A randomised controlled trial of an implementation strategy delivered at scale to increase outdoor free play opportunities in early childhood education and care (ECEC) services: a study protocol for the get outside get active (GOGA) trial

Sze Lin Yoong; Nicole Pearson; Kathryn Reilly; Luke Wolfenden; Jannah Jones; Nicole Nathan; Anthony Okely; Patti-Jean Naylor; Jacklyn Jackson; Luke Giles; Noor Imad; Karen Gillham; John Wiggers; Penny Reeves; Kate Highfield; Melanie Lum; Alice Grady

doi:10.1186/s12889-022-12883-w

A randomised controlled trial of an implementation strategy delivered at scale to increase outdoor free play opportunities in early childhood education and care (ECEC) services: a study protocol for the get outside get active (GOGA) trial

BMC Public Health. 2022 Mar 29;22(1):610. doi: 10.1186/s12889-022-12883-w.

Authors

Sze Lin Yoong^{1

2

3

4

5}, Nicole Pearson^{6

7

8

9}, Kathryn Reilly^{6

7

8

9}, Luke Wolfenden^{6

7

8

9}, Jannah Jones^{6

7

8

9}, Nicole Nathan^{6

7

8

9}, Anthony Okely^{10

11

12}, Patti-Jean Naylor¹³, Jacklyn Jackson^{6

7

8

9}, Luke Giles⁷, Noor Imad¹⁴, Karen Gillham⁷, John Wiggers^{6

7

8

9}, Penny Reeves^{6

8}, Kate Highfield¹⁵, Melanie Lum^{6

7

8

9}, Alice Grady^{6

7

8

9}

Affiliations

¹ School of Health Sciences, Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia. syoong@swin.edu.au.
² School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. syoong@swin.edu.au.
³ Hunter New England Population Health, Wallsend, NSW, 2287, Australia. syoong@swin.edu.au.
⁴ Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia. syoong@swin.edu.au.
⁵ Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. syoong@swin.edu.au.
⁶ School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
⁷ Hunter New England Population Health, Wallsend, NSW, 2287, Australia.
⁸ Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
⁹ Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
¹⁰ Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
¹¹ School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
¹² Illawarra Health and Medicine Research Institute, Wollongong, NSW, 2522, Australia.
¹³ School of Exercise Science, Physical and Health Education, University of Victoria, Mackinnon 120, PO Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada.
¹⁴ School of Health Sciences, Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
¹⁵ Early Childhood Australia, Canberra, ACT, Australia.

Abstract

Background: Increased outdoor play time in young children is associated with many health and developmental benefits. This study aims to evaluate the impact of a multi-strategy implementation strategy delivered at scale, to increase opportunities for outdoor free play in Early Childhood Education and Care (ECEC) services.

Methods: The study will employ a parallel-group randomised controlled trial design. One hundred ECEC services in the Hunter New England region of New South Wales, Australia, will be recruited and randomised to receive either a 6-month implementation strategy or usual care. The trial will seek to increase the implementation of an indoor-outdoor routine (whereby children are allowed to move freely between indoor and outdoor spaces during periods of free play), to increase their opportunity to engage in outdoor free play. Development of the strategy was informed by the Behaviour Change Wheel to address determinants identified in the Theoretical Domains Framework. ECEC services allocated to the control group will receive 'usual' implementation support delivered as part of state-wide obesity prevention programs. The primary trial outcome is the mean minutes/day (calculated across 5 consecutive days) of outdoor free play opportunities provided in ECEC services measured at baseline, 6-months (primary end point) and 18-months post baseline. Analyses will be performed using an intention-to-treat approach with ECEC services as the unit of analysis, using a linear mixed effects regression model to assess between-group differences. A sensitivity analysis will be undertaken, adjusting for service characteristics that appear imbalanced between groups at baseline, and a subgroup analysis examining potential intervention effect among services with the lowest baseline outdoor free play opportunities.

Discussion: Identifying effective strategies to support the implementation of indoor-outdoor routines in the ECEC setting at scale is essential to improve child population health.

Trial registration: Australian New Zealand Clinical Trials Registry ( ACTRN12621000987864 ). Prospectively registered 27th July 2021, ANZCTR - Registration.

Keywords: Early childhood education and care; Free play; Implementation trial; Indoor-outdoor; Outdoor play; Physical activity; Randomised controlled trial.

Publication types

Clinical Trial Protocol

MeSH terms

Australia
Child Health*
Child, Preschool
Health Promotion* / methods
Humans
New South Wales
Obesity
Randomized Controlled Trials as Topic

Associated data

ANZCTR/ACTRN12621000987864