{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:34:16Z","timestamp":1780634056118,"version":"3.54.1"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>To investigate whether increasing risk and challenge in primary school playgrounds influences interactions between children.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In a 2-year cluster-randomized controlled trial, 8 control schools were asked to not change their play environment, whereas 8 intervention schools increased opportunities for risk and challenge (eg, rough-and-tumble play), reduced rules, and added loose parts (eg, tires). Children (n = 840), parents (n = 635), and teachers (n = 90) completed bullying questionnaires at baseline, 1 (postintervention), and 2 (follow-up) years.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Intervention children reported higher odds of being happy at school (at 2 years, odds ratio [OR]: 1.64; 95% confidence interval [CI]: 1.20\u20132.25) and playing with more children (at 1 year, OR: 1.66; 95% CI: 1.29\u20132.15) than control children. Although intervention children indicated they were pushed\/shoved more (OR: 1.33; 95% CI: 1.03\u20131.71), they were less likely to tell a teacher (OR: 0.69; 95% CI: 0.52\u20130.92) at 2 years. No significant group differences were observed in parents reporting whether children had \u201cever\u201d been bullied at school (1 year: P = .23; 2 years: P = .07). Intervention school teachers noticed more bullying in break time at 1 year (difference in scores: 0.20; 95% CI: 0.06\u20130.34; P = .009), with no corresponding increase in children reporting bullying to teachers (both time points, P \u2265 .26).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Few negative outcomes were reported by children or parents, except for greater pushing\/shoving in intervention schools. Whether this indicates increased resilience as indicated by lower reporting of bullying to teachers may be an unanticipated benefit.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2016-3072","type":"journal-article","created":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T09:10:10Z","timestamp":1493025010000},"source":"Crossref","is-referenced-by-count":25,"title":["Change of School Playground Environment on Bullying: A Randomized Controlled Trial"],"prefix":"10.1542","volume":"139","author":[{"given":"Victoria L.","family":"Farmer","sequence":"first","affiliation":[{"name":"Departments of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila M.","family":"Williams","sequence":"additional","affiliation":[{"name":"Preventive and Social Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim I.","family":"Mann","sequence":"additional","affiliation":[{"name":"Departments of Medicine,"},{"name":"Human Nutrition, University of Otago, Dunedin, New Zealand; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Schofield","sequence":"additional","affiliation":[{"name":"Human Potential Centre, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia C.","family":"McPhee","sequence":"additional","affiliation":[{"name":"Human Potential Centre, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael W.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Departments of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,5,1]]},"reference":[{"issue":"2","key":"2021120916501116300_B1","first-page":"159","article-title":"The impact of play on development: a meta-analysis.","volume":"5","author":"Fisher","year":"1992","journal-title":"Play Cult"},{"issue":"1","key":"2021120916501116300_B2","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/archpedi.159.1.46","article-title":"Resurrecting free play in young children: looking beyond fitness and fatness to attention, affiliation, and affect.","volume":"159","author":"Burdette","year":"2005","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"1","key":"2021120916501116300_B3","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2011-2953","article-title":"The importance of play in promoting healthy child development and maintaining strong parent-child bond: focus on children in poverty.","volume":"129","author":"Milteer","year":"2012","journal-title":"Pediatrics"},{"key":"2021120916501116300_B4","volume-title":"Play: How It Shapes the Brain, Opens the Imagination, and Invigorates the Soul.","author":"Brown","year":"2010"},{"key":"2021120916501116300_B5","volume-title":"No Fear: Growing Up in a Risk Averse Society","author":"Gill","year":"2007"},{"key":"2021120916501116300_B6","volume-title":"Free to Learn: Why Unleashing the Instinct to Play Will Make Our Children Happier, More Self-Reliant and Better Students for Life","author":"Gray","year":"2013"},{"issue":"2","key":"2021120916501116300_B7","first-page":"33","article-title":"Outdoor play: does avoiding the risks reduce the benefits?","volume":"33","author":"Little","year":"2008","journal-title":"Aust J Early Child"},{"issue":"6","key":"2021120916501116300_B8","doi-asserted-by":"crossref","first-page":"6475","DOI":"10.3390\/ijerph120606475","article-title":"Position statement on active outdoor play.","volume":"12","author":"Tremblay","year":"2015","journal-title":"Int J Environ Res Public Health"},{"key":"2021120916501116300_B9","unstructured":"Gleave\u2008J, Cole-Hamilton\u2008I. 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