Canadian children's independent mobility during the COVID-19 pandemic: A national survey.

Independent mobility (IM) is associated with children's physical activity and indicators of social, motor, and cognitive development. We surveyed Canadian parents of 7- to 12-year-olds (n = 2291) about social-ecological correlates of IM in the second wave of COVID-19 (December 2020). We used multi-variable linear regression models to identify correlates of children's IM. Our final model (R2 = 0.353) included four individual-, eight family-, two social environment- and two built environment-level variables. The correlates of boys' and girls' IM were similar. Our findings suggest that interventions to support children's IM in a pandemic context should target multiple levels of influence.

An Intervention to Increase Outdoor Play in Early Childhood Education Centers (PROmoting Early Childhood Outside): Protocol for a Pilot Wait-list Control Cluster Randomized Trial.

BACKGROUND: Participation in outdoor play has been extensively documented as beneficial for the health, well-being, and development of children. Canadian early childhood education centers (ECECs) are important settings in young children's lives and provide opportunities to participate in outdoor play. However, there are barriers to the provision of outdoor play opportunities at ECECs, such as adverse weather conditions, poorly designed outdoor spaces, outdoor time policies, and early childhood educator comfort levels. OBJECTIVE: The PROmoting Early Childhood Outside (PRO-ECO) study is a wait-list control cluster randomized trial that evaluates the impact of the PRO-ECO intervention, an innovative outdoor play intervention, on children's outdoor play behavior. The purpose of this paper was to provide a detailed overview of the pilot study protocol and the methods that will be used to develop, implement, and evaluate the PRO-ECO intervention. METHODS: A total of 8 ECECs delivering licensed care to children aged 2.5 to 6 years in the Greater Vancouver region of British Columbia, Canada, and operated by the YMCA of Greater Vancouver (YMCA GV) are included in this study. Using a wait-list control cluster randomized trial design, we randomly allocated ECECs to either the PRO-ECO intervention arm (n=4) or the wait-list control arm (n=4). The primary outcome measures include changes in the proportion and diversity of observed outdoor play behavior during dedicated outdoor times at the ECECs as measured through observational behavior mapping. Secondary outcome measures include changes in educator attitudes; quality of ECECs' outdoor play space; and children's psychosocial strengths, physical activity levels, and social behaviors. A process evaluation of the acceptability of the PRO-ECO intervention in the 8 YMCA GV ECECs will also be assessed. Outcome data will be collected at baseline, 6-month follow-up, and 12-month follow-up. Mixed effect models will test the effect of the PRO-ECO intervention on quantitative outcomes. Baseline and postintervention data will be included in the analysis, controlling for the cluster design. Qualitative data will support quantitative findings and provide evidence for the acceptability of implementation. RESULTS: Participant recruitment for this study began in August 2021, and baseline data collection was completed at all 8 ECECs in November 2021. As of April 2022, a total of 130 children have been recruited to participate in this study. CONCLUSIONS: The PRO-ECO pilot study will develop, implement, and evaluate the PRO-ECO intervention within 8 YMCA GV ECECs in the Vancouver region of British Columbia, Canada. The findings of this study will be useful for early childhood educators, ECEC providers, and policy makers to consider means for enhancing outdoor play provision and assessing the sustainability of the intervention in ECEC settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT05075580; https://clinicaltrials.gov/ct2/show/NCT05073380. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38365.

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.

BACKGROUND: 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 at ELCCs, ranging from safety fears and lack of familiarity with supporting play outdoors to challenges around diverse perspectives on outdoor play among early childhood educators (ECEs), administrators, licensing officers, and parents. OBJECTIVE: Our study objective is to develop and evaluate a web-based intervention that influences ECEs' and ELCC administrators' perceptions and practices in support of children's outdoor play at ELCCs. METHODS: The development of the fully automated, open-access, web-based intervention was guided by the intervention mapping process. We first completed a needs assessment through focus groups of ECEs, ELCC 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 web-based intervention that are central to addressing the issues, needs, and challenges of ECEs and ELCC administrators. We used social cognitive theory and behavior change techniques to select methods, applications, and technology to deliver the intervention. 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 through a variety of web-based means, including Facebook advertisements and mass emails through our partner networks. The RCT study will be a purely web-based trial where outcomes will be self-assessed through questionnaires. The RCT participants will be randomized into the intervention group or the control group. The control group participants will read 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 use mixed effects models to test the hypothesis that there will be a difference between the intervention and control groups with respect to tolerance of risk in children's play. Differences in goal attainment will be tested using logistic regression analysis. CONCLUSIONS: The OutsidePlay web-based intervention guides users through a personalized journey that is split into 3 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. TRIAL REGISTRATION: ClinicalTrials.gov NCT04624932; https://clinicaltrials.gov/ct2/show/NCT04624932. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31041.

Few Canadian children and youth were meeting the 24-hour movement behaviour guidelines 6-months into the COVID-19 pandemic: Follow-up from a national study.

Daily life has changed for families due to the COVID-19 pandemic. The aim of this repeated cross-sectional study was to describe movement behaviours in Canadian children and youth 6 months into the pandemic (T2; October 2020) compared with the start of the pandemic (T1, April 2020). An online survey was distributed to parents (N = 1568) of children and/or youth (5-17 years; 58% girls) in October 2020. The survey assessed changes in movement behaviours (physical activity and play, sedentary behaviours, and sleep) from before the pandemic to October 2020 (T2). We compared these data with spring data (T1; April 2020; Moore et al. 2020; Int. J. Behav. Nutr. Phys. Act, 17:85) collected using identical methodology (N = 1472; 54% girls). We report correlations between movement behaviours and relevant parental factors and provide word frequency distributions for open-ended responses. During the second wave, 4.5% of children (4.6% girls; 4.3% boys) and 1.9% of youth (1.3% girls, 2.4% boys) met the movement guidelines (3.1% overall). Whereas, during the first wave, 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined guidelines (2.6% overall). Parental support was correlated with their child's movement behaviours (T1 and T2). Our study demonstrates the ongoing challenges for children and youth to engage in healthy movement during the pandemic. Novelty: Our large-scale national study demonstrates that children and youth were not meeting the 24-hour movement guidelines during the second wave of the pandemic. Our findings illustrate the need to protect children and youth from the collateral consequences of the pandemic.

"You Can't Go to the Park, You Can't Go Here, You Can't Go There": Exploring Parental Experiences of COVID-19 and Its Impact on Their Children's Movement Behaviours.

The COVID-19 outbreak and related public health guidelines have changed the daily lives of Canadians and restricted opportunities for healthy movement behaviours for children. The purpose of this study was to explore how parents experienced the pandemic-related restrictions and how they impacted their children's movement behaviours. Methods: Twenty-nine semi-structured one-on-one interviews were conducted (June-July 2020) with parents of children (5-11 years old) in Ontario and British Columbia. Interviews lasted between 24-104 min, were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Findings emphasized various individual (e.g., motivation), interpersonal (e.g., parent work schedule), built (e.g., closure of parks) and natural environment (e.g., weather) factors related to children's movement behaviours. The findings highlighted the loss of structured activities and destinations for children's physical activity, and restricted opportunities for outdoor play exacerbated by shrinking childhood independent mobility. Conclusion: Families are adapting to many pandemic-related challenges including adhering to public health restrictions, parents juggling multiple roles, conducting work and school from home, as well as exacerbating factors like weather. It will be important to continue to encourage outdoor time, support policies and practice that facilitate independent mobility, and develop centralized resources that help families in the maintenance of healthy movement behaviours.

Healthy movement behaviours in children and youth during the COVID-19 pandemic: Exploring the role of the neighbourhood environment.

This paper explores patterns of increased/ decreased physical activity, sedentary and sleep behaviours among Canadian children and youth aged 5-17 years during the COVID-19 pandemic, and examines how these changes are associated with the built environment near residential locations. A cluster analysis identified two groups who were primarily distinguished by the changes in outdoor activities. Compliance to 24-hour movement guidelines was low among both groups. For children, houses (versus apartments) was correlated with increased outdoor activities; proximity to major roads was a barrier. For youth, low dwelling density, and access to parks in high-density neighbourhoods, increased the odds of increased outdoor activities during the pandemic. Our findings can inform future urban and health crisis planning practices by providing new insights into the desirable public health messaging and characteristics of healthy and resilient communities.

Street masking: a network-based geographic mask for easily protecting geoprivacy.

BACKGROUND: Geographic masks are techniques used to protect individual privacy in published maps but are highly under-utilized in research. This leads to continual violations of individual privacy, as sensitive health records are put at risk in unmasked maps. New approaches to geographic masking are required that foster accessibility and ease of use, such that they become more widely adopted. This article describes a new geographic masking method, called street masking, that reduces the burden on users of finding supplemental population data by instead automatically retrieving OpenStreetMap data and using the road network as a basis for masking. We compare it to donut geomasking, both with and without population density taken into account, to evaluate its efficacy against geographic masks that require slightly less and slightly more supplemental data. Our analysis is performed on synthetic data in three different Canadian cities. RESULTS: Street masking performs similarly to population-based donut geomasking with regard to privacy protection, achieving comparable k-anonymity values at similar median displacement distances. As expected, distance-based donut geomasking performs worst at privacy protection. Street masking also performs very well regarding information loss, achieving far better cluster preservation and landcover agreement than population-based donut geomasking. Distance-based donut geomasking performs similarly to street masking, though at the cost of reduced privacy protection. CONCLUSION: Street masking competes with, if not out-performs population-based donut geomasking and does so without requiring any supplemental data from users. Moreover, unlike most other geographic masks, it significantly minimizes the risk of false attribution and inherently takes many geographic barriers into account. It is easily accessible for Python users and provides the foundation for interfaces to be built for non-coding users, such that privacy can be better protected in sensitive geospatial research.

Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey.

BACKGROUND: Healthy childhood development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This secondary data analysis examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth. METHODS: A national sample of Canadian parents (n = 1472) of children (5-11 years) or youth (12-17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported. RESULTS: Only 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including leisure screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources. CONCLUSIONS: This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.