Background: Outdoor risky play, such as climbing, racing, and independent exploration, is an important part of childhood and is associated with various positive physical, mental, and developmental outcomes for children. Parental attitudes and fears, particularly mothers’, are a major deterrent to children’s opportunities for outdoor risky play. Objective: The aim of this study was to evaluate the efficacy of 2 versions of an intervention to reframe mothers’ perceptions of risk and change parenting behaviors: a web-based intervention or an in-person workshop, compared with the control condition. Methods: The Go Play Outside! randomized controlled trial was conducted in Canada from 2017 to 2018. Participants were recruited through social media, snowball sampling, and community notices. Mothers of children aged 6-12 years were self-assessed through eligibility questions, and those eligible and consented to participate in the study were randomized into a fully automated web-based intervention, the in-person workshop, or the control condition. The intervention was underpinned by social cognitive theory, incorporating behavior change techniques. Participants progressed through a series of self-reflection exercises and developed a goal for change. Control participants received the Position Statement on Active Outdoor Play. The primary outcome was increase in tolerance of risky play and the secondary outcome was goal attainment. Data were collected online via REDCap at baseline, 1 week, and 3 months after the intervention. Randomization was conducted using sealed envelope. Allocations were concealed to researchers at assignment and data analysis. We conducted mediation analyses to examine whether the intervention influenced elements of social cognitive theory, as hypothesized. Results: A total of 451 mothers were randomized and completed baseline sociodemographic assessments: 150 in the web-based intervention, 153 in the in-person workshop, and 148 in the control condition. Among these, a total of 351 mothers completed the intervention. At 1 week after the intervention, 113, 85, and 135 mothers completed assessments for each condition, respectively, and at 3 months after the intervention, 105, 84, and 123 completed the assessments, respectively. Compared with mothers in the control condition, mothers in the web-based intervention had significantly higher tolerance of risky play at 1 week (P=.004) and 3 months after the intervention (P=.007); and mothers in the in-person workshop had significantly higher tolerance of risky play at 1 week after the intervention (P=.02). No other significant outcomes were found. None of the potential mediators were found to significantly mediate the outcomes. Conclusions: The trial demonstrates that the web-based intervention was effective in increasing mothers’ tolerance for risk in play. Trial Registration: ClinicalTrials.gov NCT03374683; https://clinicaltrials.gov/ct2/show/NCT03374683

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中文翻译：

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一项基于网络和面对面的风险重构干预，以影响母亲对儿童户外冒险游戏的容忍度和育儿实践：随机对照试验

背景：户外冒险游戏，如攀爬、赛车和独立探索，是儿童时期的重要组成部分，与儿童的各种积极的身体、心理和发展成果有关。父母的态度和恐惧，尤其是母亲的态度和恐惧，是儿童户外冒险游戏机会的主要障碍。目标：本研究的目的是评估两种干预措施在重塑母亲风险认知和改变养育行为方面的有效性：与对照条件相比，基于网络的干预措施或面对面的研讨会。方法：去外面玩！随机对照试验于 2017 年至 2018 年在加拿大进行。参与者通过社交媒体、滚雪球抽样和社区通知招募。6-12 岁儿童的母亲通过资格问题进行自我评估，那些有资格并同意参与研究的人被随机分配到全自动的基于网络的干预、面对面的研讨会或控制条件。干预以社会认知理论为基础，结合了行为改变技术。参与者通过一系列自我反思练习取得了进展，并制定了变革目标。对照组参与者收到了关于积极户外游戏的立场声明。主要结果是增加对冒险游戏的容忍度，次要结果是目标实现。在基线、干预后 1 周和 3 个月时，通过 REDCap 在线收集数据。使用密封信封进行随机化。分配在分配和数据分析时对研究人员隐瞒。我们进行了中介分析，以检查干预是否影响了社会认知理论的要素，如假设的那样。结 其中，共有351位妈妈完成了干预。在干预后 1 周，分别有 113、85 和 135 名母亲完成了每种情况的评估，在干预后 3 个月，分别有 105、84 和 123 名母亲完成了评估。与对照条件下的母亲相比，网络干预中的母亲在第 1 周时对冒险游戏的容忍度显着更高（P = . 004) 和干预后 3 个月 (P=.007)；在干预后 1 周，现场工作坊中的母亲对冒险游戏的容忍度显着更高（P = .02）。未发现其他显着结果。没有发现潜在的调解人对结果有显着的调节作用。结论：该试验表明，基于网络的干预可有效提高母亲对游戏风险的容忍度。试验注册：ClinicalTrials.gov NCT03374683；https://clinicaltrials.gov/ct2/show/NCT03374683 该试验表明，基于网络的干预可有效提高母亲对游戏风险的容忍度。试验注册：ClinicalTrials.gov NCT03374683；https://clinicaltrials.gov/ct2/show/NCT03374683 该试验表明，基于网络的干预可有效提高母亲对游戏风险的容忍度。试验注册：ClinicalTrials.gov NCT03374683；https://clinicaltrials.gov/ct2/show/NCT03374683

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