Parents worry that letting their children climb trees or play chase will land them in A&E, but no one has actually measured how often adventurous play leads to injury. This project addresses a critical data gap. While adventurous play is known to boost children’s physical and mental health, the perceived risk of injury is the biggest barrier to allowing it. Without solid numbers on how common those injuries really are—and how severe they get—parents, teachers, and policymakers have no evidence to balance safety against the benefits of active play. If this research succeeds, it will produce the first population-level statistics on adventurous-play injuries in children aged 0–11. A national parent survey will reveal how many children get hurt and under what circumstances. Hospital data from Addenbrooke’s will detail the healthcare burden of injuries that do require medical attention. And analysis of the National Major Trauma Registry will show whether adventurous play contributes to life-changing injuries. The findings could directly inform public health guidance, school policies, and parenting advice—replacing fear with facts so that children can play without being wrapped in cotton wool.
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Background Adventurous play (AP) is the predominant means by which children undertake physical activity and exercise. AP is typically defined as play, which is often outdoors, where children experience subjective feelings of thrill and excitement. It is vital for children's physical and mental health and a significant facilitator of childhood development . In my preliminary research I identified the largest barrier to engaging in AP is the perceived risk of physical injury however there is currently a significant data gap to investigate the association of injury with AP. This project will investigate the link between AP and injuries thereby addressing the largest barrier to children's physical activity. Aims and Objectives The aim of this research is to understand the epidemiology of AP-related injuries in children aged 0-11. The objectives are: To determine the population prevalence of AP-related injuries, the circumstances in which these occur and investigate the relative risk of children suffering an injury in those who engage in high levels of AP. To investigate the aetiology of childhood injury presenting to hospital, the risk factors for injuries and the role of AP in these injuries. To evaluate the aetiology of major trauma in children aged 0-11 in England and Wales and the role of AP in significant traumatic events. Methods Objective 1: Population-Level Survey - A cross-sectional national survey of parents with children aged 0-11. The survey will collect comprehensive data on the prevalence and nature of AP and related injuries and associated factors. It will determine the relative risk of injury in children who engage in high levels of AP. Objective 2: Detailed Hospital-Level Data Collection - A prospective cohort study will be conducted at Addenbrooke's Hospital collecting detailed data on children aged 0-11 who have sustained injuries to compare the aetiology of injuries requiring medical attention and the healthcare burden of AP. Objective 3: National Major Trauma Data Collection - A retrospective cohort study will analyse data from the National Major Trauma Registry (NMTR), focusing on major trauma incidents among children aged 0-11. Data will include incident details, demographics, injury specifics and healthcare details. This work stream leverages existing comprehensive data to investigate the incidence and impact of AP-related major trauma. PPIE Patient and public involvement and experience (PPIE) has shaped this proposal, identifying specific areas of concern for families and shaping the data analysis priorities. It also led to the introduction of objective 3 which specifically focuses on life changing injuries and the contributing factors. I plan to use the CA:RING PPIE group to co-design the details of these specific work streams throughout my PhD. Anticipated Impact and Dissemination The results will be disseminated through existing links between the MRC epidemiology unit and PEDAL departments with nationwide parenting, education and healthcare groups. It will also be presented at scientific conferences and through peer reviewed publications. The findings will empower children, parents, teachers and childcare workers to make informed decisions about allowing AP. It will also inform national policy and public health measures to prioritise children's wellbeing.
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