Change of School Playground Environment on Bullying: A Randomized Controlled Trial.

OBJECTIVE To investigate whether increasing risk and challenge in primary school playgrounds influences interactions between children. METHODS 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. RESULTS Intervention children reported higher odds of being happy at school (at 2 years, odds ratio [OR]: 1.64; 95% confidence interval [CI]: 1.20-2.25) and playing with more children (at 1 year, OR: 1.66; 95% CI: 1.29-2.15) than control children. Although intervention children indicated they were pushed/shoved more (OR: 1.33; 95% CI: 1.03-1.71), they were less likely to tell a teacher (OR: 0.69; 95% CI: 0.52-0.92) at 2 years. No significant group differences were observed in parents reporting whether children had "ever" 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: 0.06-0.34; P = .009), with no corresponding increase in children reporting bullying to teachers (both time points, P ≥ .26). CONCLUSIONS 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.