The effect of multicolor playground markings on children’s physical activity level during recess Gareth Stratton Ph.D. a, * , Elaine Mullan b a REACH Group, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 15–21 Webster St., Liverpool L3 2ET, UK b Health Promotion Division, National Assembly for Wales, UK Available online 31 August 2005 Abstract Background. British children do not meet daily physical activity recommendations, and as yet no sustainable intervention has been reported to address their sedentary lifestyle. The purpose of this investigation was twofold: First, to examine whether painting playgrounds with multicolored markings would increase the percent of recess time spent in moderate to vigorous physical activity (MVPA) and vigorous physical activity (VPA) in girls and boys and second to quantify the contribution recess makes to national recommendations for young people’s physical activity. Methods. MVPA and vigorous physical activity (VPA) were measured using short wave heart rate telemetry. Physical activity levels were compared before and after playgrounds were painted in 4 intervention schools and compared to 4 matched schools with unmarked playgrounds. Schools were situated in areas of deprivation. Ninety-nine children completed the study. Results. A significant interaction (group  time) was evident for MVPA and VPA. Time spent in MVPA and VPA increased significantly in intervention schools as a result of playground painting. Boys were more active than girls, and activity decreased with age, but neither difference reached significance. Conclusion. Multicolor playground markings can be a low-cost method of increasing children’s daily physical activity levels in the short term. If these increases were sustained, then school playgrounds with multicolor markings would make a valuable contribution to physical activity recommendations for young people. D 2005 Elsevier Inc. All rights reserved. Keywords: Schools; Children; Recess; Physical activity; Multicolor markings Introduction British children now take part in less physical activity at school than almost all of their European counterparts (Arm- strong and McManus, 1994). Furthermore, concern has been expressed that levels of physical activity among young people have declined to the stage where they may be detrimental to their current health and well-being as well as that of the future population (Centers for Disease Control and Prevention, 1997; Biddle et al., 1988). Children’s physical inactivity has been categorized as a modifiable risk factor for lifestyle-related diseases such as osteoporosis (Bailey, 1994) and coronary heart disease (Andersen et al., 2004). Sixty minutes per day of MVPA has been recommended as the optimal, and 30 min as the minimal level for 5- to 18-year-olds (Centers for Disease Control and Prevention, 1997; Biddle et al., 1988). Unfortu- nately, 6- to 7-year-old British school children continually fail to meet the optimal criterion (Welsman and Armstrong, 1997). Schools have long been recognized as key settings to promote physical activity recommendations (Centers for Disease Con- trol and Prevention, 1997; Biddle et al., 1988; Iverson et al., 1985). Children are more likely to engage in MVPA in unstructured play where they are free to interact with their play area and their peers (Pate et al., 1996). In Britain, primary age children experience up to 600 recess periods per year, 3 times a day, 5 days per week, 39 weeks per year. However, few investigators have succeeded in implementing sustainable interventions aimed at increasing children’s participation in physically active behavior during play (McKenzie et al., 1997). Welk (1999) suggested that factors that ‘‘enable’’ children to be physically active, such as playground markings, prompts from teachers, or support from parents, are key to health promotion in young people. 0091-7435/$ - see front matter D 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.ypmed.2005.07.009 * Corresponding author. Fax: +44 151 231 4334. E-mail address: g.stratton@livjm.ac.uk (G. Stratton). Preventive Medicine 41 (2005) 828 – 833 www.elsevier.com/locate/ypmed