ClinicalTrials.gg
CompletedNCT03374683Updated Jun 28, 2021Results posted

Randomized Controlled Trial of a Risk Reframing Tool to Change Mothers' Parenting Associated With Children's Risky Play

An interventional study of RR Digital Tool and RR In-Person Workshop in Risk Assessment and Parenting, sponsored by University of British Columbia. Completed at 1 site in Canada. Open to female participants, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-06-28.

Sponsored by University of British Columbia · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
451
Allocation
Randomized
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 96 studies in Motor Activity by University of British Columbia — 24 open to participants now, 26 under way, none of them phase 3. Motor Activity · University of British Columbia.

Enrollment
8th of 92
451 · median 61
Started
2017
with 4 others
No phase
88 of 96
22 open now
Registered
43rd of 96
by date

Among the 96 studies in Motor Activity by University of British Columbia, this one is the 8th largest by enrollment of the 92 interventional ones that give a count, is one of 5 that started in 2017, is one of 88 with no phase, and was the 43rd registered.

Motor Activity

9,798 studies on the registry are indexed under Motor Activity; 1,910 are open to participants now.

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Open to participants now

24 of the 96 studies in Motor Activity by University of British Columbia are open now, in 1 country. Recruiting first, the newest first:

19 more — sign in →

By country, each count listing its studies:

All 24 open studies →

Where they have run

Who these studies take

Of the 1,201 Motor Activity studies recruiting now, 517 (43%) set no upper age limit and 535 (45%) stop at 75 or younger; 180 take children under 18; 420 take healthy volunteers.

This study: female · healthy volunteers too.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 96 studies in Motor Activity by University of British Columbia, or all of them as a file.
02

Study summary

Children's risky play is associated with a variety of positive developmental, physical and mental health outcomes, including greater physical activity, self-confidence and risk management skills. Children's opportunities for risky play have eroded over time, limited by parents' fears and beliefs about risk, particularly among mothers. We have developed a digital and in-person workshop version of a tool to reframe parents' perceptions of risk. We examined whether the tool increased mothers' tolerance for risky play and influenced parenting behaviour change, in the short and long term, and whether these changes were greater than those in the control group.

We conducted a single-blind (researchers and outcome assessors) randomized controlled trial and recruited a total of 410 mothers of children aged 6-12 years. The risk reframing (RR) digital tool is designed for a one-time visit and includes three chapters of self-reflection and experiential learning tasks. The RR in-person tool is a 45-90 minute facilitated workshop in which participants were guided through discussions of the same tasks contained within the digital tool. The control condition consisted of reading the Position Statement on Active Outdoor Play.

Primary outcome was increased tolerance of risk in play, as measured by the Tolerance of Risk in Play Scale. Secondary outcome was self-reported attainment of a behaviour change goal that participants had set for themselves. We tested the hypothesis that there would be differences between the experimental and control groups with respect to tolerance of risk in play and goal attainment.

Read the detailed description

The study used 3-group parallel randomized controlled trial design.

Participants were recruited through advertising on social media, distributing notices through our networks, snowball sampling, and posting notices in community centres. The aim was to obtain complete data on 375 participants. Interested participants completed a questionnaire in REDCap electronic data capture tool hosted at British Columbia Children's Hospital Research Institute to answer eligibility questions and provide informed consent. Enrolled participants received a link to the baseline questionnaire package to be completed in REDcap.

Once participants were deemed eligible for the study, they were allocated to one of the three conditions: 1) Control group; 2) RR digital tool; and 3) RR in-person workshop. Participants in Condition 1 were provided with a link to the Position Statement on Active Outdoor Play, which included information on research and recommendations for action. Participants in Condition 2 were provided with a link to the RR digital tool to complete at their leisure. Participants in Condition 3, were scheduled to attend the RR in-person workshop. The randomization schedule was generated beforehand in sealedenvelop.com using blocks of size 3, 6, and 9. The list was then transferred to REDCap.

Honoraria were paid at each time point as compensation for participation. Participants attending in-person RR workshops were provided with an additional honorarium to compensate them for any expenses incurred in attending, such as travel or childcare.

Participants had an equal likelihood of assignment to each condition (33%). The nature of the intervention did not permit participant blinding but they were informed of their allocated treatment after completing the baseline questionnaires. The in-person workshop facilitator could not be blinded to allocation as the other two arms did not have a facilitator. Likewise, research staff who coordinated in-person workshop schedules could not be blinded to the allocation of the in-person workshop. However, allocations were concealed to the researchers at participant assignment and data analysis.

Participants completed a questionnaire package at three time points: Baseline, 1-week post-intervention, and 3-months post-intervention. Survey data were collected and managed using REDCap.

The study hypotheses were:

  1. Mothers completing the RR digital tool will have a significantly greater increase of tolerance for risk in play than mothers in the control condition.
  2. Mothers completing the RR in-person workshop will have a significantly greater increase of tolerance for risk in play than mothers in the control condition.
  3. A greater proportion of mothers completing the RR digital tool will attain their behaviour change goal, than mothers in the control condition.
  4. A greater proportion of mothers completing the RR in-person workshop will attain their behaviour change goal than mothers in the control condition.
03

Conditions studied

  • Risk Assessment
  • Parenting

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Keywords

  • Risky play
  • Physical activity
  • Injury prevention
  • Outdoor play
04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Being a mother with primary custody of a child/children aged 6-12 years
  • Residing in the Metro Vancouver Regional District
  • Being able to speak, read and understand English

Exclusion criteria

Exclusion Criteria:

  • Being a father
  • Not having a child between the ages of 6-12 years
  • Not having primary custody of the child
  • Not residing in Metro Vancouver Regional District
  • Limited English skills
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
451 participants (actual)

Study arms

  • Experimental
    RR Digital Tool

    Participants in the RR digital tool were provided with a link to the web-based intervention (https://outsideplay.ca) to complete within one week.

    Behavioral: RR Digital Tool

  • Active comparator
    RR In-Person Workshop

    Participants in the in-person workshop attended the 45-90 minute in-person workshop.

    Behavioral: RR In-Person Workshop

  • Sham comparator
    Position Statement on Active Outdoor Play

    Participants in the control condition were provided with a web link to the Position Statement on Active Outdoor Play, which includes information on research and recommendations for action.

    Behavioral: Position Statement on Active Outdoor Play

Interventions

  • BehavioralRR Digital Tool

    Participants proceed through three chapters in the tool: https://outsideplay.ca. Chapter 1: most important attributes they want for their child; their child's favourite play activities; their own childhood play activities; how their child's and their own play activities compare. Chapter 2: imagining themselves in three video segments where they must decide whether they allow their child to climb a tree, walk home from school, and use box cutters to build a fort. They reflect on their barriers and things that helped them let go. Chapter 3: revisiting the most important attributes they want for their child and whether there is anything they want to change, setting a realistic goal, outlining steps for attaining that goal, and setting start date.

  • BehavioralRR In-Person Workshop

    Participants engage in a facilitator guided discussion of the same tasks as the RR digital tool. Participants are taken through each task using PowerPoint slides that include the videos from the digital tool. The facilitator guide contains detailed guidance on discussion for each component and length of time to be dedicated to each slide. Participants are provided with a paper booklet to complete that mimics the online tasks.

  • BehavioralPosition Statement on Active Outdoor Play

    The position statement summarizes the issues and research regarding children's access to outdoor play and provides recommendations for various stakeholders. It states that "access to active play in nature and outdoors - with its risks - is essential for healthy child development" and recommends increasing children's opportunities for self-directed play in all settings. The Position Statement includes recommendations for parents, educators, health professionals, administrators and various level of governments to address the barriers to children's outdoor play. It addresses common misconceptions and encourages that danger be differentiated from risk and outdoor play and fun be valued as much as safety (ParticipACTION Canada, 2015; Tremblay et al., 2015).

06

What researchers measure

Primary outcomes

  1. Change in Tolerance of Risk in Play Scale (TRiPS)

    The primary outcome measure was increase in the total score on the Tolerance for Risk in Play Scale (TRiPS), a 31-item measure examining adults' tolerance of risk during children's play. This analysis was conducted using mirt package in R software (Chalmers, 2012). Rasch analysis of the baseline data resulted in dropping one item ("Do you allow this child to play-fight, testing who is strongest?") due to local dependence. Theta standardized scores from the Rasch analysis of the final 30-item TRiPS total scale ranged from -3.372 to 1.975, with a mean of 0.000 (SD 0.974). A higher standardized score indicates higher tolerance of risky outdoor play.

    Time frame: Baseline, 1-week-post-intervention, 3-month-post-intervention

Secondary outcomes

  1. Self-reported Behaviour Change

    The secondary outcome measure was self-reported behavior change, measured by participants' self-reported progress on attaining the goal they set for themselves within the risk reframing intervention. At each follow-up, participants were reminded of their goal (by asking "at the beginning of the study, you set a goal for yourself regarding something you wanted to change to give your child more opportunities for risky play. Have you made progress toward this goal?") and asked "Did you accomplish your goal?" with "Yes" and "No" response options. For the purpose of our analyses the category of "Yes" is an indication of behaviour change while the category of "No" is an indication of no behaviour change.

    Time frame: 1-week-post-intervention, 3-month-post-intervention

07

Results

Posted Jun 28, 2021
Limitations and caveats
Given the nature of the interventions, it was not possible to blind participants to their allocation, thus potentially introducing sources of bias.

Participant flow

Participants were recruited through advertising on online forums and social media, distributing notices through our networks, snowball sampling and posting notices in community centers. Recruitments were active from December 2017 to May 2018 in the Metro Vancouver area.

Participant flow — Overall Study
MilestonePosition Statement Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person Workshop
Started148150153
1-week post-intervention13511385
Completed12310584
Not completed254569

Outcome measures

PrimaryChange in Tolerance of Risk in Play Scale (TRiPS)

The primary outcome measure was increase in the total score on the Tolerance for Risk in Play Scale (TRiPS), a 31-item measure examining adults' tolerance of risk during children's play. This analysis was conducted using mirt package in R software (Chalmers, 2012). Rasch analysis of the baseline data resulted in dropping one item ("Do you allow this child to play-fight, testing who is strongest?") due to local dependence. Theta standardized scores from the Rasch analysis of the final 30-item TRiPS total scale ranged from -3.372 to 1.975, with a mean of 0.000 (SD 0.974). A higher standardized score indicates higher tolerance of risky outdoor play.

Time frame:
Baseline, 1-week-post-intervention, 3-month-post-intervention
Reported as:
Mean · score on a scale
Change in Tolerance of Risk in Play Scale (TRiPS)
score on a scalePosition Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person Workshop
Baseline outcome0.05 ± 1.03-0.14 ± 0.970.18 ± 0.87
1-week-post-intervention outcome-0.09 ± 1.03-0.06 ± 1.050.22 ± 0.80
3-month-post-intervention outcome-0.03 ± 0.92-0.09 ± 0.930.15 ± 0.80
SecondarySelf-reported Behaviour Change

The secondary outcome measure was self-reported behavior change, measured by participants' self-reported progress on attaining the goal they set for themselves within the risk reframing intervention. At each follow-up, participants were reminded of their goal (by asking "at the beginning of the study, you set a goal for yourself regarding something you wanted to change to give your child more opportunities for risky play. Have you made progress toward this goal?") and asked "Did you accomplish your goal?" with "Yes" and "No" response options. For the purpose of our analyses the category of "Yes" is an indication of behaviour change while the category of "No" is an indication of no behaviour change.

Time frame:
1-week-post-intervention, 3-month-post-intervention
Reported as:
Count of participants · Participants
Self-reported Behaviour Change
ParticipantsPosition Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person Workshop
1-week-post-intervention participants who responded — Yes768147
1-week-post-intervention participants who responded — No593238
3-month-post-intervention participants who responded — Yes999062
3-month-post-intervention participants who responded — No241522

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Risk Reframing (RR) Digital Tool———
RR In-Person Workshop———
Position Statement on Active Outdoor Play———

Baseline characteristics

Age, Continuous
Age, Continuous(years)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
Mean40.7 ± 5.340.8 ± 5.539.6 ± 5.040.29 ± 5.51
Sex: Female, Male
Sex: Female, Male(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
Female148150153451
Male0000
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
Population groups — White101112117330
Population groups — Other473836121
Marital status
Marital status(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
Married/Common-law118125131374
Other30252277
Education
Education(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
< university / college363633105
University / college668072218
> university college463246124
Missed data0224
Employment
Employment(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
Employed for wages/self employed11510744266
Unemployed3343109185
Home dwelling
Home dwelling(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
Single-detached697772218
Others797381233
Income
Income(Participants)Position Statement on Active Outdoor PlayRisk Reframing (RR) Digital ToolRR In-Person WorkshopTotal
< $63,300364033109
$63,300-$103,299494050139
>=$103,300525455161
Prefer not to answer11161542

5 further baseline measures are reported on the registry.

08

Study locations

1 site
  • British Columbia Children's Hospital Research Institute
    Vancouver, British Columbia V6H 3V4, Canada
09

References and documents

Publications

  • Tremblay MS, Gray C, Babcock S, Barnes J, Bradstreet CC, Carr D, Chabot G, Choquette L, Chorney D, Collyer C, Herrington S, Janson K, Janssen I, Larouche R, Pickett W, Power M, Sandseter EB, Simon B, Brussoni M. Position Statement on Active Outdoor Play. Int J Environ Res Public Health. 2015 Jun 8;12(6):6475-505. doi: 10.3390/ijerph120606475. PubMed 26062040 ↗
  • Sandseter EB. Characteristics of risky play. J Adventure Educ Outdoor Learn. 2009;9(1):3-21. doi:10.1080/14729670802702762.
  • Hill A, Bundy AC. Reliability and validity of a new instrument to measure tolerance of everyday risk for children. Child Care Health Dev. 2014 Jan;40(1):68-76. doi: 10.1111/j.1365-2214.2012.01414.x. Epub 2012 Jul 30. PubMed 22846064 ↗
  • ParticipACTION. The Biggest Risk Is Keeping Kids Indoors: ParticipACTION Report Card on Physical Activity for Children and Youth. Toronto, Ontario; 2015.
  • Brussoni M, Ishikawa T, Han C, Pike I, Bundy A, Faulkner G, Masse LC. Go Play Outside! Effects of a risk-reframing tool on mothers' tolerance for, and parenting practices associated with, children's risky play: study protocol for a randomized controlled trial. Trials. 2018 Mar 7;19(1):173. doi: 10.1186/s13063-018-2552-4. PubMed 29514699 ↗
  • Brussoni M, Han CS, Lin Y, Jacob J, Pike I, Bundy A, Faulkner G, Gardy J, Fisher B, Masse L. A Web-Based and In-Person Risk Reframing Intervention to Influence Mothers' Tolerance for, and Parenting Practices Associated With, Children's Outdoor Risky Play: Randomized Controlled Trial. J Med Internet Res. 2021 Apr 27;23(4):e24861. doi: 10.2196/24861. PubMed 33904820 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — The data set will be available from Dr. Brussoni upon reasonable request.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Starting upon publication of the RCT results until five years after publication.

Access criteria: Dr. Brussoni will review requests and share supporting information as indicated above with researchers and students doing similar research.

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Dec 2017 to primary completion in Sep 2018, 9 months.

Results were first posted in Jun 2021, 2 years 8 months after primary completion.

Of 5,147 non-industry interventional studies with no phase under Motor Activity, half reached primary completion within 17 months of starting (the median), counting those still running; a quarter within 7 and three quarters within 36. This study's 9 months is below that.

Counting every sponsor, half of 5,207 studies reached it within 17 months; a quarter within 7 and three quarters within 36.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 6, 2017
First posted
Dec 15, 2017
StartActual
Dec 1, 2017
Primary completionActual
Sep 30, 2018
CompletionActual
Sep 30, 2018
Results first posted
Jun 28, 2021
Last update
Jun 28, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 28, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03374683
Collaborators
The Lawson Foundation
Responsible party
Mariana Brussoni (Principal Investigator, University of British Columbia) — Principal investigator
First posted
Dec 15, 2017
Start date
Dec 1, 2017
Primary completion
Sep 30, 2018
Completion
Sep 30, 2018
Results posted
Jun 28, 2021
Last update
Jun 28, 2021

Study contacts

Mariana Brussoni, PhD
principal investigator · University of British Columbia

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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