title: The impact of daycare attendance on outdoor free play in young children.
abstract: Outdoor free play is important for healthy growth and development in early childhood. Recent studies suggest that the majority of time spent in daycare is sedentary. The objective of this study was to determine whether there was an association between daycare attendance and parent-reported outdoor free play.
  
  
  
  Healthy children aged 1-5 years recruited to The Applied Research Group for Kids! (TARGet Kids!), a primary care research network, were included. Parents reported daycare use, outdoor free play and potential confounding variables. Multivariable linear regression was used to determine the association between daycare attendance and outdoor free play, adjusted for age, sex, maternal ethnicity, maternal education, neighborhood income and season.
  
  
  
  There were 2810 children included in this study. Children aged 1 to <3 years (n = 1388) and ≥3 to 5 years (n = 1284) who attended daycare had 14.70 min less (95% CI -20.52, -8.87; P < 0.01) and 9.44 min less (95% CI -13.67, -5.20; P < 0.01) per day of outdoor free play compared with children who did not attend daycare, respectively.
  
  
  
  Children who spend more time in daycare have less parent-reported outdoor free play. Parents may be relying on daycare to provide opportunity for outdoor free play and interventions to promote increased active play opportunities outside of daycare are needed.
authors: Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine, The Hospital for Sick Children, Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada M5G 0A4.|Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.
authors: S
authors: S
authors: Carsley
authors: Department of Family Medicine, McMaster University, Hamilton, ON, CanadaL8S 4L8.
authors: L Y
authors: LY
authors: Liang
authors: The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, ON, CanadaM5B 1M8.
authors: Y
authors: Y
authors: Chen
authors: Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine, The Hospital for Sick Children, Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada M5G 0A4.|Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.|Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada M5G 1X8.
authors: P
authors: P
authors: Parkin
authors: Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.|The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada M5B 1M8.|Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada M5G 1X8.|Department of Pediatrics, St. Michael's Hospital, 2nd Floor St. Michael's Health Centre, Toronto, ON, Canada M5C 2T2.
authors: J
authors: J
authors: Maguire
authors: Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine, The Hospital for Sick Children, Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada M5G 0A4.|Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.|Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada M5G 1X8.
authors: C S
authors: CS
authors: Birken
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D010290:Parents; D010988:Play and Playthings; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
keywords: active outdoor play; child; child care; daycare; epidemiology; outdoor free play; preschool