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Parks are places where children can interact with others and engage in physical activity in a natural setting. Park visits can enhance children’s social, mental, and physical health. It is therefore important to better understand how parks can be designed to ensure optimal use by children. This qualitative study explored children’s perceptions of park features that may influence their park visits, park-based physical activity, and social interaction. Qualitative walk-along interviews were completed with 30 children (mean age 9.7 years (SD 1.3), female n = 16) in nine parks located in varying socioeconomic areas of Melbourne, Australia. As they walked through the park, children shared thoughts regarding characteristics that may influence their visitation, park-based physical activity, and social interactions. Features that would encourage visitation included: challenging and interesting play equipment; a pond and water play area; trees/greenery and shade; and full-sized basketball courts. Features most valued for physical activity included: sports courts, ovals, and equipment; open space; trees to climb; and nature/rocks. Features most valued for social interaction included: a large size; playgrounds; and picnic areas. Children offer unique and important views. Park designers should consider inclusion of these features, when (re)developing parks to support children to lead healthy and active lives.

Objective This study reviewed (1) the effects of physical enrichment of (pre-)school playgrounds on children’s and adolescents’ movement behaviours and their cognitive, psychological, and social development, and (2) how enrichment characteristics influenced these outcomes. Methods A systematic review with meta-analysis was conducted following the PRISMA guidelines. We searched 7 databases (SPORTDiscus, CINAHL, MEDLINE, APA PsycINFO, Cochrane Library, Web of Science, and Scopus) and two reviewers independently screened studies for eligibility. Effect sizes of interventions were calculated using standardized mean differences (Hedges’ g) and tested using random-effects models. Meta-regression was used to explore heterogeneous findings. Narrative syntheses were conducted when meta-analysis was not possible. Results Twenty-eight studies and 19,753 participants were included. Three studies had low risk of bias, 11 studies had high risk of bias, while 14 studies had some concerns. The meta-analyses for movement behaviours showed significant increases in vigorous physical activity (VPA, n  = 7 studies, g = 0.17, 95% Confidence Interval (CI): 0.06, 0.27), moderate-to-vigorous physical activity (MVPA, n  = 17, g = 0.17, CI: 0.03, 0.30), and steps per minute ( n  = 3, g = 0.81, CI: 0.03, 1.59) for enrichment interventions relative to control conditions. The results for MVPA had large heterogeneity and were only significant short-term. Line markings alone or in combination with physical structures (e.g., climbing walls) increased MVPA, while involving end-users decreased MVPA. Line markings alone or in combination with physical structures or equipment increased VPA. There was no effect of enrichment for sedentary behaviour, low or moderate intensity physical activity. The results for cognitive (attention restoration and executive functioning), psychological (wellbeing and quality of life), and social (interactions, orientations, and bullying) development were mixed. Conclusion Our findings show that studies on physical enrichment had low methodological quality and findings had high heterogeneity. Line markings in isolation or combined with other enrichment strategies might increase levels of VPA and MVPA in children and adolescents. Evidence on cognitive, psychological and social development is inconclusive due to few and weak studies for these outcomes. We provide future directions for research and practice by drawing from the environmental enrichment paradigm. Trial registration PROSPERO registration number CRD42022364392.

Playgrounds in urban parks are important for children’s physical and mental health, but global warming has led to a worsening outdoor environment and children’s outdoor activities have been affected. Improving the outdoor thermal comfort (OTC) of playgrounds can encourage children to engage in more and safer outdoor activities. However, there are a limited number of studies focusing on preschoolers’ outdoor thermal comfort (OTC) and most of them have substituted children’s thermal comfort with caregivers’ evaluations. To investigate the differences between children’s and caregivers’ evaluations of thermal sensation, thermal benchmarks and thermal adaptive behavior for children, we conducted meteorological measurements on representative playgrounds in three parks in Wuhan, China, and administered thermal perception questionnaires to preschool children and their caregivers. In addition, the Physiological Equivalent Temperature (PET) was used to establish evaluation criteria for children’s OTC and to make recommendations for the improvement of the playground environment. We draw five conclusions by analyzing 719 valid questionnaires: (1) Children were less sensitive to changes in meteorological factors than caregivers and had better tolerance of cold environments. (2) The NPET for preschoolers was evaluated by children and by caregivers, respectively, as 22.9 °C and 22.3 °C in summer and 10.6 °C and 11.2 °C in winter. (3) Playgrounds in Wuhan’s parks are uncomfortable for a long time in summer and a short time in winter. (4) Both children and caregivers want to improve summer comfort by lowering the temperature and winter comfort by increasing solar radiation. At the same time, children and caregivers show different preferences in adaptive behavior choices. (5) Adding deciduous trees and water play facilities can improve the site thermal environment. Furthermore, the OTC of humans can be improved by adding more service facilities on playgrounds.

Background Physical activity is a multifactorial trait, determined by both individual and environmental characteristics, it seems relevant to understand the determinants related to youth guidelines accomplishment. The present study aimed to verify the differences between the Brazilian federative units regarding to the prevalence of youth physical activity guidelines accomplishment and to investigate the determinants related to the inter-individual differences in this accomplishment. Methods Sample comes from the 2015 Brazilian National School Health Survey (PeNSE), comprising 99,570 adolescents (51,527 girls, 13-17y), enrolled in 3039 schools. Adolescents reported the time they spend in moderate-to-vigorous physical activity daily, and they were categorized as active or inactive, if the guidelines were achieved, or not, respectively, and multilevel statistical analyses were used, including both child and school-level variables. Multilevel Binomial model was computed in the SuperMix software. Results The majority of the adolescents did not comply with the physical activity guidelines daily, where Bahian children complied the least, while those from Amazonas, Tocantins, and Mato Grosso do Sul complied the most. Boys (OR: 2.305; 95%CI: 2.277-2.334), older adolescents (OR: 1.044; 95%CI: 1.036-1.051), and those who spent more time in active travelling to/from school (OR: 1.001; 95%CI: 1.001-1.001) complied more the physical activity guidelines. At the school level, adolescents from larger schools (OR: 0.957; 95%CI: 0.928-0.986) tended to comply less with the guidelines. Conclusion Significant differences between Brazilian federative units in youth daily physical activity guidelines compliance were observed, highlighting the role of individual but also environmental constraints in the Brazilian adolescents’ engagement in physical activity.

Background There is a lack of early (infant) mobility rehabilitation approaches that incorporate natural and complex environments and have the potential to concurrently advance motor, cognitive, and social development. The Grounded Early Adaptive Rehabilitation (GEAR) system is a pediatric learning environment designed to provide motor interventions that are grounded in social theory and can be applied in early life. Within a perceptively complex and behaviorally natural setting, GEAR utilizes novel body-weight support technology and socially-assistive robots to both ease and encourage mobility in young children through play-based, child-robot interaction. This methodology article reports on the development and integration of the different system components and presents preliminary evidence on the feasibility of the system. Methods GEAR consists of the physical and cyber components. The physical component includes the playground equipment to enrich the environment, an open-area body weight support (BWS) device to assist children by partially counter-acting gravity, two mobile robots to engage children into motor activity through social interaction, and a synchronized camera network to monitor the sessions. The cyber component consists of the interface to collect human movement and video data, the algorithms to identify the children’s actions from the video stream, and the behavioral models for the child-robot interaction that suggest the most appropriate robot action in support of given motor training goals for the child. The feasibility of both components was assessed via preliminary testing. Three very young children (with and without Down syndrome) used the system in eight sessions within a 4-week period. Results All subjects completed the 8-session protocol, participated in all tasks involving the selected objects of the enriched environment, used the BWS device and interacted with the robots in all eight sessions. Action classification algorithms to identify early child behaviors in a complex naturalistic setting were tested and validated using the video data. Decision making algorithms specific to the type of interactions seen in the GEAR system were developed to be used for robot automation. Conclusions Preliminary results from this study support the feasibility of both the physical and cyber components of the GEAR system and demonstrate its potential for use in future studies to assess the effects on the co-development of the motor, cognitive, and social systems of very young children with mobility challenges.

Play has a key role in children psychomotor development, and the quality of play spaces can be a facilitator of the former. The physical properties of the environment, such as equipment or material available, can influence children’s behavior. However, it is not clear how the provision of different loose parts impacts children’s play patterns. This study aimed to analyze the influence of four types of loose parts on the time, frequency and number of children using them during free play sessions. We recorded the 1st, 5th and 10th sessions delivered by playworkers in a primary school, with 14 children (Mage = 9.96 years). The available loose parts were categorized, and four types of materials were chosen: tarpaulin/fabrics, cardboard boxes, plastic crates and plastic tubes. The influence of these materials on the time spent using them, frequency of use and number and sex of users (dependent variables) was analyzed. Some tendencies emerged, such as the popularity of tarpaulin/fabrics, but results showed no significant differences between materials. This could mean that the specific physical qualities of each loose part were not determiners of the behavioral domains analyzed. These findings suggest that all types of materials studied can be meaningful for children to engage with in diverse play opportunities.

Children with autism spectrum disorder (ASD) have difficulties interacting with same-aged peers during unstructured play (e.g., on the playground). Thirty-five toddler and preschool children with and without ASD participated in a structured 15-min outdoor play curriculum. The intervention, the Buddy Game, used familiar songs, movement, and games to promote peer social interaction. A 2 × 3 ANOVA assessed changes in overall targeted social behaviors during baseline, the Buddy Game, and generalization to free-pay. Multiple regression analyses examined factors related to increases in social interactions. Predictors were ASD status of child and age of child. Results indicated the Buddy Game increased overall social interactions and that social interactions were influenced more by ASD status than age. Implications for practitioners are highlighted.

Background Partnership programs between medical students and patients provide students with non-clinical experiences that enhance medical learning, especially with respect to humanistic care. We explored the perceptions and experiences of medical students in a pediatric oncology buddy program. Methods Using a basic interpretive qualitative approach, we conducted interviews with 15 medical students at three time points: before meeting his/her buddy (pre-interview), four months into the partnership (4-month interview), and at the end of the partnership (post interview). We then conducted a thematic analysis of the interview data. Results All students in the program who met the study criteria ( N  = 15/16) participated. The medical students highlighted that: (a) providing support to buddies and their families is important; (b) providing care to children with serious illnesses is emotionally difficult; (c) developing deep connections with buddies and their families is rewarding; and (d) gaining empathy and personal fulfillment from buddies and their families is inevitable. Conclusions This study provides an understanding of medical students’ perceptions and experiences in a pediatric oncology, non-clinical buddy program. Tailored one-on-one partnerships between medical students and pediatric oncology patients play an important role in medical education and contributes to the teaching of humanistic care.

Outdoor recreational spaces have the potential to increase physical activity. This study used a quasi-experimental evaluation design to determine how a playground renovation impacts usage and physical activity of children and whether the visitations correlate with children’s physical activity levels and parental impressions of the playground. Observational data and intercept interviews were collected simultaneously on park use and park-based activity among playground visitors at pre- and postrenovation at an intervention and a comparison park during three 2-hour periods each day over two weeks. No detectable difference in use between parks was observed at followup. In the intervention park, attendance increased among boys, but decreased among girls although this (nonsignificant) decline was less marked than in the comparison park. Following renovation, there was no detectable difference between parks in the number of children engaged in MVPA (interaction between park and time: P=0.73). At the intervention park, there was a significant decline in girls engaging in MVPA at followup (P=0.04). Usage was correlated with parental/carer perceptions of playground features but not with physical activity levels. Renovations have limited the potential to increase physical activity until factors influencing usage and physical activity behavior are better understood.