title: The frequency of outdoor play for preschool age children cared for at home-based child care settings.
abstract: OBJECTIVE
  Given that more than 34% of U.S. children are cared for in home-based child care settings and outdoor play is associated with physical activity and other health benefits, we sought to characterize the outdoor play frequency of preschoolers cared for at home-based child care settings and factors associated with outdoor play.
  
  
  METHODS
  Cross-sectional study of 1900 preschoolers (representing approximately 862,800 children) cared for in home-based child care settings (including relative and nonrelative care) using the nationally representative Early Childhood Longitudinal Study, Birth Cohort.
  
  
  RESULTS
  Only 50% of home-based child care providers reported taking the child outside to walk or play at least once/day. More than one-third of all children did not go outside to play daily with either their parent(s) or home-based child care provider. There were increased odds of going outside daily for children cared for by nonrelatives in the child's home compared with care from a relative. Children with ≥3 regular playmates had greater odds of being taken outdoors by either the parents or child care provider. We did not find statistically significant associations between other child level (age, sex, screen-time), family level (highest education in household, mother's race, employment, exercise frequency), and child care level (hours in care, provider's educational attainment, perception of neighborhood safety) factors and frequency of outdoor play.
  
  
  CONCLUSIONS
  At a national level, the frequency of outdoor play for preschoolers cared for in home-based child care settings is suboptimal. Further study and efforts to increase outdoor playtime for children in home-based child care settings are needed.
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA. pooja@uw.edu
authors.forename: Pooja S
authors.initials: PS
authors.lastname: Tandon
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
mesh_terms: D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control; D010988:Play and Playthings