Farmer 2017.
| Study characteristics | ||
| Methods | Study design: cluster‐RCT | |
| Participants |
School inclusion criteria: state primary schools (Years 1 to 8 that are fully funded by the state and are co‐educational) with at least 150 pupils and a school decile ranking of 1 to 6 School exclusion criteria: — Student inclusion criteria: children in school years 2 and 4 Student exclusion criteria: no exclusion criteria Setting: school Age group: children Gender distribution: females and males Country where trial was performed: New Zealand |
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| Interventions |
Intervention: researchers, play worker, and school community worked together and received funding over the course of 1 year to develop a playground action plan tailored for each intervention school (e.g. addition of more interactive play equipment, alterations to school rules and policies). The majority of recommendations involved no to little cost, such as leaving trees that had been cut down in pieces or letting the grass grow long to encourage imaginative play, re‐purposing real estate signs for sledding down hills, purchasing raincoats and gumboots to allow outside play when wet, and using plastic piping and sand for water play Comparator: asked not to change anything in school play spaces Duration of intervention: 2 years Duration of follow‐up: 2 years Number of schools: 16 Theoretical framework: — |
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| Outcomes | PA duration BMI |
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| Study registration | ACTRN12612000675820 (retrospectively registered) | |
| Publication details |
Language of publication: English Funding: non‐commercial funding (research funding body) Publication status: peer‐reviewed journal |
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| Stated aim for study | "The aim of our 2‐year cluster RCT (PLAY) was to determine whether providing greater opportunities for risk and challenge in primary schools increased PA and reduced relative body weight over the long term. A secondary aim considered the effect of the intervention on how children interacted with 1 another which forms the basis of a separate paper" | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote from publication: "pairs of schools were created by matching for region, school roll and decile ranking, and were randomly assigned to intervention or control by tossing a coin" |
| Allocation concealment (selection bias) | Low risk | Comment: coin toss used |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Comment: participants not blinded |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote from publication: "measurements were obtained … by researchers blinded to group allocation" |
| Incomplete outcome data (attrition bias) Anthropometrics, Fitness | Low risk | Quote from publication: "the missing data were imputed using chained equations assuming that the data were missing at random" |
| Incomplete outcome data (attrition bias) Physical activity and sedentary time | Low risk | Quote from publication: "the missing data were imputed using chained equations assuming that the data were missing at random" |
| Selective reporting (reporting bias) | High risk | Comment: bullying, steps/d, nutrition not reported |
| Cluster RCT ‐ Recruitment bias | High risk | Comment: students enrolled after randomisation |
| Cluster RCT ‐ Baseline imbalance | Low risk | Comment: clusters similar; models adjusted |
| Cluster RCT ‐ Loss of clusters | Low risk | Comment: no loss of clusters |
| Cluster RCT ‐ Incorrect analysis | Low risk | Comment: clustering accounted for in analysis |