Broekhuizen Karen, Scholten Anne-Marie, de Vries Sanne I
TNO, Department of Life Style, P,O, Box 2215, 2301 CE Leiden, Netherlands.
Int J Behav Nutr Phys Act. 2014 May 3;11:59. doi: 10.1186/1479-5868-11-59.
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.
学前教育环境是促进儿童健康的重要场所。特别是，学前操场提供了一个重要的干预机会。本综述概述了现有证据，阐述了学校操场和学前操场在身体活动、认知及社会成果方面对儿童健康的价值。此外，我们旨在确定哪些操场特征与有益效果的相关性最强，以及对哪些儿童亚组的效果最为显著。总共总结了13项实验研究和17项观察性研究，其中分别有10项（77%）和16项（94%）显示出中等至高的方法学质量。几乎所有实验研究（n = 11）都评估了课间休息时不同强度身体活动时间的干预效果。关于学前操场对认知和社会成果影响的研究较少（n = 2）。实验研究为提供游乐设备的效果提供了中等证据，为使用操场标线、分配游乐空间和多成分干预的效果提供了不确定证据，而对于降低操场密度、工作人员促进身体活动以及增加课间休息时长对儿童健康的影响则没有证据。与此一致，观察性研究表明游乐设备与儿童身体活动水平之间存在正相关。与实验研究不同的是，儿童的身体活动与降低操场密度和增加课间休息时长之间也发现了显著关联。为了证实本综述的结果，建议研究人员开展更多采用随机对照设计的实验研究，并纳入实施策略评估和过程评估，以揭示哪些干预策略和操场特征最有效。
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