Image by Duchamp.
In most developed nations, kids get far less physical activity than they did just a few generations ago. Given the strong links between physical inactivity and health risk (and given that we’re now seeing “adult” diseases like heart disease and type 2 diabetes in children and teenagers), this has become a very real public health concern. Unfortunately, when it comes to increasing childhood physical activity levels, people often want to reinvent the wheel. For example, many people are enthralled with the Nintendo Wii as a means of increasing childhood physical activity – even though it is expensive, and the evidence supporting it is weak at best. At the same time, evidence continues to accumulate in support of simple, inexpensive interventions for increasing childhood physical activity. Today I’d like to briefly look at one of the simplest possible ways of increasing childhood physical activity levels – painting lines on a schoolyard playground.
In a 2005 study from Preventive Medicine, Dr Gareth Sutton and Elaine Mullan examined the levels of objectively measured moderate and vigorous physical activity in a group of Welsh school children before and after their playgrounds
“were painted in bright fluorescent colors that varied according to school preference, although castles, dragons, clock faces, mazes, fun trails, dens, hopscotch, letter squares, snakes and ladders, and various animals were consistently popular in early primary schools. Late primary schools included markings for netball, football, and short tennis, and targets for games related skills.”
Students attending nearby English schools which did not receive playground markings served as the control group. Although the intervention and control schools were in different countries, they were separated by just 40 miles and had similar climates, playground dimensions and socio-economic status. Baseline measurements were taken in June, immediately before the playgrounds at the Welsh schools were painted, while follow-up measurements were performed in September and October of the following school year.
Not surprisingly, both moderate and vigorous physical activity levels increased by roughly 40% in the intervention schools, while activity levels slightly decreased in the control schools. The graph below illustrates the dramatic increase in the percentage of recess which was spent being moderately or vigorously physically as a result of the intervention.
The increases in activity levels were of a similar magnitude when the authors focused exclusively on vigorous activity, and there were no age or sex related interactions. Taken together, these results suggest a clear and impressive increase in physical activity levels due to this extremely simple intervention.
Pros and Cons
It goes without saying that this study has some pros and cons. Physical activity was objectively measured using heart rate monitors (as opposed to being assessed by self-report questionnaire), which is a definite strength. The study also benefits from having a control group, which unfortunately has not always been the case with studies in this area. However, the study was of a limited duration (essentially 1 month), and children were restricted to the paved portions of the playground during the study, which may have exaggerated the benefits of the markings (if they had been allowed to play soccer in the grassed portion of the playground, some of the markings may have held less appeal). And finally, although the intervention and control groups were quite close geographically, they were in different countries. I’ve never been to Britain, but this strikes me as being less than ideal. None of these are huge problems, but things to keep in mind.
What does it all mean?
This study makes a lot of intuitive sense. Simply give kids the tools to be physically active, and many will do so of their own accord. I really want to emphasize the magnitude of the increase in physical activity levels in the intervention group – they went from being active for just a third of their breaktime to being active for a a full 50% of their breaktime! That’s pretty impressive. What’s even more impressive is how ridiculously cheap an intervention like this could be. How much could it cost for a school to paint designs on the playground every few years? Or schools could make side-walk chalk available to their students, so that they could make their own designs! And of course there is no reason that markings couldn’t be extended to sidewalks and drive-ways as well.
Many factors that influence childhood physical activity levels like socio-economic status and neighbourhood safety are both costly and complicated to address. While governments work to address these more complex concerns, it’s nice to know that simple and inexpensive tactics like giving the playground a coat of fresh paint can also have tangible benefits. Similar studies have shown that providing children with inexpensive game equipment including jump ropes, balls, and hoops have a similarly impressive impact on moderate and vigorous physical activity levels. These interventions are cheap, they are easy, and they should be among the first items addressed by any school attempting to increase overall physical activity levels.
A big hat tip to my friend and colleague Meghann Lloyd for alerting me to Dr Stratton’s work in this area. Have a great afternoon and Happy St Patrick’s Day!
STRATTON, G., & MULLAN, E. (2005). The effect of multicolor playground markings on children’s physical activity level during recess Preventive Medicine, 41 (5-6), 828-833 DOI: 10.1016/j.ypmed.2005.07.009