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The value of (pre)school playgrounds for children’s physical activity level: a systematic review

Karen Broekhuizen12, Anne-Marie Scholten13 and Sanne I de Vries14*

Author Affiliations

1 TNO, Department of Life Style, P.O. Box 2215, 2301 CE Leiden, Netherlands

2 Institute for Evidence-Based Medicine in Old Age IEMO, P.O. Box 9600, 2300 RC Leiden, Netherlands

3 The Hague University of Applied Sciences, Nutrition and Dietetics, P.O. Box 13336, 2501 EH The Hague, Netherlands

4 Research group Healthy Lifestyle in a Supporting Environment, The Hague University of Applied Sciences, P.O. Box 13336, 2501 EH The Hague, Netherlands

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International Journal of Behavioral Nutrition and Physical Activity 2014, 11:59  doi:10.1186/1479-5868-11-59

Published: 3 May 2014


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.

Playground; Physical activity; Children; Kindergarten; Schoolyard; Recess