Abstract
Playgrounds are facilities that may increase children’s physical activity. Territorial authorities provide playgrounds in public parks. The link between children’s needs for physical activity and subsequent provision of play equipment was acknowledged in the Dunedin City Council’s (DCC) 2006 Play Strategy. Implementation of the Strategy through planned up-grades in a spatially-defined area provided an opportunity to test whether children’s physical activity increased with improved play facilities. Two playgrounds were up-graded by the DCC in early 2008 providing the opportunity to conduct a natural experiment study known as LOCATE (Location of Children's Activity in Their Environment) set in Dunedin, New Zealand (NZ).
The Location Of Children’s Activity in Their Environment Study (LOCATE) was a natural experiment, set in Dunedin, New Zealand (NZ). At baseline (October - December 2007), 184 children, aged five to ten years old, were recruited from participating schools in intervention and control communities with comparable demographic and spatial characteristics. There were 156 participants at follow-up (15% attrition).
There were two phases: a baseline assessment and the follow-up assessment, with 12 months between each assessment. To obtain parents/guardians perceptions of their neighbourhood and other information associated with physical activity, a self-administered questionnaire was developed and tested for reliability in a pilot study. It was mailed to each participant’s home when they began each assessment phase. Participants’ heights and weights were measured, and age- and sex-standardised BMIs determined. Mean Total Daily Physical Activity (TDPA), measured by an Actigraph GT1M accelerometer, was matched with location data collected at one minute intervals using a GlobalSat DG-100 Global Positioning System Data Logger.
A regression model was used to compare the log-transformed mean TDPA at follow-up, with baseline scores included as a covariate. All models controlled for repeated measures and clustering by schools by using random effects. Univariate screening was carried out using p<0.1 for inclusion in the model with a priori exploratory subgroup analyses by sex, age, and BMI performed by using interactions between these variables and the community. Non-linear associations were explored and fractional polynomial models were used where appropriate.
There was evidence of statistically significant associations with mean TDPA at follow-up for participant age, sex and ethnicity; school day and usual mode of travel to school. Statistically significant interactions were found between sex and ethnicity; community and BMI z-score. Compared to the control community, participants in the intervention community did not have a statistically significantly different mean TDPA (p=0.456).
Compared to baseline data, integrated location and physical activity follow-up data indicated a small, but statistically significant increase in median TDPA located at the two up-graded playgrounds in the intervention cohort (4,196 counts; Wilcoxon signed-rank test p=0.040). There was also evidence of statistically significant differences in the distance from home to the nearest up-graded playground, between those who visited following the playground up-grades, and those who did not. For each 100 metre increase in distance from the closest up-graded park, logistic regression indicated a 15.6% decrease in the odds of using that park (95% CI: 1.0, 28.0, p=0.037).
These findings suggest that although playgrounds are promoted as facilities which support community physical activity, in NZ, they may have less influence than initially estimated. Nevertheless, playgrounds should be considered as one in a range of opportunities provided in communities for promoting physical activity amongst children.