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Jerebine A, Mohebbi M, Lander N, Eyre ELJ, Duncan MJ, Barnett LM. Playing it safe: The relationship between parent attitudes to risk and injury, and children's adventurous play and physical activity. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102536. [PMID: 37696315 DOI: 10.1016/j.psychsport.2023.102536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/08/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Children naturally seek risk in play and adventurous play outdoors confers many benefits, including the potential to increase moderate-to-vigorous physical activity (MVPA). This study aimed to investigate the relationship between parent attitudes to risk and injury, and their elementary school-aged child's daily adventurous play and MVPA. METHODS A panel sample of 645 Australian parents/guardians completed an online survey consisting of several validated measures of risk and injury attitudes, and physical activity and play behaviour. Data were analysed via descriptive statistics, univariate and multivariable regressions using Stata 17. A series of exploratory univariate logistic regressions were conducted, followed by a series of multivariable logistic regressions fitted to test the association between parent risk and injury attitudes and (i) children's MVPA, (ii) active play and (iii) adventurous play, while adjusting for socio-demographic factors. RESULTS Most adult participants (81%) were female. The mean age of the child participants (53% male) was 8.6 years (SD = 2.4). On average, parents were positive about children's engagement with risk, however, 78% of parents had low tolerance of risk when presented with specific play scenarios, and attitudes towards injuries varied, with mothers more concerned than fathers. After adjusting for confounders, children with parents who were tolerant of risk in play were more likely to meet the MVPA guideline of ≥60 min daily (OR 2.86, CI: 1.41, 5.82, p < 0.004) and spend more time playing adventurously (OR 3.03, CI: 1.82, 5.06, p < 0.001). Positive associations for MVPA and adventurous play were observed across all models examining parent attitudes to risk and injury. Younger children engaged in more play and physical activity, however, more positive parent attitudes appeared to moderate the age-related influences. CONCLUSIONS We found a divergence between the outcomes parents desire for their children through engagement with risk and the play activities they are comfortable with in practice. Parent attitudes to risk and injury are potentially modifiable factors that may increase children's affordances for adventurous play and physical activity. Interventions that provide parents with practical approaches to address injury concerns and support children's risk-taking in play outdoors are recommended.
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Affiliation(s)
- Alethea Jerebine
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia; Centre for Sport, Exercise and Life Sciences, Faculty of Applied Science and Health, Coventry University, Coventry, CV1 2TU, UK.
| | - Mohammadreza Mohebbi
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Natalie Lander
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Emma L J Eyre
- Centre for Sport, Exercise and Life Sciences, Faculty of Applied Science and Health, Coventry University, Coventry, CV1 2TU, UK
| | - Michael J Duncan
- Centre for Sport, Exercise and Life Sciences, Faculty of Applied Science and Health, Coventry University, Coventry, CV1 2TU, UK
| | - Lisa M Barnett
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia; Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
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Smith J, Chhina H, Sidhu P, Brussoni M, Pike I, Cooper A. Paediatric elbow fractures and public play spaces: adherence to standards for children's playground equipment and surfacing. BMJ Paediatr Open 2021; 5:e001125. [PMID: 34786490 PMCID: PMC8587356 DOI: 10.1136/bmjpo-2021-001125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/05/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Supracondylar humerus fractures (SCHF) are the most common fractures sustained following a fall onto an outstretched hand among healthy children, and one of the leading causes of hospital admission and surgical intervention. The aim of this study was to examine SCHF occurring at public play spaces-particularly to determine whether or not the playground equipment implicated in injurious falls aligned with Canadian playground safety standards. METHODS Cases of children who attended the provincial paediatric orthopaedic clinic following SCHF at a public playground between April 2017 and October 2019 were included in the study. A research assistant visited each playground to measure the play structure type and dimensions, height of the equipment at the point from which the child fell and the type and depth of the surface material, and compare measurements to the 2016 safety standards. Child demographics and injury classification were also noted. Descriptive statistics were calculated and a scatterplot of fall height and surface depth was generated. RESULTS Forty-three sites, representing 47 SCHF cases (18 female, 29 male), were included in the final analysis. Fourteen children sustained type 1 fracture, 23 had type 2 fracture and the remaining 10 had type 3 fracture. Five children with type 2 fracture and all 10 children with type 3 fracture required surgery. The majority of sites had engineered wood fibre surfacing, with surfacing at 35 sites being less than 300 mm deep. Twenty-six play structures were upper body equipment (ie, monkey bars or similar), seven were track rides, five were rotating structures and the rest comprised a variety of classified and unclassified structures. Twenty-seven children fell from a height exceeding 2 m. CONCLUSIONS The majority of SCHF cases occurred at playgrounds with insufficient surface depth and/or non-compliant equipment. Upper body equipment, track rides and rotating play structures were of particular concern, as the children fell from heights exceeding the recommended standard, likely reflecting the degradation and compaction of the surfacing material over time.
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Affiliation(s)
- Jennifer Smith
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Harpreet Chhina
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Pardeep Sidhu
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Mariana Brussoni
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada.,Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.,Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Anthony Cooper
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Orthopaedics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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Bierbaum M, Curtis K, Mitchell R. Incidence and cost of hospitalisation of children with injuries from playground equipment falls in New South Wales, Australia. J Paediatr Child Health 2018; 54:556-562. [PMID: 29111619 DOI: 10.1111/jpc.13777] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/10/2017] [Indexed: 11/30/2022]
Abstract
AIMS To describe the epidemiological profile and cost of hospitalised injuries caused by playground equipment falls of children aged 0-14 years, in New South Wales, Australia. METHODS Linked New South Wales hospitalisation data from 1 January 2010 to 30 June 2014 were used to describe the incidence of hospitalisation for playground falls, the age-standardised rate of hospitalisation per year, age group and gender, the characteristics of the injured children and the injury incident. Health outcomes, such as length of stay in hospital, and the hospital costs associated with the injuries were examined by age group. Negative binomial regression assessed the trend in hospitalisation rates over time. RESULTS There were 7795 hospitalisations of children for playground fall injuries. The highest hospitalisation rate was for the 5-9 year olds (220.7 per 100 000 population) and was higher in males than females (234.2 and 206.3 per 100 000 population, respectively). The majority of these injuries occurred in schools (17.1%) and homes (14.6%), and were as a result of falls from trampolines (34.3%) and climbing apparatuses (28.2%). Over half the playground falls led to fractures of the elbow and wrist (54.7%). The total hospital cost of playground fall-related injuries was $18 million. CONCLUSION Rates of hospitalisation of children for playground fall injuries remain high despite implementation of national playground safety standards in Australia. This research highlights where interventions should be targeted to reduce the incidence and burden of injuries following falls from playground equipment.
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Affiliation(s)
- Mia Bierbaum
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Kate Curtis
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Playground slide-related injuries in preschool children: increased risk of lower extremity injuries when riding on laps. Inj Epidemiol 2018; 5:13. [PMID: 29637487 PMCID: PMC5893512 DOI: 10.1186/s40621-018-0139-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background The purpose of this study was to better understand the factors associated with playground slide-related injuries in preschool children and to test the hypothesis that riding on laps increases the likelihood of lower extremity injuries. Methods Playground slide-related injuries (product code 1242) in children ≤5 years of age treated in emergency departments from 2002 to 2015 were identified (N = 12,686) using the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS). Descriptive and comparative analyses, including chi-square testing and binary logistic regression, were performed. Results Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015. Overall, 59% of the children were male, and 65% were white. Almost 60% of injuries occurred in parks or other public areas. The most frequent diagnosis was a fracture (36%); lacerations were 19% of the injuries. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3–5 years of age (p < 0.001). Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person’s lap at the time of injury. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0–58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7–77.4). Conclusions Decreasing age was associated with a higher likelihood of being identified as sliding down on another person’s lap and a higher likelihood of lower extremity injuries. Healthcare providers should be mindful of the potential for these slide-related injuries as they can result in a toddler’s fracture of the tibia, which may be occult. Parents should also be made aware of this increased risk and counseled that a child’s foot can catch on the slide’s surfaces when going down on a person’s lap with subsequent twisting forces that can result in a fracture.
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Billock RM, Anderegg JJ, Mehan TJ, Chounthirath T, Smith GA. Zipline-related injuries treated in US EDs, 1997-2012. Am J Emerg Med 2015; 33:1745-9. [DOI: 10.1016/j.ajem.2015.08.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 11/28/2022] Open
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Abstract
Background Rapid urbanization and unplanned population development can be detrimental to the safety of citizens, with children being a particularly vulnerable social group. In this review, we assess childhood playground injuries and suggest safety mechanisms which could be incorporated into playground planning. Methods Inclusion criteria were “children” as the focus group, “playground” as the main field of study, and “unintentional injury” and “safety” as the concepts of study. The keywords used for the PubMed search were “playground”, “children”, and “injury”. Initially we 182 articles. After screening according to inclusion criteria, 86 articles were found, and after reading the abstracts and then the full text, 14 articles were finally included for analysis. The papers reviewed included four case-control studies, three case studies, three descriptive studies, two interventional studies, one retrospective study, one cross-sectional study, and one systematic review. Results Playground-related fractures were the most common accidents among children, underscoring the importance of safety promotion and injury prevention in playgrounds, lowrisk equipment and playing hours (week days associated with higher risk), implementation of standards, preventing falls and fall-related fractures, and addressing concerns of parents about unsafe neighborhoods. With the exception of one study, all of the reviewed papers had not implemented any practical safety plan. Safe engineering approaches were also ignored. Conclusion We recommend a systematic safety approach based on the “safety circle” which includes three main areas, ie, equipment, environment, and children.
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Rubie-Davies CM, Townsend MAR. Fractures in New Zealand elementary school settings. THE JOURNAL OF SCHOOL HEALTH 2007; 77:36-40. [PMID: 17212758 DOI: 10.1111/j.1746-1561.2007.00160.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND There is a need for greater international understanding of student safety in schools. This New Zealand study investigated the causes and school location of fractures sustained by students attending elementary school, with special emphasis on the types of fractures sustained following falls from playground equipment of various heights. METHODS Over a 1-year period, 76 participating schools (with a combined roll of over 25,000 students) completed a questionnaire about the nature and circumstances of student fractures sustained during regular school hours. RESULTS Some 118 students sustained a total of 131 fractures. Injuries from playground equipment were no more frequent than those from general activities at school, and most were sustained in falls from heights less than 59 inches. Most fractures were to the upper limbs. Fractures were found to vary by gender and school size. CONCLUSIONS The results are discussed in terms of the conditions and policies present in local schools, and the tension that exists in maintaining safety while offering appropriate challenges to students. Improvements in school safety may be more likely to result from a greater focus on the way that students interact at school, rather than on modifications to playground equipment.
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Mitchell R, Cavanagh M, Eager D. Not all risk is bad, playgrounds as a learning environment for children. Int J Inj Contr Saf Promot 2006; 13:122-4. [PMID: 16707350 DOI: 10.1080/17457300500310269] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Rebecca Mitchell
- NSW Injury Risk Management Research Centre, formerly, Injury Prevention and Policy Branch, NSW Health Department, Australia.
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Sherker S, Short A, Ozanne-Smith J. Thein situperformance of playground surfacing: implications for maintenance and injury prevention. Int J Inj Contr Saf Promot 2005; 12:63-6. [PMID: 15814379 DOI: 10.1080/17457300512331339184] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Shauna Sherker
- Accident Research Centre, Monash University, Victoria, Australia.
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Affiliation(s)
- C Norton
- Department of Child Health, University of Wales College of Medicine, Llandough Hospital, Penarth CF64 2XX, Wales, UK
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