Can preschool playground factors explain children's step counts during outdoor play?

Background: Low levels of physical activity are characteristic in preschoolers. To effectively promote physical activity, it is necessary to understand factors that influence young children's physical activity. The present study aimed to investigate how activity levels are influenced by environmental factors during recess in preschool. Methods: Preschool playground observations and pedometry during recess were carried out in 39 randomly selected preschools (415 boys and 368 girls; 5.3 ± 0.4 years old). In order to examine the contribution of playground variables to physical activity levels, taking adjustment for clustering of subjects within preschools into account, multilevel analyses were conducted. Results: During recess boys took significantly more steps per minute than girls (65 ± 36 versus 54 ± 28 steps/min). In both genders higher step counts per minute were significantly associated with less children per m2 and with shorter recess times. Only in boys physical activity levels were higher on playgrounds with a hard ground surface. In girls higher step counts were associated with the presence of less supervising teachers. Playground markings, access to toys, the number of playing or aiming equipment pieces and the presence of vegetation or height differences were no significant physical activity predictors in both genders. Conclusion: In preschool children physical activity during outdoor play is associated with modifiable playground factors. Further study is recommended to evaluate if the provision of more play space, the promotion of continued activity by supervisors and the modification of play ground characteristics can increase physical activity levels in preschoolers.