The sydney playground project: popping the bubblewrap - unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills
© Bundy et al; licensee BioMed Central Ltd. 2011
Received: 15 August 2011
Accepted: 1 September 2011
Published: 1 September 2011
In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills.
This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment.
These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health.
Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932.
Disturbing numbers of children in the westernised world are overweight, bullied or have poor mental health. These are all serious childhood problems that are notoriously difficult to treat. Prevention is undoubtedly best, but their continued increase shows how difficult it is to reverse these new and dangerous trends. Burdette and Whitaker  suggested a compelling common cause for all three problems: a decrease in outdoor free play. While previous generations spent most of their discretionary time engaged in free play outdoors, today's children play indoors; their free time is often spent in sedentary and solitary activity (e.g., computers, television). Time spent outdoors is often in structured sport rather than in unstructured play that facilitates social interaction and physical activity. Physical activity promotes energy expenditure and has additional benefits such as improved cardiovascular health and gross motor skills. However, less obvious is the role of free play in children's social, emotional and cognitive development. The shift from outdoor play to indoor activities, combined with an increased push for academic achievements, potentially leave children more stressed and with poorer mental health . Most young children love active outdoor play but parents, teachers and carers may limit this, fearing injury or misadventure.
Risk aversion in the short term can lead to greater risks in the long term
Adult fears are often disproportionate to actual risk: while children can be injured when playing outdoors, most are minor cuts and bruises. On the other hand, restricting children's outdoor play activities may have unintended consequences, such as reducing children's opportunities for reasonable, age-appr