Playground Design Matters: A Cross-Sectional Study on the Association Between Playground Features and Children’s Usage

This study aimed to evaluate the associations between playground features and utilization. Following a cross-sectional study design, we assessed the features of 38 playgrounds using the Play Space Audit Tool (PSAT). Thereafter, we monitored the playground utilization by children (0–12 y) using a headcount approach during multiple site visits. Generalized Estimating Equations regression models were used to analyze the associations between the PSAT scores and playground utilization. Significant associations were found between the PSAT scores ‘overall’, ‘path’, and ‘play structure’ and playground utilization. For boys specifically, their playground usage was positively related to the scores ‘overall’, ‘general amenities’, and ‘play’. For girls, their playground usage was positively related to the scores ‘overall’, ‘path’, and ‘play structure’. In conclusion, the ‘overall’ and ‘play structure’ PSAT scores were robustly associated with higher playground utilization, and the associations for domain scores vary between boys and girls. The outcomes enforce that playgrounds of higher quality attract more children.