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Clothing Choices Present Barrier to Outdoor Activity for Kids in Child Care Centers

CINCINNATI, Nov. 5 /PRNewswire-USNewswire/ -- Over half of US children ages 3 to 6 attend child care centers, and many may not be getting enough outdoor exercise because of the way they are dressed when they go to school.

The study, reported in BioMed Central's open access journal, International Journal of Behavioral Nutrition and Physical Activity, will be published on November 6.

A team led by Kristen Copeland, MD, Division of General and Community Pediatrics at Cincinnati Children's Hospital Medical Center, conducted a study of 53 child care providers from 34 child care centers in Cincinnati to examine why physical activity levels may vary across centers. Through a series of focus groups, they found, unexpectedly, that clothing was potentially an important barrier to children's outdoor physical activity.

Inappropriate clothing included inadequate outdoor clothing, such as a lack of coats and gloves in the wintertime; unsuitable footwear, such as flip flops; and "nice" or expensive outfits that were not to be ruined. The study found that a few children dressed improperly could prevent the entire class from going outside, thus restricting physical activity.

Dr. Copeland noted that in some child care centers, if one child in a class showed up without a coat on a chilly day, the whole class had to stay inside. "Even more surprising to our team was the fact that the child care center staff members said some parents appeared to send children to the centers without coats so they'd have to stay inside," Dr. Copeland said. "The staff attributed that to parents concerns about their children getting injured or dirty or having a cold that my be exacerbated by cold weather," she said.

"We were surprised that some teachers reported that they had seen a few parents intentionally take their child's coat with them to work, so that the child would not be allowed outside." Teachers attributed these actions to parents' concerns about their children getting sick if exposed to cold weather, concerns about clothes getting ruined, or their child getting injured, Dr. Copeland explained.

The study also revealed that clothing choices were a significant source of conflict between parents and child care providers. Caregivers suggested several reasons why parents may dress their child inappropriately, including forgetfulness, a rushed morning routine, limited income to buy clothes, a child's preference for a favorite item, and parents not understanding the importance of outdoor play.

"The study suggests that parents may need to be reminded about the importance and benefits of active play for children's development," Copeland said. She added that child care centers might consider implementing clear and specific policies regarding the type of clothes permitted at these centers so that children's active play opportunities aren't curtailed.

About Cincinnati Children's

Cincinnati Children's Hospital Medical Center is one of 10 children's hospitals in the United States to make the Honor Roll in U.S. News and World Reports 2009-10 Americas Best Children's Hospitals issue. It is #1 ranked for digestive disorders and is also highly ranked for its expertise in respiratory diseases, cancer, neonatal care, heart care, neurosurgery, diabetes, orthopedics, kidney disorders and urology. One of the three largest children's hospitals in the U.S., Cincinnati Children's is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health.

President Barack Obama in June 2009 cited Cincinnati Children's as an island of excellence in health care. For its achievements in transforming health care, Cincinnati Children's is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases. Additional information can be found at

SOURCE Cincinnati Children's Hospital Medical Center

SOURCE Cincinnati Children's Hospital Medical Center
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