Involving primary care providers may be one way to promote children’s outdoor physical activity Project Nature (PN) was initially developed as an intervention program delivered by health-care providers to promote physical activity in children ages 0-3. This study aimed to develop and pilot test an expansion of this program to promote active outdoor play in 4–10 year-old children.
This multi-stage study was conducted in cooperation with a pediatric health clinic serving primarily publicly insured children in Seattle. During the first phase, 14 parents participated in interviews discussing barriers to outdoor play for children ages 4-10. Fourteen pediatric care providers also participated in Phase 1 by sharing ideas about the feasibility and acceptability of adapting the original PN for older children. During Phase 2, the existing PN materials were adapted for the older group and reviewed by a multidisciplinary team for developmental appropriateness, consistency with the core components of PN, and considerations related to equity and inclusion. Phase 2 also included the testing of the revised materials by 20 parents and 5 clinic staff for acceptability and usability. Phase 3 consisted of a pilot evaluation of the revised program. PN materials (a brochure and nature toys) were delivered to the partner clinic and provided to 26 parents of children ages 4-10. The toy options included a kite, jump rope, bubble wand, frisbee, colored chalk, bug catcher and magnifying glass, and shovel and seeds. The participating parents completed a survey before their scheduled well-child visit during which they received the PN materials and again three weeks after the visit. During the visit, pediatric providers discussed PN with the families. In addition to the surveys completed by the parents, evaluation data also included information gathered from 4 providers about implementation of the program.
Feedback from the parents indicated that most of them (82%) liked the information they received during the clinic visit. They did not, however, use the associated website. They would have liked more information about outdoor physical activities for cold and wet weather conditions. They and the providers found the nature toy to be “the most memorable aspect of the intervention.” According to the providers, the materials facilitated conversation about physical activity (PA) changes with families. Results showed “no statistically significant changes in PA and outdoor time pre- and post-intervention,” which was expected given the small number of families involved in the study.
This research indicates that parents and providers may welcome programs like Project Nature as a practical intervention to promote outdoor active play. Further development and evaluation of this approach to intervention may help reduce health inequities in low-resourced communities.
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