Improving Childhood Physical Activity Rates through Playground Greening

By: Abbie Bowers, Nicole Lerebours, Mackenzie Godoy, and Azline Exime

Description of the Public Health Problem

         The prevalence of childhood obesity in America has been steadily increasing since the 1970s. In 1978, 5% of children were obese but by 2016 the percentage had increased to 18.5% (Anderson et al., 2019). The CDC reports that in 2017-2020, 19.7% of children were obese, affecting nearly 15 million children, with obesity rates higher amongst minority groups (Childhood Obesity Facts | Overweight & Obesity | CDC, 2022). The prevalence of childhood obesity is increasing and determining a proper intervention is critical (Ogden et al., 2014; Tsoi et al., 2022). There is a known association between increasing physical activity and improving childhood obesity (Boutelle et al., 2017) and improving childhood physical activity patterns has the added benefit that childhood behaviors persist into adulthood (Gladwell et al., 2013; Telama et al., 1997). Since the prevalence of adult obesity is also increasing in America, an intervention aimed at increasing physical activity patterns amongst children may also have an added benefit of lowering adult obesity rates as well (Stierman et al., 2021).

         The average American school-aged child spends an average of 6.64 hours per day in school with 29.6 minutes per day spent in recess (Results from the School Health Policies and Practices Study 2016, 2016; Schools and Staffing Survey (SASS), 2007). The 2020 WHO guidelines recommend that children and adolescents receive 60 minutes of moderate to vigorous physical activity (MVPA) per day (Chaput et al., 2020). Because of the length of time children spend in school each day, children can accumulate “up to 40% of their recommended MVPA minutes during recess” (Raney et al., 2019). Additionally, studies have shown that children are more active in playgrounds that have access to greenspace (such as grass, trees, and fields) (Gladwell et al., 2013; Klinker et al., 2014; Wheeler et al., 2010). This supports choosing a school-based, playground greening and physical activity intervention.

         Due to our intervention affecting elementary schools within New York City, our primary population are children between the ages of 5 and 10. Recess is usually phased out of the curriculum and replaced with physical education classes by middle and high school, so a playground greening intervention is less likely to apply to these students. Some public schools in NYC are a mix of elementary and middle school, so in these schools children up to age 14 would have access to the playground and could benefit from the intervention. The primary stakeholders are community members (both children as well as parents and other taxpayers) and the Trust for Public Land (TPL). TPL is a non-profit focused on bringing parks and nature to communities who need it the most. They are a national organization, however, they have previously worked with the New York Department of Education on two separate NYC school playground projects (PlaNYC Schoolyards to Playgrounds : NYC Parks, n.d.; Uteuova, 2022). Their experience and connections working with the NY Department of Education as well as administrators working at the individual schools will be invaluable.

Program Plan

Development & Dissemination of Interventions 

Intervention #1: Development of simple, nature oriented playgrounds at primary schools

Children spend an estimated 40-60% of their time in an academic setting, making it the prime real estate for establishing green spaces that provide a creative and physical outlet, which is especially important as we observe increasing rates of “nature-deficit disorder” due to rapid urbanization. Research has linked exposure to nature to improved focus, vitality, productivity and reduced stress. A 2017 study even found an unexpected relationship between access to green playgrounds and improved reading performance in primary school children, which has opened the door for further research regarding the impact of nature on academic performance (Hodson & Sander, 2017). However, it is important to keep in mind when developing these green playgrounds that variation in landscape is crucial in order to take into account differences in physical and cognitive capabilities among children. A 2014 study found that children tend to be more willing to engage with playground structures when they did not perceive them as serious challenges, noting that children were more attracted to simple gap-crossing structures, and climbing structures between 20-30 cm high while avoiding those 40 cm or taller (Prieske et al., 2015).   

Intervention #2: Greenification of walkable spaces in urban settings

In an urban setting, walkability is a built-in facet of life, making it so that the population can easily maneuver around the city with an expectation of pedestrian safety in mind. However, with improvements in public transport and the perceived convenience, in addition to bleak, industrial surroundings, less people are opting to walk to their destinations; this includes children who are within walking distance to their schools or extra curricular locations. Enter here the concept of “smart growth” which posits that lack of physical activity may be tied to community design and suggests that vibrant communities characterized by greeness can not only enhance perceived safety of a community, which is important for parents to feel confident in allowing their children to commute by foot, but also increase desires to walk more frequently.  A 2012 study found that even just momentary exposures to greenness on a commute path had a positive association with increased physical activity among children. This same study determined that establishment of “smart growth” areas lead to upticks of leisurely outdoor play and increased rates of community engagement amongst children and their parents both before and after school as well as on the weekends (Almanza et al., 2012).   

Intervention #3: Intentional participation initiatives among children and their green spaces 

The establishment of more green spaces for children can be further optimized by involving the children and community members in the development and maintenance of such spaces.  A 2017 study found that greenspaces developed without contribution from children within the community face greater damages over time than those developed in collaboration with the community. When incorporating a participatory approach in which children were able to contribute ideas and aid in planting, painting, or erecting structures, the spaces experienced less rates of damages and were subsequently well maintained. By encouraging children to play a key role in the development and maintenance of these spaces, they build a sense of respect for the space and are less likely to engage in damaging behaviors (like trampling plants or handling play structures roughly). Additionally, these children develop a sense of responsibility over the green space which encourages them to attend the grounds more frequently and participate in play (Jansson et al., 2017).  

Evaluation  and Maintenance

Creating more green spaces to increase the physical activity of children can lead to many positive outcomes such as a decrease in child and adult obesity, increase in physical activity, and improved mood and self-esteem. To ensure the success and progress of the program, data from community members, including school faculty, parents, and children would be collected via questionnaires and surveys. A baseline would first need to be established, and so the first round of data collection would occur prior to the implementation of greenification initiatives with the following categories in mind: (1) Feelings of Safety (2) Average Hours of Weekly Physical Activity (3) Perceived Status of Overall Physical Health (Good or Bad) (4) Perceived Status of Overall Mental Health (Good or Bad) (5) Perceived Behavioral Changes (Good or Bad) (6) Trends in Academic Performance. Program information and objectives will be provided to parents prior to greening to ensure that informed consent is received for data collection. Once a baseline is established, bi-annual or annual data collection covering the same topics may occur and a comparison between the baseline and new data sets would be compared to quantify the progress. It is recommended to do a follow up on the program in 5 to 10 years with questionnaires/surveys to ensure that long term outcomes were met. Designated task forces would interpret and present data to stakeholders; if the data shows that the interventions have been unsuccessful, then a program evaluation will take place to pinpoint areas that need improvement prior to reimplementation. Program maintenance would be held bi-annually to address structure/landscape maintenance scheduling, blueprint updating, and community engagement planning.  Throughout the program, the search for new federal, state and/or private grants would be held. 

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