Ecological study of playground space and physical activity among primary school children

Associations between outdoor play features and children's behavior and health: A systematic review

The decline of children's opportunities to play outdoors raises a new concern about the quality of outdoor play environments, and their developmental and well-being benefits for children. This systematic review aims to synthesize the associations between outdoor play features and children's behavior and health. PRISMA guidelines were followed (2021). The inclusion criteria were studies with children aged between 5 and 12 (Population); that addressed presence, absence or disposition of equipment, natural elements, loose parts, resources availability, type of terrain and space modifications (Intervention or Exposure); in pre-post intervention or between groups (Comparison); related to health and behavior in different domains (Outcomes); with an experimental, observational, descriptive or longitudinal design (Study design). Indoor context, adult-led activities and structured activities were excluded. A literature search of five databases (PubMed, Web of Science, ERIC, Scopus, and PsycINFO) was concluded in March 2022. After identifying 28,772 records, duplicates and irrelevant titles were removed, and abstracts and full-text articles were screened in duplicate. The remaining 51 eligible articles (45 primary studies) were assessed for risk of bias with QualSyst. A narrative synthesis of the results was conducted. The most frequent behavioral or health outcome addressed was physical activity. Included studies focused on the following space features: fixed structures, space naturalness, floor markings, loose parts/equipment, area available, and the combination of factors. Although some positive effects were found, the heterogeneity between studies did not allow to draw firm conclusions on the effects of each environmental feature on primary children's health and behavior. Systematic review registration: PROSPERO CRD42020179501.

The role of playgrounds in the development of children's fundamental movement skills: A scoping review

Fundamental movement skills (FMS) are the basic skills children should develop but are low in children from high-income countries. Literature indicates that playgrounds can play an important role challenging children's balance, agility, and coordination. However, knowledge on the influence of playgrounds on children's FMS development is fragmented. The aim of the present scoping review was to create an overview of all research that is relevant when studying the influence of unstructured playground play on children's FMS. Four electronic databases (Scopus, Web of Science, SportDiscus, and PsycInfo) were searched systematically in May 2022 and October 2023 following the PRISMA guidelines, leading to a final set of 14 publications meeting the inclusion criteria. The results of these publications indicate that it is important to design playgrounds with various features targeting balance, climbing, throwing, and catching to provide opportunities for children to enhance each FMS (i.e., stability, locomotor skills, and object control skills). Also, spreading features over a large area of the playground seems to ensure ample space per child, stimulate children to use locomotor skills by moving to and from features, and to play active games without equipment. Possibly, also natural play settings develop children's FMS. These findings, however, should be read with caution. More experimental studies using objective and standardized FMS tests are needed in this research field for a more robust conclusion.

Association of Recess Provision With Elementary School-Aged Children's Physical Activity, Adiposity, and Cardiorespiratory and Muscular Fitness

PURPOSE

To identify associations between amount of school recess provision and children's physical activity (PA), weight status, adiposity, cardiorespiratory endurance, muscular strength, and muscular endurance.

METHOD

Data from 6- to 11-year-old participants (n = 499) in the 2012 National Youth Fitness Survey were analyzed. Parents/guardians reported children's PA levels and recess provision, categorized as no/minimal (9.0%), low (26.1%), medium (46.0%), or high (18.9%). Children wore a wrist-worn accelerometer for 7 days and completed anthropometric measurements. Fitness was assessed using grip strength and treadmill, pull-up, and plank tests. Cross-sectional linear and logistic regression compared outcomes across levels of recess provision adjusting for the survey's complex sampling design.

RESULTS

Children with high provision of recess were 2.31 times more likely to meet PA guidelines according to parent report than those with no/minimal recess. Accelerometer-measured PA followed a more U-shaped pattern, wherein PA was higher in children with high, compared to low, recess provision but comparable to those with no/minimal recess provision. There were no associations with weight status, adiposity, or fitness.

CONCLUSION

Current recess recommendations (20 min·d-1) may be insufficient as 30 minutes per day of recess was associated with a 2-fold greater likelihood of achieving recommended PA levels. Additional research on recess quantity and quality is needed.

Evaluation of Social Impact Within Primary School Health Promotion: A Systematic Review

BACKGROUND

Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions.

METHOD

A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom.

RESULTS

A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%).

CONCLUSIONS

This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.

Adaptive school grounds design in response to COVID-19: Findings from six primary schools in South East England

The purpose of this research is to look at how primary schools in England have adapted their outdoor spaces in the context of COVID-19 rules and guidelines to meet the needs of students returning from school closures and national lockdown of Spring/Summer 2020, how that impacted play and learning value of their grounds, and to consider how these findings might inform future school grounds design. Thus, we used a mixed-method approach that included qualitative interviews with representatives from six primary schools (three in rural and three in urban areas), quantitative desk research, and in-person site surveys. We used literature-based scoring criteria to quantify changes in the playground before and after the implementation of COVID-19 measures. The research reveals that the zoning of play areas and other aspects of the school grounds may negatively affected the value of play and learning. We also found a substantial disparity in the amount of outside space per pupil (OSPP) available across schools. Those with the lowest OSPP also had the lowest outdoor and environmental learning provision, lacking the flexibility to accommodate this alongside other requirements of staggered play breaks and PE. The amount of outdoor space that a school has available per pupil averaged at 32 m² for urban schools and 43 m² for rural schools. Finally, we have explored how spatial layout and design elements may have supported or inhibited schools' abilities to respond to children's needs, and how this might inform adaptive school grounds design considerations for the future.