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Originally published by 2 Minute Medicine® (view original article). Reused on AccessPediatrics with permission.

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1. Generally speaking, increasing risk and challenge in the playground had relatively little effect on how children interacted with one another

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2. Children at intervention schools where play spaces were altered to increase risk opportunities reported playing with more children after 1 year of intervention and higher odds of being happy after 2 years of intervention than control children.

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Evidence Rating Level: 1 (Excellent)

Study Rundown:

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Research suggests that keeping children active and engaged during recess and playtime decreases the rates of bullying. For children, healthy play usually involves some form of risk, whether it is trying something new, overcoming a specific fear, or losing control. Understanding that children seek to engage in risk during playtime, this study aimed to look at the pros and cons of greater risk and challenge in play as it influences bullying rates. Researchers sought to evaluate if creating more interesting playgrounds that meet the risks and challenges of children may make them less likely to seek out other forms of unwanted risky behaviors such as bullying. Schools were randomized to either alter their play spaces to reflect increased risk (intervention) or keep their play spaces the same (control). Results showed that children at intervention schools reported playing with more children after 1 year of intervention than control children. These children also reported higher odds of being happy at school after 2 years than control children. Generally speaking, increasing risk and challenge in the playground had relatively little effect on how children interacted with each other. Although intervention children reported an increase in pushing/shoving, this did not translate into an increased rate of bullying, as they seemed less likely to inform an adult of these incidences. Teaching staff attributed this to greater resilience in the intervention children. The main limitation in this study is the assessment of bullying – the tool used to assess bullying in this this study, Peer Relations Assessment Questionnaire – Revise (PRAQ-R), is a short questionnaire and may be insufficient for such a complex behavior. Bullying is an incredibly important topic – especially in the field of pediatrics. More studies like this are needed in order to address effective ways to eliminate bullying from our schools.

In-Depth [randomized controlled trial]:

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This study included 16 elementary schools serving students of lower socioeconomic backgrounds (grades 1-8) in New Zealand that were randomly assigned to intervention or control. School playgrounds were assessed for different play opportunities including risk and challenge, engagement with natural elements, ability to actively manipulate and change play environment, wheeled play, ball games, opportunity for children to socialize, and quality of independent access. After baseline evaluations, intervention schools were advised to do the following: reduce the number of school rules, allowing children to play outside when raining, using bicycles and skateboards, and encouraging free play. Validated questionnaires were given to students, parents and teachers. Results indicated that intervention children were more likely to play with a lot of children at 1 year (OR 1.66; 95%CI 1.29–2.15) and reported significantly higher odds of being happy at school at 2 years (OR 1.64; 95%CI 1.2–2.25). While intervention children were more likely to say that they had been pushed/shoved at 2 years (OR 1.33; 95%CI 1.03–1.71), no significant difference in the number of reports to adults was observed. Parents reported that intervention children were more likely to report being happy with other students at school at 1 year (OR 1.96; 95%CI 1.18–3.26), but this pattern was reversed at follow-up (OR 0.49; 95%CI 0.26–1.00). Teachers reported a higher frequency of physical pushing (difference in scores 0.23; 95%CI 0.07–0.39) and a tendency for more deliberate exclusion at 2 years (0.20; 95% CI0.00–0.40), however, there was no increase in reported bullying to teachers from children, nor did it affect how teachers viewed the safety of their school environment.

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