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Abstract Background 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. Methods/Design 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. Discussion 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. Trial registration Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932.

Our aims were to examine the efficacy of a new observational instrument "System for Observing Outdoor Play" for detecting changes in outdoor play and chart the use of recycled and repurposed materials in the school playground during the course of an intervention to increase outdoor play. Children from one Sydney primary school were observed (N = 111; 5-12 years) using an observational instrument developed as part of the Sydney Playground Project. Data on types of activities and frequencies were collected at baseline and seven times during intervention. Use of intervention materials was consistently high and associated with increases in play-related activities (40-77%), while inactive pursuits decreased (52-31%), on average. The observational instrument proved efficacious in tracking changes in play. Modification of the school playground environment by introducing loose parts changed children's play-related behaviour; the variety of activities increased, including construction and creative play. Physical inactivity decreased. Recycled materials can increase children's creative, social and physical play.

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 = 0.002), minutes of moderate/vigorous physical activity (MVPA) (ß = 1.8 min, 95% CI 0.52-3.12, p = 0.006), and reductions in sedentary time (ß = -2.1 min, 95% CI -3.77-(-0.51), p = 0.01). Although the changes in time spent in play and nonplay were not statistically different (p = 0.08) the effect size (d = 0.27) indicates clinical significance. Conclusions: This intervention was effective for increasing MVPA during recess and demonstrated capacity to improve play opportunities in school playgrounds.

This paper reports the results of risk reframing, an intervention to offer parents and educators a context for building new and complex perceptions of risk in children's outdoor free play. Our objective was to alter these adults' perceptions of risk to increase the sustainability of an innovative child-centred playground intervention. Qualitative data in the form of audio-recordings of risk-reframing sessions, brief participant evaluations and field notes kept by project staff were collected and either transcribed in their entirety or summarised in brief written reports. These data were subjected to constant comparative analysis to identify emergent themes. Results suggest that educators and parents benefit from opportunities to share risk perceptions and discuss the costs and benefits for offering outdoor free play to children to achieve their common goals for children: health, happiness and resilience.

School playgrounds offer everyday opportunities for physically active and social play that combats obesity, develops skills, and promotes well-being. However, teachers' fear of the legal consequences of injury can elicit over-zealous risk reduction with the result that playgrounds lack challenge, and the potential benefits of play become limited. In this research, we trialled a simple, cost-effective strategy to encourage children to be more active and social on a school playground. Over 11 weeks, we made available materials with no fixed purpose (e.g. car tires, boxes) to a playground of children aged five to seven. Accelerometers showed children became significantly more active. Interviews with teachers suggested children also became more social, creative, and resilient. However, despite no incidence of injuries, teachers perceived an increased risk and encountered dilemmas regarding duty of care. We conclude that future interventions should address issues of 'surplus safety' at individual, school, system, and policy levels.

Parents are often concerned about managing risks for their children, particularly in the context of disability. This paper reports qualitative findings from an intervention study and examines how parents of children with developmental disabilities (mainly autism) manage risks during play. Interviews (n = 17) highlighted parents' fears about their child's safety, which were often exacerbated by concerns about the child's (lack of) cognitive and intellectual capabilities to 'appropriately' negotiate harms. Outdoor play and play that involved other children were reported as particularly challenging. In these contexts, parents described how they would intervene and redirect play activities to avoid any emergent physical, emotional and social harms. The social aspects of risk and disability gave way to adult-mediated and controlled forms of play. We conclude by considering opportunities to support the full inclusion of children with disabilities and their rights to play. Play is an important aspect of all children's health and development Children with disabilities often experience fewer opportunities to engage in play Parents responses to 'risk-taking' in their children's play help understand the barriers to play for children with a disability Social aspects of play are particularly challenging for parents of a child with disability Developing socially inclusive contexts is important to enhance all children's opportunities to play. [ABSTRACT FROM AUTHOR]

Based on research conducted as part of the Sydney Playground Project, this paper provides an exploratory investigation of the perspectives of girls relating to the ideal school playground experience, and whether their perspectives are influenced by a loose-parts playground intervention. The focus is on the play behaviours of 22 girls aged 8-10 years, from the perspective that school playgrounds are generally designed in ways that are more suited to the play behaviours of boys. The research is based on a qualitative analysis of children's drawings, interviews and focus groups, exploring meanings associated with desired play experiences. Findings indicate that girls' views of the ideal school playground are influenced by the geographies of the spaces they play in, and that girls highly valued changes provided by a loose-parts intervention. [ABSTRACT FROM AUTHOR]

Introduction: Children with disabilities often experience unsupportive environments that restrict their play opportunities and inclusion on the school playground. This exclusion can perpetuate inequities for children with disabilities, with lifelong implications. The Sydney Playground Project uses a simple, innovative intervention consisting of placing recycled materials on the playground and engaging parents and educators in risk reframing sessions to create increased playground choice, control, independence and inclusion for all children., Methods: The purpose of this study was to learn from participants about the utility of the intervention for promoting choice and control among children with disability on the school playground. Data included evaluative interviews with 27 school staff (teaching assistants, teachers, therapists, school leadership) across five participating schools after completing of the intervention. Analysis was thematic and explored prominent ideas first within schools, and then between schools., Results: Prior to the intervention, participating school staff focused on active supervision to support play and student needs. During the intervention, school staff experienced role shift and confusion as they allowed the children increased independence while using the recycled materials and learned to navigate how much independence to give the children. Children engaged in increased imaginative and social play, and school staff adopted higher expectations of children's capabilities., Conclusion: Interventions such as the Sydney Playground Project that collaboratively shift adult perceptions to focus on the capabilities of children with disabilities and increase the supportiveness of the physical environment have great promise in increasing play choice and inclusion on the school playground., (© 2019 Occupational Therapy Australia.)