1 1 Department of Social Sciences, Université Sainte-Anne, Church Point, Nova Scotia, Canada.
2 2 PERFORM center, Concordia University, Montreal, Quebec, Canada.
3 3 Departement of Childhood Education, University of Johannesburg, Johannesburg, South Africa.
4 4 Collège d'étude mondiale, Fondation Maison des Sciences de l'Homme, Paris, France.
5 5 Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada.
6 6 Sainte-Justine Children's Hospital Research Centre, Montreal, Quebec, Canada.
7 7 Epidemiology and Biostatistic Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada.

Prospective Associations Between Play Environments and Pediatric Obesity.

Am J Health Promot. 2019 May;33(4):541-548

Authors: Fitzpatrick C, Alexander S, Henderson M, Barnett TA

Abstract

PURPOSE: To identify school typologies based on the availability of play equipment and installations. We also examined the associations between availability of play items and child adiposity.

DESIGN: Secondary analysis of longitudinal data.

SETTING: Elementary schools in Montreal, Canada.

PARTICIPANTS: We used data from the Quebec Adipose and Lifestyle Investigation in Youth study (QUALITY), an ongoing investigation of the natural history of obesity and type 2 diabetes in Quebec children of Caucasian descent.

MEASURES: The presence of play items was assessed in each child's school. A trained nurse directly assessed child anthropometric measurements to derive body mass index and waist circumference. Body fat composition was measured using DEXA Prodigy Bone Densitometer System.

ANALYSES: The final analytic sample comprised 512 students clustered in 296 schools (81% response). We used K-cluster analyses to identify school typologies based on the variety of play items on school grounds. Generalized estimation equations were used to estimate associations between school clusters and outcomes.

RESULTS: We identified 4 distinct school typologies. Children in schools with the most varied indoor play environments had lower overall body fat, B = -1.26 cm (95% confidence interval [CI], -2.28 to -0.24 cm), and smaller waist circumference, B = -4.42 cm (95% CI, -7.88 to -0.96 cm), compared to children with the least varied indoor play environment.

CONCLUSION: Our results suggest that policies regulating the availability of play items in schools may enrich comprehensive school-based obesity prevention strategies. Extending research in this area to diverse populations is warranted.

PMID: 30354254 [PubMed - in process]