INSERT DESCRIPTIONWhat’s keeping your child inside? (Sara Cedar Miller/Central Park Conservancy)

Outdoor play at day care centers is often stifled because a child arrives wearing flip-flops or without a coat or because teachers don’t feel like going outside.

Those were some of the surprising findings from a new study of children’s physical activity in day care settings. More than half of American children between the ages of 3 and 6 are in child care centers or preschools.

Researchers at Cincinnati Children’s Hospital Medical Center held focus groups with staff members at 34 area child care centers to learn more about how kids spend their time in day care and the reasons they may or may not spend time outside.

Many of their answers were unexpected. Day care workers keep children inside if they show up in flip-flops rather than sneakers or if they don’t have a coat on a chilly day. Sometimes, the entire class is kept indoors if one child doesn’t have appropriate clothes for outdoor play. One problem is that parents who don’t want their child going outside on a given day will intentionally keep the child’s coat so he or she will be kept indoors.

One surprising problem the researchers learned was about the mulch used to landscape playgrounds and outdoor spaces at day care centers. Staff members complained that kids eat the mulch or use it as weapons, or it gets caught in their shoes, making outdoor play troublesome for teachers.

“It’s certainly not something that we had anticipated as an issue, but judging by the amount of and intensity of the discussions among child care teachers, it really is,'’ said Dr. Kristen Copeland, assistant professor of pediatrics and the study’s lead author.

The feelings of teachers and parents also influenced whether children played outside. Although children learn important gross motor and social skills on the playground by learning to kick a ball or negotiate with another child for a turn on the swing, teachers said they felt pressure from some parents who were more concerned with children spending time on academic skills like reading and writing.

Some workers said outdoor play is too much trouble because it requires time to bundle up kids during cold weather. Other staff members just said they didn’t like going outside.

“Finding out what the barriers are is the first step in addressing the problem and getting more kids involved in more much-needed physical activity,” Dr. Copeland said.

The research, which was funded by the National Heart, Lung and Blood Institute, was presented Monday at the annual meeting of the Pediatric Academic Societies in Honolulu.