Sydney Playground Project: A Cluster-Randomized Trial to Increase Physical Activity, Play, and Social Skills.

BACKGROUND: We assessed the effectiveness of a simple intervention for increasing children's physical activity, play, perceived competence/social acceptance, and social skills. METHODS: A cluster-randomized controlled trial was conducted, in which schools were the clusters. Twelve Sydney (Australia) primary schools were randomly allocated to intervention or control conditions, with 226 children (5-7 years old) selected randomly to participate. Data were collected at baseline and after 13 weeks. The intervention consisted of introducing recycled materials without an obvious play purpose into school playgrounds and a risk-reframing workshop for parents and teachers. RESULTS: Children from the intervention schools increased physical activity and reduced sedentary time while control schools decreased physical activity and increased sedentary time. The intervention yielded increases in total accelerometer counts (ß = 9350 counts, 95% CI 3490-1522, p = .002), minutes of moderate/vigorous physical activity (MVPA) (ß = 1.8 min, 95% CI 0.52-3.12, p = .006), and reductions in sedentary time (ß = -2.1 min, 95% CI -3.77-(-0.51), p = .01). Although the changes in time spent in play and nonplay were not statistically different (p = .08) the effect size (d = .27) indicates clinical significance. CONCLUSIONS: This intervention was effective for increasing MVPA during recess and demonstrated capacity to improve play opportunities in school playgrounds.

Increasing physical activity in young primary school children--it's child's play: a cluster randomised controlled trial.

OBJECTIVE: To explore the effects of an innovative school-based intervention for increasing physical activity. METHODS: 226 children (5-7 years old) randomly selected from 12 Australian primary schools were recruited to a cluster randomised trial with schools randomly allocated to intervention or control conditions. The 13-week intervention comprised: (1) altering the school playground by introducing loose materials and (2) a teacher-parent intervention exploring perceptions of risk associated with children's free play. The primary outcomes were total accelerometer counts and moderate-vigorous physical activity during break times. Testing took place in Sydney, 2009-2010. RESULTS: 221 participants were tested at baseline. Mixed-effect multilevel regression revealed a small but significant increase from the intervention on total counts (9400 counts, 95% CI 3.5-15.2, p=0.002) and minutes of MVPA (1.8 min, 95% CI 0.5-3.1, p=0.006); and a decrease in sedentary activity (2.1 min, 95% CI 0.5-3.8, p=0.01) during break times. We retested children in one intervention school after 2 years; they maintained the gains. CONCLUSIONS: Capturing children's intrinsic motivations to play while simultaneously helping adults reconsider views of free play as risky provided increases in physical activity during break times. Using accelerometry as the sole measure of physical activity may underestimate the effect. TRIAL REGISTRATION: ACTRN12611000089932.