A pilot study using nature-related activities to address obesity offers support for more rigorous research

Sobko, T. ., Jia, Z. ., Kaplan, M. ., Lee, A. ., & Tseng, C.- h. . (2016). Promoting healthy eating and active playtime by connecting to nature families with preschool children. Evaluation of pilot study "Play&Grow". Pediatric Research, 81, 572-581. https://doi.org/http://dx.doi.org/10.1038/pr.2016.251

The primary purpose of this study was to evaluate the “Play&Grow” program which is designed to promote healthy dietary habits and playtime routines through adult educational experiences and “connectedness to nature” experiences in Hong Kong families with young children. Desired outcomes of the “Play&Grow” program include positive changes in dietary and physical activity habits in both pre-school children and their caregivers.

Thirty-eight preschool children (age 2-4), their mothers, and their domestic workers were recruited to participate in the study. Participating families attended one workshop each week over a four-month period. Each workshop included a health-related discussion, food-related games, and nature-related outdoor activities.

A test of lifestyle habits was administered to adult and children participants before and after the program. This test included an assessment of caregiver feeding styles, children's eating habits, and the physical activity levels of both caregivers and children. The children's “connectedness to nature” was also measured using a nature relatedness scale (NRS) adapted for pre-school age children.

Results included improvements in the caregivers' (mothers and domestic helpers) feeding practices, BMI (Body Mass Index), and physical activity. Children's activity levels did not increase. This lack of program impact on children's active play is inconsistent with other research indicating that programs with nature-related activities tend to increase physical activity. The researchers thus looked for other ways to increase children's engagement with natural elements, including more activities that weave in plants and gardening. Additional ideas were offered by parents, including forming play groups to engage children in nature-related activities.

Overall, the results of this pilot study confirm the effectiveness of the program's design protocols, evaluation instruments, and logistics. The researchers plan to conduct a more rigorous study to determine the long-term impact of Play&Grow on obesity prevention in Hong Kong.

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