The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective.

The purpose of this study is to increase our understanding of environmental correlates that are associated with route choice during active transportation to school (ATS) by comparing characteristics of actual walking and cycling routes between home and school with the shortest possible route to school. Children (n = 184; 86 boys, 98 girls; age range: 8–12 years) from seven schools in suburban municipalities in the Netherlands participated in the study. Actual walking and cycling routes to school were measured with a GPS-device that children wore during an entire school week. Measurements were conducted in the period April–June 2014. Route characteristics for both actual and shortest routes between home and school were determined for a buffer of 25 m from the routes and divided into four categories: Land use (residential, commercial, recreational, traffic areas), Aesthetics (presence of greenery/natural water ways along route), Traffic (safety measures such as traffic lights, zebra crossings, speed bumps) and Type of street (pedestrian, cycling, residential streets, arterial roads). Comparison of characteristics of shortest and actual routes was performed with conditional logistic regression models. Median distance of the actual walking routes was 390.1 m, whereas median distance of actual cycling routes was 673.9 m. Actual walking and cycling routes were not significantly longer than the shortest possible routes. Children mainly traveled through residential areas on their way to school (>80 % of the route). Traffic lights were found to be positively associated with route choice during ATS. Zebra crossings were less often present along the actual routes (walking: OR = 0.17, 95 % CI = 0.05–0.58; cycling: OR = 0.31, 95 % CI = 0.14–0.67), and streets with a high occurrence of accidents were less often used during cycling to school (OR = 0.57, 95 % CI = 0.43–0.76). Moreover, percentage of visible surface water along the actual route was higher compared to the shortest routes (walking: OR = 1.04, 95 % CI = 1.01–1.07; cycling: OR = 1.03, 95 % CI = 1.01–1.05). This study showed a novel approach to examine built environmental exposure during active transport to school. Most of the results of the study suggest that children avoid to walk or cycle along busy roads on their way to school.

Background: Active transport to school is associated with higher levels of physical activity in children. Promotion of active transport has therefore gained attention as a potential target to increase children’s physical activity levels. Recent studies have recognized that the distance between home and school is an important predictor for active travel among children. These studies did not yet use the promising global positioning system (GPS) methods to objectively assess active transport. This study aims to explore active transport to school in relation to the distance between home and school among a sample of Dutch elementary school children, using GPS. Methods: Seventy-nine children, aged 6-11 years, were recruited in six schools that were located in five cities in the Netherlands. All children were asked to wear a GPS receiver for one week. All measurements were conducted between December 2008 and April 2009. Based on GPS recordings, the distance of the trips between home and school were calculated. In addition, the mode of transport (i.e., walking, cycling, motorized transport) was determined using the average and maximum speed of the GPS tracks. Then, proportion of walking and cycling trips to school was determined in relation to the distance between home and school. Results: Out of all school trips that were recorded (n = 812), 79.2% were classified as active transport. On average, active commuting trips were of a distance of 422 meters with an average speed of 5.2 km/hour. The proportion of walking trips declined significantly at increased school trip distance, whereas the proportion of cycling trips (β = 1.23, p < 0.01) and motorized transport (β = 3.61, p < 0.01) increased. Almost all GPS tracks less than 300 meters were actively commuted, while of the tracks above 900 meters, more than half was passively commuted. Conclusions: In the current research setting, active transport between home and school was the most frequently used mode of travel. Increasing distance seems to be associated with higher levels of passive transport. These results are relevant for those involved in decisions on where to site schools and residences, as it may affect healthy behavior among children.

Children’s motor competence (MC) has declined in the past decades, while sedentary behavior (SB) has increased. This study examined the association between MC and physical activity (PA) levels among primary schoolchildren. Demographics, body height and weight, MC (Athletic Skills Track), and PA levels (ActiGraph, GT3X+) were assessed among 595 children (291 boys, mean age = 9.1 years, SD = 1.1). MC was standardized into five categories: from very low to very high. PA levels were classified into SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). Mixed-model analyses were conducted with PA levels as dependent variables and MC as the independent variable, while adjusting for age, gender, and body mass index (BMI) z-score on the individual level. A negative association between MC and SB and a positive association between MC and MVPA were found. The strength of both associations increased as children expressed lower or higher levels of MC. MC is an important correlate of both SB and MVPA, particularly for children with very high or low MC. Developing and improving children’s MC may contribute to spending less time in SB and more time in MVPA, particularly for high-risk groups, i.e., children with low MC. Moreover, addressing MC development and PA promotion simultaneously might create positive feedback loops for both children’s MC and PA levels.