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A Framework for Pediatric Health Care Providers to Promote Active Play in Nature for Children
Pooja S Tandon1,2, Kiana Hafferty1, Emily Kroshus1,2
1Seattle Children's Hospital, Seattle, WA, USA.
Insights
Barriers to children
Area of Science:
- Pediatric Health
- Environmental Health
- Child Development
Background:
- Outdoor time and nature contact benefit children's health.
- Pediatricians can promote active play in nature (APN) but face challenges.
- Understanding barriers to APN is crucial for effective promotion.
Purpose of the Study:
- To identify barriers to children's APN before and during the COVID-19 pandemic.
- To explore how healthcare providers can effectively promote APN.
- To inform strategies for integrating APN promotion into pediatric care.
Main Methods:
- Focus groups with 14 pediatric providers.
- Interviews with 14 parents of children aged 3-10 on public insurance.
- Content analysis using Dedoose, contextualized by WHO framework.
Main Results:
- Parental barriers include material (time, finances, access) and psychosocial (safety, weather) factors, worsened by the pandemic.
- Provider barriers include time constraints, competing priorities, and lack of resources.
- Pandemic exacerbated pre-existing barriers to children's APN.
Conclusions:
- Well-child visits are a potential setting for discussing APN benefits.
- Contextually appropriate resources are needed for providers and families.
- Addressing barriers is key to promoting children's APN post-pandemic.
Aim:
Time outdoors and contact with nature are positively associated with a broad range of children's health outcomes. Pediatricians are uniquely positioned to promote active play in nature (APN) but may face challenges to do so during well child visits. The objective of this study was to understand barriers to children's APN, before and during the COVID-19 pandemic, and how health care providers could promote APN.
Methods:
Focus groups were conducted with 14 pediatric providers and interviews with 14 parents (7 in English, 7 in Spanish) of children ages 3 to 10 on public insurance. Dedoose was used for coding and content analysis. We contextualized this work within the WHO's Commission on Social Determinants of Health conceptual framework.
Results:
Parents mentioned a range of material circumstances (time, finances, family circumstances, access to safe outdoor play spaces and age-appropriate activities) and behavioral/psychosocial factors (previous experiences in nature, safety, and weather concerns), many of which were exacerbated by the pandemic, that serve as barriers to children's APN. Providers said they were motivated to talk to families about children's APN but mentioned barriers to this conversation such as time, other pressing priorities for the visit, and lack of resources to give families.
Conclusions:
Many pre-pandemic barriers to APN were exacerbated by the COVID-19 pandemic. Well-child visits may be an effective setting to discuss the benefits of APN during and beyond the pandemic, and there is a need for contextually appropriate resources for pediatric providers and families.
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