scholarly journals A Web-Based Risk Reframing Intervention to Influence Early Childhood Educators’ Attitudes and Supportive Behaviors Toward Outdoor Play: Protocol for the OutsidePlay Study Randomized Controlled Trial (Preprint)

10.2196/31041 ◽  
2021 ◽  
Author(s):  
Mariana Brussoni ◽  
Christina S Han ◽  
John Jacob ◽  
Fritha Munday ◽  
Megan Zeni ◽  
...  
2021 ◽  
Author(s):  
Mariana Brussoni ◽  
Christina S Han ◽  
John Jacob ◽  
Fritha Munday ◽  
Megan Zeni ◽  
...  

BACKGROUND Outdoor play supports children’s physical, social, emotional and intellectual development, yet opportunities for outdoor play are declining in many societies. Early learning and childcare centers (ELCCs) can offer young children critical opportunities for quality outdoor play. There are multiple actual and perceived barriers to outdoor play in ELCCs, ranging from safety fears and lack of familiarity with supporting play outdoors to challenges around diverse perspectives on outdoor play among colleagues, administrators, licensing officers and parents. Building on OutsidePlay.ca, our previous web-based intervention to change parents’ attitudes and behaviors toward risky play, we sought to develop a web-based intervention for Canadian ELCC stakeholders. OBJECTIVE Our study objective was to develop and evaluate a web-based intervention that influences early childhood educators’ (ECEs) and ELCC administrators’ perceptions and practices in support of children’s outdoor play in ELCCs. METHODS Our study was guided by the intervention mapping process. We first completed a needs assessment through focus groups of ELCC educators, administrators and licensing officers. We identified key issues, needs and challenges, opportunities to influence behavior change, and intervention outcomes and objectives. This enabled us to develop design objectives and identify features of the OutsidePlay.ca web-based intervention that are central to addressing ECEs and ELCC administrators’ issues, needs and challenges. We used social cognitive theory and behavior change techniques to select methods, applications and technology to deliver the intervention. A mock-up of the intervention was created and revised based on ELCC stakeholders feedback and recommendations. We will use a two-parallel-group randomized controlled trial (RCT) design to evaluate the efficacy of the intervention. We will recruit 324 ECEs and ELCC administrators to randomize into the intervention or the control group. The control group is reading the Position Statement on Active Outdoor Play. RESULTS The primary outcome is increased tolerance of risk in children’s play, as measured by the Teacher Tolerance of Risk in Play Scale. The secondary outcome is self-reported attainment of a self-developed behavior change goal. We will test the hypothesis that there will be a difference between the experimental and control groups with respect to tolerance of risk in children’s play using mixed-effects models. Differences in goal attainment will be tested using logistic regression. CONCLUSIONS The OutsidePlay.ca web-based intervention guides users through a personalized journey that is split into three chapters. An effective intervention that addresses the barriers to outdoor play in ELCC settings has the potential to improve children’s access to outdoor play and support high quality early childhood education. CLINICALTRIAL ClinicalTrials.gov PRS – NCT04624932


2019 ◽  
Author(s):  
Jan van Lieshout ◽  
Joyca Lacroix ◽  
Aart van Halteren ◽  
Martina Teichert

BACKGROUND Growing numbers of people use medication for chronic conditions; non-adherence is common, leading to poor disease control. A newly developed web-based tool to identify an increased risk for non-adherence with related potential individual barriers might facilitate tailored interventions and improve adherence. OBJECTIVE To assess the effectiveness of the newly developed tool to improve medication adherence. METHODS A cluster randomized controlled trial assessed the effectiveness of this adherence tool in patients initiating cardiovascular or oral blood glucose lowering medication. Participants were included in community pharmacies. They completed an online questionnaire comprising an assessments of their risk for medication non-adherence and subsequently of barriers to adherence. In pharmacies belonging to the intervention group, individual barriers displayed in a graphical profile on a tablet were discussed by pharmacists and patients at high non-adherence risk in face to face meetings and shared with their general practitioners and practice nurses. Tailored interventions were initiated by the healthcare providers. Barriers of control patients were not presented or discussed and these patients received usual care. The primary outcome was the difference in medication adherence at 8 months follow-up between patients with an increased non-adherence risk from intervention and control group, calculated from dispensing data. RESULTS Data from 492 participants in 15 community pharmacies were available for analyses (intervention 253, 7 pharmacies; control 239, 8 pharmacies). The intervention had no effect on medication adherence (-0.01; 95%CI -0.59 – 0.57; P= .96), neither in the post hoc per protocol analysis (0.19; 95%CI -0.50 – 0.89; P=.58). CONCLUSIONS This study showed no effectiveness of a risk stratification and tailored intervention addressing personal barriers for medication adherence. Various potential explanations for lack of effect were identified. These explanations relate for instance to high medication adherence in the control group, study power and fidelity. Process evaluation should elicit possible improvements and inform the redesign of intervention and implementation. CLINICALTRIAL The Netherlands National Trial Register: NTR5186. Date: May 18, 2015 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5186)


2021 ◽  
Author(s):  
Erin K. Tagai ◽  
Suzanne M. Miller ◽  
Shawna V. Hudson ◽  
Michael A. Diefenbach ◽  
Elizabeth Handorf ◽  
...  

2021 ◽  
Vol 59 ◽  
pp. 158-163
Author(s):  
Juliet S.K. Ng ◽  
Janita P.C. Chau ◽  
Aileen W.K. Chan ◽  
Jacky K.C. Lui ◽  
James W.C.H. Cheng

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