Effect of major school playground reconstruction on physical activity and sedentary behaviour: Camden Active Spaces

Background: The physical school environment is a promising setting to increase children's physical activity although robust evidence is sparse. We examined the effects of major playground reconstruction on physical activity and sedentary time in primary schools using a quasi-experimental design (comparison group pre-test/post-test design). Methods: Five experimental and two control schools from deprived areas of inner city London were recruited at baseline. Main outcome was physical activity and sedentary time measured from objective monitoring (Actigraph accelerometer) at one year follow up. Pupils' impressions of the new playground were qualitatively assessed post construction. Results: A total of 347 pupils (mean age = 8 years, 55% boys; 36% Caucasian) were recruited into the study at baseline; 303 provided valid baseline Actigraph data. Of those, 231 (76%) completed follow-up (n=169 intervention; n=62 control) and 77.4% of the sample recorded at least 4 days of Actigraph wear. In mixed models adjusted for age, sex, ethnicity, ratio activity or sedentary/wear time at baseline, wear time at follow up, and school, no differences were observed in total moderate – vigorous activity (B=-1.4, 95% CI, -7.1, 4.2 min/d), light activity (B=4.1, 95% CI, -17.9, 26.1), or sedentary time (B=-3.8, 95% CI, -29.2, 21.6 min/d) between groups. There were significant age interactions for sedentary (p=0.002) and light intensity physical activity (p=0.008). We observed significant reductions in total sedentary (-28.0, 95% CI, -1.9, -54.1 min/d, p=0.037) and increases in total light intensity activity (24.6, 95% CI, 0.3, 48.9 min/d, p=0.047) for children aged under 9 yrs old in the intervention. Conclusion: Major playground reconstruction had limited effects on physical activity, but reduced sedentary time was observed in younger children. Qualitative data suggested that the children enjoyed the new playgrounds and experienced a perceived positive change in well-being and social interactions.