Promoting physical activity at the pre-school playground: The effects of providing markings and play equipment

Objectives. We aimed to investigate the effects of providing play equipment and markings at the preschool playground on physical activity engagement levels. Methods. We performed a cluster randomised control trial. In November and December 2007, a convenience sample of 40 public pre-schools in Flanders, Belgium, was randomly assigned to one of the following conditions: 1) in 10 pre-schools play equipment was provided, 2) in 10 pre-schools markings were painted on the playground, 3) in 10 schools play equipment was provided and markings were painted, 4) 10 schools served as a control condition. Accelerometer-based physical activity levels during recess were evaluated at baseline and 4 to 6 weeks after the implementation of the intervention in 583 children (52% boys; mean age 5.3 years, SD 0.4). Results. At baseline pre-schoolers spent only 11.2% (average: 4.7 min) of recess time in moderate to vigorous activity, while 61.3% (average: 25.7 min) was spent in sedentary activity. The interventions were not effective in increasing the average activity levels or the percentages of engagement in moderate or vigorous activity, or in decreasing sedentary time. Conclusion. Providing playground markings or play equipment is not sufficient to increase activity levels and decrease levels of sedentary activity during pre-school recess. More activating supervision and the inclusion of more structured physical activity seem needed. (C) 2009 Elsevier Inc. All rights reserved.