Creating safe playgrounds: a safety promotion approach

Abstract

BACKGROUND: Playground is a common platform for play and recreation, offering children opportunities to run, jump, climb and socialising with other children. In general, playgrounds are not as hazardous as playing on streets; however they still bear high risk of injuries that become alarming worldwide. This study aims to understand playground injuries from a wider perspective by making use of injury data from a hospital injury surveillance system (HISS) and to develop an educational intervention to promote playground safety. METHODS: Sports related injury incidents of children aged 0 to 14 for the period of January 2009-June 2011 were analysed spatially to identify 10 playgrounds with high incidence of injury in Kwai Tsing and Sham Shui Po. Additional selection criteria including location, accessibility and playground size were used to select playgrounds. Site survey observations were conducted in selected playgrounds to evaluate design of playgrounds and environmental factors. Safety hazards and play risks identified in observations were used to develop educational play booths that to induce safe play concepts and enhance supervision through play activities among parents and caregivers. Pre- and post-evaluation questionnaires were used to measure the effect of educational play booth, which aimed at altering parents' supervision behaviour. RESULTS: There were a total of 784 injury incidents of children aged 0 to14 identified, which represented 27% of the two districts' overall injury incidents. The top four play risks which observed in all surveyed playgrounds were play balls or toys on play equipment; play equipment with improper clothing; eating on play equipment; and play on equipment occupied by adults. The use of educational play booth has successfully increased parents' knowledge level as well as attitude towards playground safety within a very short period of time. CONCLUSION: This study has illustrated a systematic method in developing intervention for playground injuries. From the use of HISS data analysed spatially to locate injury hotspots, providing the prerequisite for playground selection that to conduct site survey, and finally making use of site survey findings to develop educational play booth. In view of the heavy burden of playground injury among children, it is advisable to apply the current project's practice in 18 districts of Hong Kong to reduce the risk of injury in playgrounds.