Waleed Abdulaziz Altwaijri, Tuline A Almazyad, Yara Ahmad Abuzaid, Jumanah Nasser Alkhater, Dalal M Ashmawi, Ghadah Khalid Alnami, Lujain A Almazyad, Sadeem Khalid Alnami, Rawan Ahmad Abuzaid, Lujeen Nasser Alkhater
Parental awareness of headaches among elementary school-aged children in Riyadh, Saudi Arabia: A cross-sectional studyz
Journal of family medicine and primary care
understanding determinants childrens outdoor play important improving low physical activity levels schools key setting safety concerns shape childrens opportunity play actively outdoors therefore qualitative evidence synthesis aimed examine adult eg parent teacher yard supervisor principal perspectives safety risk childrens active play recess elementary andor middle schools ii identify safety risk influence playground supervision decision making setting six electronic databases systematically searched march 2021 updated search june 2022 records screened eligibility criteria using covidence software data extraction synthesis performed using predesigned coding forms microsoft excel nvivo framework synthesis methodology employed guided conceptual framework structured socioecological model sem affordance theory 10370 records 25 studies included represented 608 adults across 89 schools nine countries synthesis identified 10 constraining four affording factors influenced whether school staff riskaverse risk tolerant recess turn degree childrens play managed constraining factors stemmed fears childrens physical safety fear blame liability event playground injury shaped parent school staff institutional responses risk interrelated factors across sem levels combined drive riskaverse decision making constraining supervision emerging evidence suggests childrens active play schools promoted fostering risk tolerant play friendly culture schools play facilitation training eg riskreframing conflict resolution engaging stakeholders development school policies rules balance benefits play potential risks findings show several sociocultural factors limited ability school staff genuinely promote active play future work seek foster risk tolerance schools challenge cultural norms shape parent attitudes institutional responses risk childrens play explore novel methods overcoming policy barriers fear liability schools prospero registration crd42021238719