Abstract
The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective.
Highlights
During childhood and adolescence, regular physical activity is associated with improvements in both physiological and psychological health [1,2,3,4]
According to Escalante et al [25] who summarized five experimental studies, interventions based on playground markings, game equipment, or a combination of the two do not increase the physical activity level of children aged 4–11 years, but interventions based on playgrounds markings plus physical structures can be effective in the short to medium term
Looking at the evidence on the value of different playground-based intervention strategies, moderate evidence was generated for an effect of the provision of play equipment at all school types, and for an effect of multi-component interventions, including the provision of playground markings, play equipment and/or play space on the physical activity level of children at primary schools
Summary
Regular physical activity is associated with improvements in both physiological and psychological health [1,2,3,4]. According to Escalante et al [25] who summarized five experimental studies, interventions based on playground markings, game equipment, or a combination of the two do not increase the physical activity level of children aged 4–11 years, but interventions based on playgrounds markings plus physical structures can be effective in the short to medium term. Studies that examined combined strategies showed mixed findings They conclude that there are some promising recess-based interventions, there is no conclusive evidence for an effect of any type of recess-based intervention on the physical activity level of children aged 5–11 years. None of the reviews have looked for evidence on the beneficial effects of playgrounds on outcomes other than physical activity
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