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Status unknownNCT02715544Play&GrowUpdated Aug 27, 2018

Promoting Healthy Eating and Active Playtime by Connecting Preschool Children to Nature

An interventional study of Healthy lifestyle and physical activity and dietary guidelines in Sedentary Lifestyle, Overweight and Eating Disorders, sponsored by The University of Hong Kong. Status unknown at 1 site in Hong Kong. Open to participants aged 2 Years to 6 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-08-27.

Sponsored by The University of Hong Kong · Not applicable, Interventional, and Prevention

The sponsor has not verified this record recently (last verified Aug 2018), so the status shown — last known as Recruiting — may be out of date.

From the registry’s dates

  • Registered 1 year 2 months after the study started (first participant enrolled Jan 2015, registered Mar 2016).
Phase
Not applicable
Study type
Interventional
Enrollment
240
Allocation
Randomized
Ages
2 Years to 6 Years
Sex
All
01

Study summary

Recent research suggests a majority of Hong Kong's toddlers (aged 2 to 4) are much less active than is recommended and are increasingly engaged in sedentary behaviour, which places them at risk of becoming overweight or obese. The proposed project will test whether connecting families to nature positively influences physical activity (that is, active playtime) and healthy eating routines in children aged 2 to 4. The investigators have recently conducted a pilot study Play \& Grow (P\&G), a programme based on the most successful international preschool interventions described in the literature. In addition to adopting healthy eating and physical activity intervention elements, the programme was enhanced by including a novel third element: connectedness to nature (CN). To test the effectiveness of this enhanced intervention, the plan is to run a family-based randomised controlled trial (RCT). The intervention will include 240 families with children aged 2 to 4, will take the form of one-hour activity sessions for parents and children held once a week for 10 weeks. The investigators will assess lifestyle-related habits before, immediately after the completion the intervention, at 6 months and one year after the intervention. Created for this purpose, a novel measuring tool for connectedness to nature, Nature Relatedness Scale (NRS), will be validated and tested for reliability prior to the RTC. The results of RCT are intended to be used to understand which components of the intervention were most effective. The objectives of this project will be achieved over a 36-month period, and it is expected to contribute to a close examination of key components of successful healthy lifestyle promotion programme during early childhood. The investigators predict that is that the new element CN will significantly improve the intervention. Finally, the overall aim is that connecting families to nature will result in sustainable lifestyle changes that remain with them for a lifetime.

Read the detailed description

Proper nutrition and physical activity are essential for a healthy life. Time spent in nature has also been proven beneficial. Systematic reviews have shown that nature-related activities enhance general well-being as reflected in increased physical activity, a healthier diet, reduced stress and better sleep. However, existing programmes promoting healthy lifestyles in children focus almost exclusively on diet and physical activity. None, to the inestigators's awareness, taken into consideration interactions, or connectedness with nature. Connectedness to nature/nature relatedness is a relatively new concept that, to date, has been investigated primarily in adults.The concept suggests, for example, that engaging in activities in a natural environment can induce a feeling of connectedness to nature. Exposing preschool children to nature and to thinking about nature in different ways could stimulate nature relatedness as a measurable construct. When children are placed in a natural setting, they are more likely to be physically active. Natuxral products such as fruits and vegetables are widely acknowledged to improve health. As noted above, parents are children's role models, and the investigators therefore believe that connecting parents with nature will have benefits for their children. Many habits and attitudes are developed early in life, and those related to the natural world are no exception. In fact, children are inherently interested in their environment and in nature in general. The hypothesis is that both indoor and outdoor nature-related activities may induce connectedness and bring about positive changes in both eating and activity habits (short-term outcomes) in preschool children, in turn leading to a healthier lifestyle (long-term outcomes).The aim of P\&G is to encourage healthy eating habits and active play in children from an early age, and to bring about healthy behavioural changes in families. The programme also includes a CN element designed to equip parents with environmental knowledge and skills. The generated re- and post-test comparison data indicated the effectiveness of the programme (not presented here). A detailed manual and full resource kit were created, and each session consisted of: (i) a 15-minute theoretical education component (food, activity, CN), and (ii) a 30-minute component on indoor and outdoor nature-related activities, such as playing with nature objects and searching for natural treasures. Some nature activities were food-related (e.g. growing plants, creating miniature indoor gardens, and healthy cooking). The control group received an information folder containing government-recommended physical activity and dietary guidelines for children. To enhance participation, the sessions were scheduled for weekends. The outcome data was collected using a number of scales and questionnaires addressed eating, active play and nature-related habits before and after the program, and focus group discussions were held at the beginning and end of the programme. The programme proved popular amongst participants and the results demonstrated significant positive changes on number of health-related outcomes, such as food habits and caregiver physical activity levels.

02

Conditions studied

  • Sedentary Lifestyle
  • Overweight
  • Eating Disorders

Keywords

  • Intervention
  • Physical activity
  • Eating habit
  • Connectedness to nature
03

In context

Overweight

3,670 studies on the registry are indexed under Overweight; 849 are open to participants now.

This study's planned enrollment of 240 is above the median of 73 across 3,175 interventional studies indexed under Overweight.

Browse Overweight studies →

Lead sponsor

The University of Hong Kong is the lead sponsor of 1,262 studies on the registry; 340 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years to 6 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • 2-4 year old children
  • With English-speaking parents

Exclusion criteria

Exclusion Criteria:

  • Children with chronic health conditions
  • Families who have recently taken part in a healthy lifestyle promotion programme
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
240 participants (estimated)

Study arms

  • Experimental
    Intervention group

    The group will receive healthy lifestyle intervention

    Other: Healthy lifestyle

  • Active comparator
    control group

    Other: physical activity and dietary guidelines

    Other: physical activity and dietary guidelines

Interventions

  • OtherHealthy lifestyle

    The families will receive a designed for these purposes intervention

  • Otherphysical activity and dietary guidelines

    The families will receive a designed for these purposes intervention

06

What researchers measure

Primary outcomes

  1. Eating habits

    A short validated Eating and Physical Activity Questionnaire (EPAQ)

    Time frame: 3 years

  2. Physical activity

    Physical Activity Questionnaire for Preschool-aged Children (Pre-PAQ®)

    Time frame: 3 years

  3. Nature relatedness

    a short, age-adjusted NRS scale

    Time frame: 3 years

Secondary outcomes

  1. Parental knowledge of nutrition

    Nutrition Knowledge Questionnaire (NKQ)

    Time frame: 3 years

  2. Parental feeding behaviours

    The Preschool Child Feeding Questionnaire (PCFQ)

    Time frame: 3 years

  3. weight

    weight in kilograms

    Time frame: 3 years

  4. height

    height in meters

    Time frame: 3 years

  5. child neophobia

    Pliner's Child Neophobia Scale (PCNS)

    Time frame: 3 years

07

Study locations

1 of 1 sites recruiting
  • The University of Hong Kong
    Hong Kong, 000, Hong Kong
    Recruiting
08

References and documents

Publications

  • Nisbet EK, Zelenski JM. The NR-6: a new brief measure of nature relatedness. Front Psychol. 2013 Nov 1;4:813. doi: 10.3389/fpsyg.2013.00813. eCollection 2013. PubMed 24198806 ↗
  • Cleland V, Crawford D, Baur LA, Hume C, Timperio A, Salmon J. A prospective examination of children's time spent outdoors, objectively measured physical activity and overweight. Int J Obes (Lond). 2008 Nov;32(11):1685-93. doi: 10.1038/ijo.2008.171. Epub 2008 Oct 14. PubMed 18852701 ↗
  • Dyment JE, Bell AC. Grounds for movement: green school grounds as sites for promoting physical activity. Health Educ Res. 2008 Dec;23(6):952-62. doi: 10.1093/her/cym059. Epub 2007 Oct 22. PubMed 17956885 ↗
  • Bell JF, Wilson JS, Liu GC. Neighborhood greenness and 2-year changes in body mass index of children and youth. Am J Prev Med. 2008 Dec;35(6):547-53. doi: 10.1016/j.amepre.2008.07.006. PubMed 19000844 ↗
  • Veselinovska SS, Osogovska TL: Engagement of Students in Environmental Activities in School. Procedia - Social and Behavioral Sciences 2012, 46:5015-5020.
  • Barratt Hacking E, Barratt R, Scott W: Engaging children: research issues around participation and environmental learning. Environmental Education Research 2007, 13:529-544.
  • Mullis F: Active parenting: an evaluation of two Adlerian parent education programs. Journal of Individual Psychology 1999, 55:225-232.
  • Liefländer AK, Fröhlich G, Bogner FX, Schultz PW: Promoting connectedness with nature through environmental education. Environmental Education Research 2013, 19(3):370-384
  • Cutter-Mackenzie A, Edwards S: Toward a Model for Early Childhood Environmental Education: Foregrounding, Developing, and Connecting Knowledge Through Play-Based Learning. The Journal of Environmental Education 2013, 44(3):195-213.
  • The Biophilia Hypothesis [http://books.google.com/books?hl=nl&lr=&id=qOg3-J0BoGoC&pgis=1]
  • Sobko T, Brown GTL, Cheng WHG. Does connectedness to nature improve the eating behaviours of pre-schoolers? Emerging evidence from the Play&Grow randomised controlled trial in Hong Kong. Appetite. 2020 Nov 1;154:104781. doi: 10.1016/j.appet.2020.104781. Epub 2020 Jun 30. PubMed 32615145 ↗
  • Sobko T, Jia Z, Brown G. Measuring connectedness to nature in preschool children in an urban setting and its relation to psychological functioning. PLoS One. 2018 Nov 29;13(11):e0207057. doi: 10.1371/journal.pone.0207057. eCollection 2018. PubMed 30496300 ↗
  • Sobko T, Tse M, Kaplan M. A randomized controlled trial for families with preschool children - promoting healthy eating and active playtime by connecting to nature. BMC Public Health. 2016 Jun 13;16:505. doi: 10.1186/s12889-016-3111-0. PubMed 27296723 ↗

Individual participant data

Plan to share: No — Hong Kong Ethics Committee

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 27, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02715544
Lead sponsor
The University of Hong Kong
Responsible party
Dr. Tanja Sobko (Assistant Professor, The University of Hong Kong) — Principal investigator
First posted
Mar 22, 2016
Start date
Jan 2015
Primary completion
Dec 2019 (estimated)
Completion
Dec 2020 (estimated)
Last update
Aug 27, 2018

Study contacts

Tanja Sobko, PhD
Contact
tanja.sobko@gmail.com
+85251816160
Tanja sobko
principal investigator · The University of Hong Kong

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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