Sending PReschoolers OUTside (SPROUT) Prospective Cohort Study: Study Protocol (Preprint)
Bibliographic record
Abstract
BACKGROUND Active outdoor play supports children’s physical, social, and cognitive development, yet opportunities are declining as indoor, screen-based childhoods become the norm. Early Learning and Child Care (ELCC) centres are key settings for promoting outdoor play, but limited evidence exists on the health and developmental outcomes of licensed nature-based ELCC programs, particularly for children with and without disabilities. OBJECTIVE The SPROUT and SPROUT-able studies aim to examine the impact of one of Canada’s first purposely designed and built licensed outdoor-focused ELCC programs. The primary objective is to examine the health and developmental outcomes of children aged 10–59 months, with and without disabilities, attending an outdoor-focused, full-day licensed ELCC program compared to those in conventional (e.g., not outdoor-focused) ELCC settings. Secondary objectives are to: (1) examine educator job satisfaction, health, wellbeing, and attitudes toward teaching outdoors for children with and without disabilities; (2) examine caregiver beliefs and attitudes toward children’s participation in outdoor play and learning; and (3) identify barriers and facilitators to outdoor play and learning for children with and without disabilities (i.e., the SPROUT-able study) in an outdoor-focused ELCC program. METHODS This prospective longitudinal (with replacement) cohort study follows children, caregivers, and educators over three years. Participants are recruited from one outdoor-focused (experimental) and three conventional (usual care) ELCC centres in Ontario, Canada; all sites are licensed. Assessments occur every six months and include direct measures of children (anthropometry, motor skills, accelerometry) and caregiver and educator questionnaires. Mixed-effects modeling will examine changes over time and between groups (experimental vs. usual care). RESULTS As of August 2025, 86 caregiver-child dyads are enrolled in the study (67 experimental, 43 control). Of these, 70 children who enrolled at study initiation have completed baseline, and T1 and T2 assessments (43 experimental, 27 control), while 18 children enrolled at the 6-month timepoint (T1; 13 experimental, 5 control) have completed T1 and T2 (with a missing baseline assessment). Nineteen children from the experimental group were identified as having a disability meeting criteria for the SPROUT-able sub-study: four with a formal diagnosis, three with caregiver-reported functional difficulties, and 12 receiving additional support from an inclusion support worker. CONCLUSIONS By combining a holistic and comparative approach with a focus on children with and without disabilities, the SPROUT and SPROUT-able studies will generate comprehensive evidence to inform ELCC practice and policy in Canada and internationally. This model within Canada provides timely evidence on outdoor-focused ELCC delivery, integrating disability inclusive outdoor play into ELCC settings, and has the potential to guide meaningful improvements in child development, educator wellbeing, and community health and wellbeing.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Protocol About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Protocol About the Canadian research system: no · About a Canadian topic: no | Observational | high |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.009 |
| Meta-epidemiology (narrow) | 0.002 | 0.003 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.062 | 0.018 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".