Active Play at School

Title Interventions to Change School Recess Activity Levels in Children and Adolescents: A Systematic Review and Meta-Analysis
Design Systematic review and meta-analysis
Participants Children and/or adolescents aged 5-18 year olds
Intervention Eight different categories of school recess intervention strategies: loose equipment, structured recess, unstructured recess, playground modifications, playground density, group contingency, natural environments, multicomponent.
Comparator Usual recess, no control, self-implementation, paved school yards
Major outcomes Objectively measured physical activity and/or sedentary behaviour during school recess
Settings School recess. Interventions delivered at school before or after school were excluded.
Main results Overall mean difference between intervention and control group for:
  • time spent in MVPA (RCTs, n = 6) was 0.18 (95% CI : 0.00 , 0.36) with a marginal significant effect (p = 0.05).
  • time spent in MVPA (non-RCTs, n = 7) was not significant (p = 0.05).
  • time spent in sedentary behaviour (RCTs , n = 3) was not significant (p = 0.30).
  • All outcomes had high heterogeneity.
Conclusion School recess interventions show promise for increasing children’s MVPA and reducing sedentary behaviour. But due to the small number of studies that could be included for each outcome in the meta-analysis, strong conclusions could not be drawn.
Link https://pubmed.ncbi.nlm.nih.gov/33068273/
Reference Parrish, A. M., Chong, K. H., Moriarty, A. L., Batterham, M., & Ridgers, N. D. (2020). Interventions to Change School Recess Activity Levels in Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Medicine, 50(12), 2145–2173. https://doi.org/10.1007/s40279-020-01347-z
Title Increasing children’s physical activity levels during recess periods in elementary schools: the effects of providing game equipment
Design Cluster RCT
Participants 235 fifth and sixth grade children
Intervention Intervention schools received games equipment and activity cards to provide to students during recess
Comparator Control schools did not receive games equipment or activity cards and had comparable playground space
Major outcomes % of recess time engaged in MVPA
Settings Elementary school
Main results During lunch break, MVPA significantly increased in the intervention group (moderate: from 38 to 50%, vigorous: from 10 to 11%), while it decreased in the control group (moderate: from 44 to 39%, vigorous: from 11 to 5%).
At morning recess, game equipment provision was effective in increasing children’s MVPA (from 41 to 45%), while it decreased in the control group (from 41 to 34%).
Conclusion Providing game equipment during recess periods was found to be effective in increasing children’s physical activity levels. This finding suggests that promoting physical activity through game equipment provision during recess periods can contribute to reaching the daily activity levels recommended for good health.
Link https://pubmed.ncbi.nlm.nih.gov/16431866/
Reference Verstraete, S. J. M., Cardon, G. M., De Clercq, D. L. R., & De Bourdeaudhuij, I. M. M. (2006). Increasing children’s physical activity levels during recess periods in elementary schools: The effects of providing game equipment. European Journal of Public Health, 16(4), 415–419. https://doi.org/10.1093/eurpub/ckl008
Title PACE: A group randomised controlled trial to increase children’s break-time playground physical activity
Design Two-arm parallel group randomized controlled trial
Participants 1582 children (4–13 years old) from 4 schools in New South Wales, Australia.
Intervention The two intervention schools implemented a 4-months long multicomponent intervention which included policy changes (e.g., a maximum 5 min sitting period at morning-break) and portable equipment (e.g., basketballs, skipping ropes, catch cups etc.) provision.
Comparator Wait-list control
Major outcomes Proportion (%) of recess time spent in moderate-to-vigorous physical activity (MVPA)
Settings School
Main results
  • Compared to the control schools, students from the intervention schools had a greater increase of break-time MVPA at follow-up (adjusted difference = 12.5 % , 95% CI : -13.0 , 38.0 ; P = 0.17; r = 0.6).
  • MVPA at morning-break significantly increased (adjusted difference = 18.0 %, 95% CI : 6.9 , 29.1 ; P = 0.02; effect size = 0.7).
  • There were no significant increases in MVPA when examining overall break times.
  • Results were greater for girls compared to boys.
Conclusion Environmental and policy changes are promising strategies for promoting MVPA during school break-time.
Link https://pubmed.ncbi.nlm.nih.gov/26205775/
Reference Parrish, A. M., Okely, A. D., Batterham, M., Cliff, D., & Magee, C. (2016). PACE: A group randomised controlled trial to increase children’s break-time playground physical activity. Journal of Science and Medicine in Sport, 19(5), 413–418. https://doi.org/10.1016/j.jsams.2015.04.017
Title The effect of multicolor playground markings on children’s physical activity level during recess
Design Cluster-randomised controlled trial
Participants 4-11
Intervention Playground multicoloured markings at 4 intervention schools
Comparator 4 control schools matched in playground dimension and socio-economic status
Major outcomes MVPA and VPA measured by short wave heart rate telemetry
Settings Primary schools
Main results A significant interaction effect (group x time) was evident for MVPA (p<0.01) and VPA (p<0.03). Time spent in MVPA and VPA increased significantly in intervention schools as a result of playground painting.
Conclusion Multicolor playground markings can be a low-cost method of increasing children’s daily physical activity levels in the short term.
Link https://www.sciencedirect.com/science/article/pii/S0091743505001106
Reference Stratton, G., & Mullan, E. (2005). The effect of multicolor playground markings on children’s physical activity level during recess. Preventive Medicine, 41(5–6), 828–833. https://doi.org/10.1016/j.ypmed.2005.07.009