROUND: and Purpose: Outdoor play is widely acknowledged for its benefits to physical health and psychological well-being, yet its relationship with school readiness remains understudied in preschoolers. To address this gap in the literature, this study investigated how outdoor play relates to cognitive and psychosocial development among a nationally representative sample of preschoolers.
METHODS: Data on the duration of outdoor play (on weekdays and weekends) and specific cognitive and psychosocial outcome variables (i.e., early learning skills, self-regulation, social-emotional development, and flourishing) were collected via questionnaires provided to the caregivers of preschoolers. Logistic regressions were performed to examine the associations between outdoor play with cognitive and psychosocial outcomes while adjusting for covariates and calculate the odds ratio with 95 % confidence intervals (CI).
RESULTS: Among the 10,682 preschoolers (i.e., 3-5y) included in this study (i.e., 5558 boys, Mage = 3.98 ± 0.99 years), there was a lower percentage of preschoolers engaged in outdoor play for over 3 h per day on weekdays (33.39 %) compared to weekends (56.85 %). Outdoor play in preschoolers is positively associated with various domains of school readiness, and engaging in outdoor play for more than 3 h per day is associated with more beneficial outcomes.
CONCLUSIONS: The findings of this cross-sectional study suggest that promoting outdoor play among preschoolers can be an effective strategy for enhancing cognitive, social, and emotional development in this age group although further intervention studies are required to buttress this assumption empirically.

Despite the growing evidence on the influence of neighborhood safety on physical activity, few studies have specifically focused on preschool-aged children and differentiated the various domains of neighborhood safety. This study investigates the relationship between parental perceptions of neighborhood safety and preschool children\'s time spent outdoors and explores potential sex differences in this relationship. This study analyzed nationally representative data from 1656 Korean children (848 boys and 808 girls) aged 3, 5, 6 years collected over the course of three waves of the Panel Study on Korean Children (PSKC). Outdoor playtime was measured by maternal reports of the time their children spent playing outdoors on a typical weekday. Parental perceptions of neighborhood safety were assessed using two items that inquired about neighborhood safety in terms of crime and accidents, respectively. Fixed effects estimates revealed that parental perceptions of social safety were associated with an increase in children\'s outdoor physical activity (b = 3.778, p < 0.05), whereas perceptions of physical safety were not. Sex-stratified models showed that the association between parental perceptions of social safety and children\'s outdoor play was driven largely by boys (b = 8.498, p < 0.001), with no association observed for girls. The findings of this study underscore the importance of addressing the social safety of neighborhood environments to promote outdoor play in preschool children. Moreover, sex differences should be considered when developing interventions aimed at increasing physical activity among young children.

UNASSIGNED: Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas.
UNASSIGNED: We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019-2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage.
UNASSIGNED: A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1-3 days (b = 0.25, 95%CI:0.04, 0.46) and 4-7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines.
UNASSIGNED: Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.

BACKGROUND: Social determinants of health (SDOH) may impact caregivers\' ability to implement evidence-based health practices at home during early childhood, especially in families with children with intellectual and developmental disabilities (IDD). Therefore, we examined the influence of SDOH and children\'s diagnosis (typically developing [TD], Down syndrome [DS], autism) on caregiver\'s self-report of meeting evidence-based health practices.
METHODS: Caregivers (n=172) of children ages 2-6 years (TD: n=93, DS: n=40, autism: n=39) completed an online survey on SDOH and health practices related to child nutrition (CN), physical activity (PA), outdoor play (OP), and screen time (ST). A total SDOH score was computed by assigning 1 point for each favorable SDOH metric (range 0-13). Linear regressions were used to examine associations between SDOH and CN, PA, OP, ST health practices and the moderating effect of IDD diagnosis.
RESULTS: Most caregivers were non-Hispanic White (84.3%), female (76.7%), 18-35 years old (55.2%), and married (89.5%). The DS group had the lowest SDOH score (mean = 8.4±1.0) compared to autism (mean = 10.1±1.0) and TD (mean = 11.0±0.9). No family scored 100% in evidence-based practices for any health practice. SDOH score was significantly associated with evidence-based practices met score for CN (b = 1.94, 95% CI = 0.84, 3.04; p = 0.001) and PA (b = 4.86, 95% CI = 2.92, 6.79; p <0.0001). Moderation analysis showed no association in the DS and autism groups between SDOH score and CN percent total score, or between SDOH score and CN, PA, and OP for percent evidence-based practices met. SDOH score was also not associated with OP percent total score for the DS group.
CONCLUSIONS: This study highlights the differential influence of SDOH on caregivers\' implementing health practices in families with children of different IDD diagnoses. Future research is needed to understand impacts of SDOH on non-typically developing children.

This study aimed to evaluate the children\'s usage and their physical activity levels at playgrounds with (N = 4) and without (N = 4) organized sports activities, following a quasi-experimental study design. Direct observations were used to assess the playground usage and estimate the playground users\' age category, sex, and physical activity intensity level. The results indicated that playgrounds with sports activities were associated with 53% more users at the time of the activities. However, this increase was only seen in boys. Furthermore, playgrounds with sport activities were not associated with different physical activity levels in children as compared to children on regular playgrounds.

Background: Children and youth benefit from outdoor play; however, environments and policies to support outdoor play are often limited. The purpose of this paper is to describe a case study of the development of a municipal outdoor play policy in Nova Scotia, Canada. The outdoor play policy was developed by the Town of Truro with support from the UpLift Partnership, a School-Community-University Partnership in Nova Scotia, Canada. UpLift supports the health and well-being of school-aged children and youth using a Health Promoting Schools approach which identifies the important role of municipal government in creating healthy school communities. The UpLift Partnership and the municipality hosted online workshops for municipal staff, community leaders and partners that included content about the importance of outdoor play, barriers and facilitators to outdoor play, best practices for youth engagement, the policy development process, and how policy actions can support outdoor play. Workshop participants developed policy actions for their community of Truro, Nova Scotia to increase opportunities for outdoor play for children and youth. Following the workshops, a small team from the municipality and UpLift drafted an outdoor play policy and submitted it to Truro town council for approval. The outdoor play policy was adopted in Fall 2021 and has since informed recreation and municipal planning decisions. By presenting a case study of the development of this outdoor play policy, we hope other communities may be inspired to develop and adopt their own outdoor play policies to benefit children and youth in their communities.

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.

BACKGROUND: This study examined the after-school activities of Japanese elementary school children in which little information is available for understanding the process by which participation in organized activities leads to the decrease in children\'s independent mobility.
METHODS: One thousand eight hundred and twenty-four mothers of elementary school children participated in an online survey. The mothers responded to the questions on the number of lessons (or cram schools) their children attended weekdays, as well as their children\'s behavior after classes, and parents providing transportation when their children go out to play.
RESULTS: The proportion of children attending lessons and/or cram schools increased as their grades progressed. A significant interaction existed between the degree of parental transportation and grade in terms of whether or not the children attended lessons and/or cram schools. Parental involvement included pick up or drop-off for a large percentage of younger children without lessons, whereas the degree of parental involvement was greater for older children attending lessons. In other words, parents of children without attending lessons or cram schools tended to allow children to engage in independent activities when they reached the higher grades, whereas parents of children who frequently attended lessons and cram schools tended to remain involved in transporting their children, even when they reached the higher grades.
CONCLUSIONS: The results suggested that the participation of children in organized activities leads to a routine of parental pickup and/or drop-off, which renders difficult the facilitation of opportunities for children to independently participate in play activities.

Outdoor play in the home yard is an important source of physical activity for many preschoolers. This study investigated if home yard size and vegetation are related to preschooler outdoor play time. High-resolution remotely sensed data were used to distinguish between types of vegetation coverage in the home yard. Shrub and tree cover, and yard size, were positively associated with outdoor play. Following stratification by socio-economic status (SES - parent education), only tree cover was positively associated with preschooler outdoor play in low SES households. All types of vegetation cover were positively associated with preschooler outdoor play in higher SES households. This study highlights the importance of larger yard sizes and higher levels of vegetation for facilitating outdoor play in preschoolers.

UNASSIGNED: For many children, public playgrounds represent environments that are playful and important in developing good health. Without efforts to facilitate climate change adaptation of outdoor playgrounds there may be a negative impact on children\'s health and well-being.
UNASSIGNED: With a special focus on play value, to explore the reasoning and described strategies among professionals responsible for development, planning and solutions concerning outdoor playgrounds in the context of climate change.
UNASSIGNED: Eight semi-structured interviews were held with purposefully selected interviewees. Analysis was conducted with manifest content analysis.
UNASSIGNED: Four themes with supporting categories; 1: a new design paradigm for outdoor play environments, 2: a need for updated regulation- and security guidelines for outdoor play environments, 3: nature-based play environments are more climate change resilient, and 4: maintenance and construction of nature-based outdoor play environments. The findings showed an overall awareness and a will to use innovative and nature-based strategies and planning to deal with climate change implications for outdoor play environments.
UNASSIGNED: The findings suggest that the strategies employed lean towards implementation of increased ecosystem services and natural elements. Ensuring strengthened resilience against hazardous climate change effects may positively facilitate diverse play activities with high play value.