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Arch Pediatr Adolesc Med. 2011 May;165(5):435-42. doi: 10.1001/archpediatrics.2010.267. Epub 2011 Jan 3.

Wide variability in physical activity environments and weather-related outdoor play policies in child care centers within a single county of Ohio.

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General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.



To examine the variability of physical activity environments and outdoor play policies in child care centers and to determine whether this variability is associated with the demographic characteristics of the child care centers surveyed.


Early Learning Environments Physical Activity and Nutrition Telephone Survey.


Child care centers in Hamilton County (greater Cincinnati area), Ohio, during the period from 2008 to 2009.


Directors of all 185 licensed full-time child care centers in Hamilton County.


Descriptive measures of playground and indoor physical activity environments and weather-related outdoor play policies.


Of 185 eligible child care centers, 162 (88%) responded to our survey. Of the 162 centers that responded, 151 (93%) reported an on-site playground, but slightly more than half reported that their playgrounds were large, that they were at least one-third covered in shade, or that they had a variety of portable play equipment. Only half reported having a dedicated indoor gross motor room where children could be active during inclement weather. Only 32 centers (20%) allowed children to go outside in temperatures below 32°F (0°C), and 70 centers (43%) reported allowing children outdoors during light rain. A higher percentage of children receiving tuition assistance was associated with lower quality physical activity facilities and stricter weather-related practices. National accreditation was associated with more physical activity-promoting practices.


We found considerable variability in the indoor and outdoor physical activity environments offered by child care centers within a single county of Ohio. Depending on the outdoor play policy and options for indoor physical activity of a child care center, children's opportunities for physical activity can be curtailed as a result of subfreezing temperatures or light rain. Policy changes and education of parents and teachers may be needed to ensure that children have ample opportunity for daily physical activity.

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