Background and Purpose
Prevalence of sedentary lifestyles has increased awareness about the importance of environments that children experience everyday, especially those where they spend significant time away from home. Thus, childcare centers have become a focus of research regarding indoor and outdoor design. Early childhood providers realize that physical changes in play areas are required to promote active lifestyles and introduce children to edible plants, and consequently are seeking help from landscape architects/designers/contractors to physically enhance their sites. However, the lack of evidence-based design guidelines (Moore & Cooper Marcus, 2008) offers an inadequate design decision-making/policy environment. Consequently, action is not taken or functionally limited improvements are executed mainly limited to the addition of manufactured play equipment. Meanwhile, nationally the children and nature movement has gained traction to the point where childcare providers are realizing that cost-effective naturalization strategies can extend the functionality and motivational power of the outdoor environment to increase both physical activity (PA) and gardening opportunities.

In 2007 North Carolina Division of Child Development replaced “playground” with “outdoor learning environment” (OLE) in the licensing rules. However, current quality assessment scales used for childcare licensing [Harms et al, 1998; Harms et al., 2006)] deal almost exclusively with indoor environments and provide insufficient guidance for outdoor development. As an effort to improve childcare center quality, including OLE, Shape NC was launched in 2011, as a multi-sector, comprehensive intervention to counteract obesity and sedentary lifestyles, coordinated by the NC Partnership for Children. Partners include the Natural Learning Initiative (NLI, known in NC as purveyors of Preventing Obesity by Design (POD), NC State University; Be Active Kids®, a signature program of the BCBSNC Foundation focused on early childhood PA; and the Center for Health Promotion and Disease Prevention, UNC Chapel Hill, developers of Nutrition and Physical Activity Self Assessment for Child Care (NAPSACC). The objective of this presentation is to share the development, use, and preliminary results of the OLE best practice indicators (BPI) developed by NLI for Shape NC to assess OLE efficacy and to provide a research-based tool usable by landscape professionals to guide design of preschool OLE layout and setting function (Moore, 1978).

Description
The BPI constitute a set of criteria to assess preschool OLE quality in support of health outcomes such as increased PA, food awareness, outdoor comfort, and reduced UV radiation exposure. The BPI evolved from several prior research initiatives: the NC Statewide Baseline Survey; the Preschool Outdoor Environment Assessment Scale (POEMS, DeBord et al. 2005); a study of 30 OLEs in NC used behavior mapping to assess design-related OLE functions (Cosco et al, 2010) and layout-PA associations (Smith et al, under review); and evaluation of 27 POD centers (Cosco et al, under review) demonstrating how specific design parameters influence PA. Indicators were identified based on these studies and offer information at a level of detail appropriate to design practice.

Lessons Learned
Annual assessments filed by Shape NC participating centers (N=20) over a three-year period show that the indicators served as guiding principles to create designs and action plans, develop sites, establish a common language among all involved, break the indoor vs. outdoor early childhood paradigm, and support longer time outdoors. Preliminary results of Shape NC assessments and policy implications will be shared (project end date: December 2013).

Conclusions and Implications
Like most states, NC childcare is a highly regulated and policy driven system. However, NC also exercises high evidential standards.  Arguments for change must be at least “evidence-informed” if not “research-based.” With this in mind, sponsored by NC DCDEE, in 2011 NLI trained 200 state regulators, licensing consultants, and environmental assessors on outdoor learning environment design and management. The project Advisory Board produced recommendations for OLE additions to the licensing rules and procedures now being considered by an internal NC DCDEE OLE committee. Furthermore, the NC Quality Rating and Improvement System – QRIS (DCDEE, 2012) currently under review now acknowledges the OLE as an “area of specialization” eligible to earn Specialization Points and designated DCDEE “Program of Distinction” at the highest level of qualification.

Next Steps
Work continues with DCDEE to substantiate the standing of OLE as a health promotion strategy, including measurement quality. Meetings with regulators, environmental assessors, and sanitation agents have refined OLE best practices, dispelled myths, and gathered support from multi-sector state authorities. In parallel, the project Preventing Obesity by Design POD3 (cubed) was launched in 2012 to impact a larger proportion of the nearly 5000 licensed childcare centers by transferring knowledge, building capacity, and extending reach. Interdisciplinary OLE education modules are being developed for delivery through community college programs in early childhood education, culinary arts, physical education, and landscape design/construction technologies. “OLE lab sites” serve as training and on-going research and demonstration best practice hubs linked to regional symposia bringing multi-sector audiences together to create “networks of excellence” to guide creation of OLEs that meet BPI.

References

1. Cosco N, Moore R, Islam Z. Behavior mapping: Linking preschool physical activity and outdoor design. Med Sci Sports Ex. 2010;42(3):513-519.
2. Cosco, N. 2006. Motivation to Move: Physical Activity Affordances in Preschool Play Areas. Doctoral Thesis. Herriot Watt University/School of Landscape Architecture. London: British Library.
3. DCDEE. Division of Child Development and Early Education. The Quality Rating and Improvement System (QRIS): Advisory Committee Executive Summary. (September, 2012).
4. DeBord et al. 2005. Preschool Outdoor Environment Assessment Scale. Winston Salem: Kaplan, Inc.
5. Harms T, Clifford R, Cryer D. Early Childhood Environment Rating Scale. Revised Edition. New York: Teachers College Press; 1998. 40 p.
6. Harms T, Cryer D, Clifford R. Infant/toddler Environment Rating Scale. Revised Edition. New York: Teachers College Press; 2006. 62 p.
7. Moore R, Cooper Marcus C. Healthy Planet, Healthy Children: Designing Nature into the Daily Spaces of Childhood. In Kellert S, Heerwagen J, Mador M, editors. Biophilic Design: The Theory, Science, and Practice of Bringing Buildings to Life. New Jersey: John Wiley & Sons; 2008. p.153-203.
8. Moore R. Meanings and Measures of Child/Environment Quality: Some Findings from the Environmental Yard. In: Rogers W, Ittelson W, editors. New Directions in Environmental Design Research. Washington DC: EDRA; 1978. p. 287-306.

Support / Funding Source
Shape NC is a program of The North Carolina Partnership for Children supported by the Blue Cross and Blue Shield of North Carolina Foundation.