title: The Sydney playground project: popping the bubblewrap--unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children's physical activity and social skills.
abstract: BACKGROUND
  In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children's physical activity and social skills.
  
  
  METHODS
  This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment.
  
  
  CONCLUSIONS
  These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trials Registration Number ACTRN12611000089932.
authors: Faculty of Health Sciences, University of Sydney, Lidcombe, Australia. anita.bundy@sydney.edu.au
authors: Anita C
authors: AC
authors: Bundy
authors: Geraldine
authors: G
authors: Naughton
authors: Paul
authors: P
authors: Tranter
authors: Shirley
authors: S
authors: Wyver
authors: Louise
authors: L
authors: Baur
authors: Wendy
authors: W
authors: Schiller
authors: Adrian
authors: A
authors: Bauman
authors: Lina
authors: L
authors: Engelen
authors: Jo
authors: J
authors: Ragen
authors: Tim
authors: T
authors: Luckett
authors: Anita
authors: A
authors: Niehues
authors: Gabrielle
authors: G
authors: Stewart
authors: Glenda
authors: G
authors: Jessup
authors: Jennie
authors: J
authors: Brentnall
mesh_terms: D058445:Bullying; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008603:Mental Health; D009517:New South Wales; D050177:Overweight / Q000517:prevention & control; D010988:Play and Playthings / Q000523:psychology*; D012574:Schools; D012951:Socialization