You may not remember how you spent your days when you were four years old, but they helped shape the person you are today. You might have spent your days at a child care center, which provided outdoor play time. There you got daily physical activity that was a fundamental part of your development. It not only helped prevent obesity, but it taught you coordination, fine motor skills, social skills and more.
An alarming number of children may not be getting enough outdoor play time, said Robert Wood Johnson Foundation (RWJF) Physician Faculty Scholar Kristen A. Copeland, M.D., F.A.A.P. (2008-2011).
An assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center, Copeland and colleagues published a study on the variability of physical activity environments and outdoor play policies in licensed child care centers in the area of Hamilton County, Ohio (the greater Cincinnati area). The study appeared in the January 2011 issue of the Archives of Pediatric and Adolescent Medicine and is the second in a series of three by Copeland and her team that examines child care environments’ influence on physical activity.
Using a survey of child care center directors, Copeland assessed the playground equipment, indoor facilities, and the weather-related play policies at 162 Hamilton County child care centers.
While most centers reported having an on-site playground (151 centers), there was a substantial variability in the quality of these playgrounds. Furthermore, there was variability in the centers’ weather-related policies. Only 20 percent of the centers reported that they allow children to go outside in temperatures below 32 degrees, and 43 percent reported that they allow children outdoors in light rain.
Given the climate of Hamilton County, Copeland estimated that children in the area miss more than a month and a half of play time because of freezing temperatures, and another 132 days because of light rain.
“That’s 46 percent of the year that children are not allowed outside,” she said. “I think that’s more than any parent or pediatrician would want children to be missing play time.”
A lack of indoor play facilities also impedes efforts to give children enough physical activity, Copeland said. Her study found that only 51 percent of Hamilton County child care centers had a dedicated indoor facility that could be used when outdoor play was not permitted.
The American Academy of Pediatrics’ (AAP’s) recommendations on weather-related outdoor play are more inclusive than those of Hamilton County child care centers, Copeland noted. For instance, AAP’s guidelines say children can be taken outside so long as wind chills are not at or below -15 degrees. The state also offers some minimum criteria for outdoor play policies and physical activity promotion, but directors at individual centers have vast discretion.
“The state and individual centers could be more permissive of their weather policies, recognizing that this is probably the only chance some children have for outdoor play,” Copeland said.
Copeland and her team recently spent time at 30 of the 162 centers, measuring children’s physical activity and taking more formal assessments of the play environments. They also completed more in-depth questionnaires with teachers and parents, and hope to use the results to inform recommendations that would ensure that children have ample opportunity for daily physical activity.
The findings in Hamilton County are similar to research done in other parts of the country, Copeland said. “We have no reason to suspect we’re different from any other part of the country,” which could mean child care environments across the country are impeding ample physical activity, she added.
“Children in this age group learn better when they’re moving,” Copeland said. “Child care is where these children spend most of their time. Outdoor play is not just obesity prevention, it’s a fundamental part of healthy growth and development.”
The study was supported by the RWJF Physician Faculty Scholars program, which provides research opportunities for junior physician faculty members through mentoring, protected time, networking and the opportunity to gain valuable research experience. The program produces academic leaders who are creative and well-positioned to improve the nation’s health and health care.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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