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The International Journal of Behavioral Nutrition and Physical Activity logoLink to The International Journal of Behavioral Nutrition and Physical Activity
. 2025 Sep 25;22:117. doi: 10.1186/s12966-025-01813-9

2025 Position statement on active outdoor play

Eun-Young Lee 1,2,3,4,, Louise de Lannoy 4, Yeong-Bae Kim 5, Apoorva Rathod 4, Maeghan E James 3,4,6, Olivia Lopes 6, Brianna Nasrallah 3,7, Anujah Thankarajah 8, Dina Adjei-Boadi 9, Maria Isabel Amando de Barros 10, Scott Duncan 11, Robyn Monro Miller 12, Lærke Mygind 13, Leigh M Vanderloo 14,15, Po-Yu Wang 16, Mark S Tremblay 3,4,6,7; AOP10 Steering Committee Group
PMCID: PMC12462132  PMID: 40999404

Abstract

Background

In 2015, the Position Statement on Active Outdoor Play was released in Canada, emphasizing the critical role of active outdoor play—with its risks—in fostering children’s healthy development. Building on this foundation, a 10-year update of the Position Statement on Active Outdoor Play (AOP10) was initiated to broaden its scope and impact, by encompassing all age groups and extending its reach conceptually and globally. Here we explain and present the new 2025 Position Statement.

Methods

Development of the 2025 Position Statement was informed by 18 rigorous literature reviews, a series of leadership group meetings, three rounds of draft AOP10 surveys, followed by extensive communication, translation, production, and dissemination activities.

Results

The 2025 Position Statement on Active Outdoor Play states: “Active outdoor play promotes holistic health and well-being for people of all ages, communities, and environments, and for our entire planet. It is critical given the multiple global challenges we face today (e.g., social and health inequities, climate change and digital addiction). Together, as a collective of the outdoor play sector, we recommend increasing opportunities for active outdoor play in all settings where people live, learn, work, and play. To achieve this, it is important to collaborate across sectors, settings, and societies to preserve, promote, and value equitable access to active play outdoors and in nature.” We also provide key evidence pertaining to the nine core themes that informed the development of the 2025 Position Statement and offer recommendations across sectors, calling for multi-sectoral, multi-level collaborations. Across all three survey rounds, responses indicated strong support for the 2025 Position Statement and its supporting content (Round 3: 93–98%). Comprehensive, proactive knowledge translation and dissemination plans were executed to maximize the reach and impact of the 2025 Position Statement.

Conclusions

The 2025 Position Statement calls for systemic changes that prioritize equitable access to active outdoor play opportunities and aims to create healthier communities. Achieved through international collaboration and consensus, the 2025 Position Statement aspires to connect, advise, inspire, and activate active outdoor play worldwide.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-025-01813-9.

Keywords: Health promotion, Leisure, Nature, Nature-based solution, Planetary health, Physical activity, Recreation, Risky play

Background

In 2015, the Position Statement on Active Outdoor Play was released [1], calling for a fundamental shift in how society perceives and supports children’s active outdoor play in the Canadian context. Driven by scientific evidence from diverse disciplines—including public health, child development, early child education and care, and injury epidemiology— the statement emphasized the foundational importance of active outdoor play for children’s physical, mental, and social well-being [2]. The 2015 Position Statement also highlighted the need to balance risk and safety, recognizing that some degree of risk is essential for healthy child development [3]. A decade later, the world has changed in ways that make active outdoor play more important than ever. The COVID-19 pandemic, climate change, rising mental health concerns, and the increasing use of digital technologies have reshaped people’s lives, limiting and replacing opportunities for unstructured active outdoor play [1, 48].

Despite progress in outdoor play research, policy, and practice [1, 9, 10], many barriers to active outdoor play remain [11, 12]. Moreover, new challenges are emerging on a global scale. The widespread use of digital technologies and increasing prevalence of screen-based recreational activities is shifting people toward indoor, sedentary activities [4, 1315]. Climate change is also playing a significant role, with rising temperatures, natural disasters, and unpredictable weather patterns impacting the feasibility of outdoor play in many regions [1619]. Economic and geopolitical challenges in conflict zones [2022], as well as socioeconomic disparities within and between countries [2325] continue to create inequitable outdoor play opportunities, disproportionately affecting individuals from marginalized groups and communities on a regional- and global-scale.

Addressing these evolving challenges requires an integrated, cross-sectoral approach that merges urban planning, public health, education, and environmental sustainability efforts to ensure all individuals value and have access to safe, engaging, and healthy outdoor play experiences. In response to these challenges, an international leadership group came together to create an updated Position Statement on Active Outdoor Play (AOP10 project hereafter). The goal of this update was to reaffirm and expand upon the original statement’s principles while integrating new evidence pertaining to all age groups and addressing emerging global challenges. The updated 2025 Position Statement aims to respond to the evolving issues faced by humanity, emphasizing the need for systemic action across various sectors—including policy and legislation, education and schools, urban and community planning, culture and society, media, and research and granting agencies. It calls for collective efforts to ensure that all individuals have equitable access to active outdoor play regardless of background or ability. Furthermore, it advocates for integrating active outdoor play into system-level strategies and initiatives that promote the health and well-being of the Earth’s ecosystems.

Now, more than ever, we must prioritize and protect the right to play outside for all. The overarching aim of the AOP10 project was to update the 2015 Position Statement on Active Outdoor Play [1], expanding its scope to encompass all age groups, broader concepts, and reflect a global perspective [1]. The emphasis on active outdoor play is intentional, distinguishing it from broader concepts such as outdoor play, outdoor time, or outdoor learning [5]. While these terms are interconnected, they carry distinct meanings, and prioritizing active outdoor play highlights our consensus on its unique benefits for the health and well-being of humans and the planet. We used the international consensus definition of active outdoor play, defined as “voluntary engagement in activity that takes place outdoors, involving physical activity of any intensity, that is fun and/or rewarding and usually driven by intrinsic motivation [5]”. Accordingly, new to the 2025 Position Statement is the recognition that active outdoor play applies across the lifespan. While terms such as ‘recreation’ and ‘leisure’ may be used more commonly for adults, they are included under the umbrella of active outdoor play, as long as they align with the above definition [5]. In line with this broader scope, the evidence reviews conducted to inform this update included studies on outdoor physical activity among adults and nature-based walking among older adults (e.g., [26]), while excluding studies focused on organized sport or structured exercise. To guide the inclusion and interpretation of data, we developed a typology of active outdoor play, presented in Table 1, which outlines the criteria used to define what constitutes active outdoor play for the purposes of this work. Operational definitions of active outdoor play and key terms used in and related to the 2025 Position Statement are provided in Appendix A–Supplementary Table 1.

Table 1.

Typology of active outdoor play

Considerations
General Age Country-Specific Context
Activity
Outdoor play Play outdoors is generally assumed to be active; if outdoors, there is a higher likelihood of being active, even sporadically Play is not considered something that adults do. A narrow definition of play excludes most age groups beyond children
Natural outdoor environments are more conducive to sporadic and spontaneous play for both children and adults alike; greenspaces or blue spaces provide organic opportunities for unplanned'play-like'activities
Physical activity Physical activity for the purposes of health improvement (e.g., walking-based intervention for obesity/type 2 diabetes management) is not considered play
Sport Sport as a career, elite-level sport, competitive sport is generally not considered play Adult recreational sport leagues are considered play (especially if self-refereed), whereas child sport is not as it typically adult-directed and supervised Within many African countries, sport is the primary way that children play, where it is often child-led and intrinsically motivated and/or voluntary
Recreation Outdoor recreation as part of a job/career (e.g., hiking guide) is generally not considered play
Recreation needs to be unstructured to be considered play
Active transport Active transport is generally not considered play
Play-based learning Play needs to be explicitly mentioned (playful, play-based, etc.) in education-focused research to be included in order to have clarity on the intentionality within learning environments Adventure camping as part of higher-level education is not considered play because it is not intrinsically motivated In Denmark, guided play in early years settings is often used to initiate child-led play, and so is still considered play. In countries where the focus of early childhood education is much more on education, much less is considered play
In education, there is a continuum of unstructured free play to teacher directed play, with guided play somewhere in the middle (e.g., setting up invitations for play where there is still opportunity for child-led play)
Active outdoor play in educational settings can be considered anything involving movement outdoors. This means loose parts, exploring as a class, actively engaging in a science activity, etc
Measurement Methods
Play-based evaluation Early years research typically uses play methods to assess developmental stages; as this is not intrinsically motivated by the child, this is not considered play
Proximity to outdoor recreation spaces Proximity to an outdoor play/recreation space without discussing use of that space is generally excluded

The objective of the present paper was to explain and present the updated 2025 Position Statement on Active Outdoor Play and describe its release.

Methods

The development of the AOP10 project followed a multi-phase, participatory approach to ensure global representation, scientific rigor, and global relevance. The detailed preparatory process and methodology underpinning this report are documented in a separate methods-focused manuscript [27], which outlines the study design, data collection tools, and analytical approach in depth. The current manuscript focuses on interpreting the findings, highlighting key insights, and offering actionable recommendations.

Reviews of the literature

Based on the conceptual framework developed for the AOP10 project (Appendix A–Supplementary Fig. 1) [27], 12 reviews were undertaken to provide key evidence on the core themes identified in the framework, along with six world region reviews. A full list of the reviews can be found in Supplementary Table 2 [27]. Methodological details of this phase is described in Sect. 2.5 of the accompanying AOP10 Methods paper [27]. The present paper provides a Summary of the key findings from the 18 reviews and relevant studies that informed the 2025 Position Statement.

AOP10 leadership group meeting

The 11-person AOP10 Leadership Group convened in Seoul, South Korea, December 6–9, 2024, for an intensive three-day working meeting. The meeting was co-organized by the AOP10 Executive Committee and the Department of Sport Industry Studies at Yonsei University. The primary objectives of this gathering were to 1) review and synthesize the latest evidence on active outdoor play based on the 18 reviews conducted, 2) engage in collaborative discussions, and 3) draft the 2025 Position Statement and its supporting evidence statements. Through structured brainstorming sessions, the group worked to refine key messages, ensuring they reflected current research, emerging global challenges, and the needs of global communities. This in-person meeting provided an opportunity for interdisciplinary dialogue, fostering a shared vision to draft the 2025 Position Statement.

AOP10 Steering Committee Group Consultation.

The AOP10 Steering Committee consisted of a diverse group of experts interested in outdoor play leadership, research, practice, and advocacy [27]. The first round of the consultation survey was conducted between January 10 and 21, 2025, and the second survey was circulated between February 14 and 21, 2025—via the online survey platform, REDCap [28] (BN, MEJ)—distributed to the AOP10 Steering Committee (N = 143). The purpose of engaging the AOP10 Steering Committee at this early stage of the consultation process was to create space for detailed feedback, identify areas requiring clarification or refinement, and collaboratively shape the tone, structure, and messaging of the 2025 Position Statement.

Survey Round 1 gathered initial feedback on the Statement’s clarity, level of agreement with the content, and alignment with the AOP10 Steering Committee members’ understanding, research, and/or practice. Each question included a five-point Likert response scale (strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, strongly disagree), along with an open-text field for respondents to provide written feedback. We also gathered qualitative feedback for each section (i.e., Position Statement, Evidence, and Recommendations). In February 2025, Survey Round 2 was circulated with the Steering Committee after refinement based on the input from Round 1, ensuring alignment with current evidence and expert opinion pertaining to active outdoor play. The surveys distributed during Round 1 and Round 2 are available in Appendix B.

Global collaboration group consultation

To further enhance the global relevance and cultural applicability of the 2025 Position Statement draft, we circulated the further revised statements to the broader global community, leveraging the membership of the PLaTO-Net (Play, Learn, Teach Outdoors Network; https://www.outdoorplaycanada.ca/plato-net/) on March 21, 2025 via the online survey platform, REDCap [28] (BN, MEJ). This consultation was conducted in the six official languages of the United Nations (UN; i.e., Arabic, Simplified Chinese, English, French, Russian, and Spanish) to gather diverse perspectives and feedback from partners and interested parties worldwide. Initial translations for each language were generated using Chat Generative Pre-trained Transformer (ChatGPT), then reviewed and refined by two or three professionals actively working in the field, each fluent in English and one of the UN official languages. All reviewer-provided translations were consolidated, and consensus was reached. This multi-step process aimed to ensure that the final Position Statement reflects the needs, experiences, and cultural contexts of a broad and representative range of communities on a global scale. The survey was disseminated through the various networks of the AOP10 Leadership and Steering Committee members and followed a snowball sampling methodology to maximize reach and input. To minimize the risk of fraudulent responses in survey, multiple safeguards were employed including targeted recruitment, reCAPTCHA verification within the REDCap platform, use of survey access codes, and by refraining from posting a public survey link on social media platforms [29]. English and translated versions of the Global Collaboration Consultation Survey (Round 3) are available in Appendix B. The list of those who contributed to the translation process is presented in Appendix A– Supplementary Table 3.

Analysis and integration

Both quantitative and qualitative feedback from the AOP10 Steering Committee and Global Collaboration Group consultation via three rounds of consultation surveys were systematically analyzed and integrated into the final version of the 2025 Position Statement. The final statements were informed by both scientific evidence as well as expert knowledge and lived experiences shared via the surveys in an open-ended format from the AOP10 Steering Committee and the Global Collaboration Group (Appendix C). Immediately after each survey closed, two trainees (AT, BN) organized and summarized the responses. The Executive Leadership Team (E-YL, LDL, MST), together with the trainees (AT, BN, MJ), convened after each survey round to review both the quantitative results and qualitative feedback, which had been thematically grouped. Each written comment was carefully evaluated and triangulated (E-YL, LDL, MEJ, MST) to assess its validity and relevance to the refinement process. One trainee (AR) conducted an additional round of review and reorganization. Specifically, responses from all three rounds of the survey were systematically Summarized and restructured according to key thematic areas. This process aimed to improve comprehension, highlight patterns across rounds, and present the findings in a more coherent and accessible format for interested actors and readers of the final report. This was done in three stages: 1) reading all the qualitative comments for each section and highlighting common words and phrases across the comments, 2) grouping together all the comments with similar words and phrases and identifying possible themes, and 3) going over the themes and comments to see if there was further need for reorganization or regrouping. Where possible, these themes were also maintained across sections to be able to pinpoint overarching areas of concern and guide future works. For descriptive data, consensus was considered achieved a priori if 75% or more of valid respondents—respondents who provided complete data—indicated agreement (combining 'strongly agree' and 'somewhat agree') [30].

Results

This section presents the 2025 Position Statement and its eight key supporting evidence statements. The final 2025 Position Statement, its supporting evidence statements, emerging areas, and recommendations are available in Fig. 1, with versions in each of the other UN languages are available at https://www.outdoorplaycanada.ca/aop10/. Below, the evidence that supported the development of the 2025 Position Statement are explained further, followed by the summary of the AOP10 consultation process. Draft versions of the 2025 Position Statement and evidence statements used during the three rounds of the consultation process are available in Appendix B.

Fig. 1.

Fig. 1

2025 Position statement on active outdoor play. Note: Visit https://www.outdoorplaycanada.ca/aop10/ to access the 2025 Position Statement in higher-resolution, print-quality format.

2025 Position statement evidence

Evidence statement 1: movement behaviors

This evidence is consistent with and builds on the evidence used for the 2015 Position Statement [2, 31]. In general, active outdoor play is associated with higher levels of physical activity, less sedentary behavior, including recreational screen time, and better sleep. Specifically, compared to being indoors, spending more time outdoors is associated with higher levels of physical activity among both children [2, 3139] and adults [4044]. Furthermore, being outside often reduces the likelihood of prolonged sitting and screen time for children [38, 39, 45] and adults [42, 44]. Outdoor settings provide diverse and dynamic stimuli that encourage movement—whether through walking, running, climbing, biking, wheeling, or simply exploring in urban greenery or nature—which not only helps expend energy but also supports better sleep quality and/or duration among children [31, 45, 46] and adults [4749].

In addition to contributing to more physically active lifestyles, outdoor environments offer unique conditions that entice individuals to engage in spontaneous and enjoyable activities [4954]. Natural features like trees, open fields, uneven terrain, and loose parts, or playground structures could inspire creative spontaneous active play, which is often unstructured and self-directed [11, 55]. The sensory experiences of being outdoors—sunlight, fresh air, varied textures, smells, and sounds—also contribute to emotional regulation and stress relief, which are linked to improved sleep patterns [46, 51, 52, 56]. Therefore, frequent engagement in active outdoor play on a regular basis helps individuals establish a healthy cycle of activity and rest throughout the day.

Evidence statement 2: health & well-being

This evidence is also consistent with and builds on the evidence used for the 2015 Position Statement [2, 3, 57, 58]. A recent umbrella review [58] synthesizing evidence from six systematic reviews [3, 5963] (Summarizing results from 381 published articles) reported overall favorable associations between active outdoor play and a broad range of physical, mental, social, and spiritual health and well-being outcomes, with partial support for causality. Of note, five reviews included in the umbrella review focused exclusively on active outdoor play in natural spaces. Nevertheless, these findings, in general, offer robust support for the multifaceted benefits of active outdoor play across the lifespan. A recent scoping review also highlighted that physical activity outdoors in nature provides greater health benefits compared to exposure to nature or physical activity alone [51].

Growing evidence suggests that the benefits of active outdoor play for children, regardless of where it takes place—either in open fields, playgrounds, urban centers, or public spaces—, extend beyond physical health, showing generally positive associations with social and mental health [3, 57] and executive functioning [64], and even mediates the negative impact of screen time on neurodevelopmental outcomes [65]. Furthermore, active outdoor play was associated with better cognition compared to physical activity done indoors [66]. In a recent systematic review on risky play and health outcomes among children aged 3–12 years [57], engaging in risky play—including rough-and-tumble play—was positively associated with physical health and fitness, as well as general gains in mental health, self-efficacy, self-regulation, and resilience. Taken together, these findings affirm that active outdoor play enhances health and well-being across physical, mental, social, and spiritual dimensions for people of all ages.

Evidence statement 3: risky play

This evidence is also consistent with and builds on the evidence used for the 2015 Position Statement [3, 57]. Outdoor environments provide rich and dynamic spaces that foster playful adventures and healthy risk-taking—both of which are essential for development across the lifespan [5, 67, 68]. Among children, risky play—such as climbing, rough-and-tumble activities, or exploring unknown terrain—allows them to test their physical limits, manage fear, and develop risk perception skills that are critical for safety and resilience [3, 6971]. These experiences are not just physically engaging; they also enhance children's confidence, resilience, and problem-solving capacities [3, 57, 72], while promoting their agency, well-being, and physical literacy [7375]. This is particularly true when children are supported by nurturing social environments that support risky play [76]. On the other hand, emerging evidence suggests that “a mismatch between a child’s innate proclivity for risk-taking and the rise of ultra-safe and intensively parented play spaces” may have contributed to increased prevalence of anxiety among youth reported in recent data [7779].

The value of active outdoor play—involving risky or thrill-seeking play [79]—extends into adulthood. Among adolescents and adults, activities like rock climbing, cliff diving, mountain biking, base jumping, and big wave surfing are often categorized as risky play [68]. The concept of risky play is rarely applied to older adults, whose play is often characterized as safe, slow, and stoic [80]. For older adults, play, in general, can be understood as a positive, creative, and stimulating behavior that is beneficial for social and physical well-being [81, 82], stress coping [83], personal development and instilling pro-environmental behavior [82]. It is noted that risky play, even for older adults, can be conceptualized as existing on a spectrum influenced by factors such as age, gender, ability, and personal preference [84, 85], which can include physically challenging activities that push personal comfort or ability levels, depending on individual capacity and interest. Regardless of the level of risks involved in play behavior, play-enabling outdoor spaces have been recognized as especially beneficial for older adults, as they foster social connection, reduce isolation, and support the maintenance of functional mobility and cognitive engagement [85]. Whether navigating childhood or aging, access to outdoor play environments that balance freedom with safety can be an important public health investment that fosters lifelong health and well-being.

Evidence statement 4: One Health

This evidence is newly incorporated to inform the 2025 Position Statement. Active outdoor play can serve to connect benefits across sectors including, but not limited to, public health, education, recreation, and environment sectors to address global challenges. One Health is a multi-sectoral, integrated, transdisciplinary approach to addressing global health challenges, while recognizing the interconnectedness of animal, human, and environmental health [86]. The One Health approach fosters opportunities for individuals to move, learn, and thrive in environments that simultaneously promote biodiversity and ecological health through collective, cross-sectoral efforts [87]. This movement is gaining momentum worldwide, supported by a growing body of evidence and international collaborations that bridge cultural, geographical, and disciplinary boundaries [8893]. As countries continue to grapple with complex and interconnected challenges of rising communicable and non-communicable diseases [94], active outdoor play offers a promising part of the solution by supporting healthier communities and fostering more resilient ecosystems across the lifespan and around the world [17, 26, 87].

Global momentum has been catalyzed through initiatives such as the AOP10 six world region reviews—representing Africa [92], Asia [90], Europe [88], Latin America and the Caribbean [93], Northern America [89], and Oceania [91]—highlighting how the 2015 Position Statement has united researchers, practitioners, and policymakers in Canada and the urgent need to engage global communities for collaboration and partnership to address shared global challenges. Complementing this, a global scoping review exploring Indigenous knowledge systems related to outdoor play [95] highlighted the importance of place-based, relational worldviews in which outdoor play is not simply a recreational activity, but a deeply embedded practice that nurtures wholistic well-being [9698]. In a similar vein, indigenizing outdoor play can be understood as integral to intergenerational learning, cultural continuity, decolonization, and shared responsibilities for conservation efforts and the advancement of Indigenous sovereignty [9598].

Evidence statement 5: nature and the environment

This evidence is newly incorporated to inform the 2025 Position Statement. Experiences in natural settings—whether through distance running, adventures, gardening, forest school programs or spiritual connections with the environment—can evoke personal transformation, eco-sensitivity, and a sacred appreciation for nature [99103]. These embodied and emotional experiences have shown to play a role in shaping environmental attitudes and behaviors across the lifespan. As suggested by a recent review [103], regular outdoor play experiences can foster environmental stewardship, contributing not only to individual well-being but also to collective ecological consciousness. Therefore, when active outdoor play is integrated into everyday life, it can develop lifelong habits of caring for both personal and planetary health [5, 100, 104106].

Caused by human industrial activity, climate change increasingly threatens opportunities for active outdoor play by altering landscapes, increasing exposure to extreme weather, and heightening health risks such as heat stress and air pollution [107]. These disruptions are known to reduce safe, accessible play opportunities for individuals and communities affected [17, 26]. At the same time, promoting active outdoor play is reported to offer a meaningful way to engage individuals and communities in climate adaptation and resilience building [26, 108110]. As scholars in physical activity and public health have noted [111113], the ostensibly apolitical framing of physical activity, including active outdoor play, can be strategically leveraged to engage with pressing global challenges, such as climate change. In this context, active outdoor play operates not only as a means of individual health promotion but also as a political act that aligns personal behavior with broader environmental and public health imperatives, aligning with the efforts being made primarily in the transportation sector for health co-benefits [114, 115].

Promoting local, low-impact outdoor play opportunities can help minimize travel-related emissions and foster stronger connections with nearby natural environments [26]. It is also important to acknowledge that not all outdoor play activities are inherently sustainable, the use of motorized recreational vehicles (e.g., snowmobiles and all-terrain vehicles) or the development and maintenance of large-scale, corporate-run, recreational resorts geared toward activities such as skiing/snowboarding, golfing, or scuba diving may contribute to environmental degradation and climate change [19, 26]. Recognizing these nuances is critical to guiding policies and practices that support both human and planetary health.

Evidence statement 6: social capital

This evidence is newly incorporated to inform the 2025 Position Statement. Across age groups and settings, engaging in active outdoor play as a collective—whether through community gardens, public parks, schoolyards, or urban green spaces—has been shown to promote intergenerational connection, mutual understanding, and a shared sense of belonging [103, 116]. For children, active outdoor play is reported to facilitate the development of social skills, trust, safety, and empathy while also contributing to community-level social capital [72, 117, 118]. For adolescents, active outdoor play is reported to reduce social anxiety surrounding peer evaluation while enhancing social interactions [119], as well as allowing adolescents to acquire the social safety and support they need, particularly in rural and small-town settings [120]. Among adults and older adults, inclusive and play-enabling physical and social spaces have been shown to enhance perceptions of community connection, reduce social isolation, and encourage playful engagement with others [54, 81, 85, 121]. This is particularly relevant in urban settings where age-friendly design and inclusive planning are critical to ensuring all individuals, regardless of age or ability, can participate meaningfully in community life [54, 122, 123].

In turn, cohesive communities can create safe and supportive environments that promote citizenship, agency, and equitable access to active outdoor play [116]. Community cohesion and strong social networks are foundational to the development of public spaces that are perceived as safe, welcoming, and reflective of cultural values [122, 124]. When individuals feel a sense of ownership and representation in outdoor environments, it is reported that they are more likely to engage in activities that reinforce shared values and civic participation. This finding was particularly important for marginalized groups as it allows them to reshape power dynamics and improve access to play [117, 121, 122, 125]. Furthermore, evidence suggests that when adolescents and young adults have access to safe, culturally relevant, and socially supported outdoor play spaces, they report greater well-being and sustained engagement in physical activity [121, 126]. These findings collectively point to the potential role of active outdoor play as a vehicle for social inclusion, cultural celebration, and the strengthening of community resilience across the lifespan [116].

In nations grappling with the ongoing impacts of colonial legacies, a growing body of Indigenous scholarship and knowledge affirms that outdoor play must be understood not merely as an individual or developmental benefit, but as a practice deeply embedded in place-based, relational worldviews [95]. From this perspective, outdoor play is not separate from culture or community but is a living practice that strengthens ties to land, identity, and responsibility. These Indigenous frameworks challenge dominant paradigms by centering connection over consumption, reciprocity over extraction, and shared responsibilities for conservation [9598]. Furthermore, among children and youth with disabilities, two recent reviews noted that the literature remains limited, with most studies focusing on supervised play in manufactured playgrounds rather than natural environments [123, 125]. These findings highlight a gap in understanding how natural outdoor settings—such as forests, parks, and open green spaces—may offer inclusive and developmentally supportive experiences for children with diverse abilities.

Evidence statement 7: education

This evidence is newly incorporated to inform the 2025 Position Statement, to recognize the interconnectedness between active outdoor play and learning [5]. From early childhood through older adulthood, play—particularly in outdoor, unstructured, or semi-structured settings—serves as a dynamic foundation for lifelong learning that supports social, emotional, and cognitive growth [54, 59, 64, 127]. In early childhood, engaging with the natural environment through play is shown to enhance sustainable thinking through inquiry-based learning and environmental exploration, as well as opportunities for movement, imaginative engagement, and cooperative learning [128]. Outdoor learning environments, especially those that offer choice and adventure, promote social-emotional development by encouraging autonomy, empathy, and emotional regulation [129]. Nature-based play in school settings has also been associated with increased attention, engagement, and classroom readiness [130].

Active outdoor play-based learning continues well beyond early childhood [131]. School-aged children and youth can also benefit from adventure-based outdoor learning—such as rock climbing, mountain biking, orienteering, or group wilderness challenges—which fosters resilience, adaptability, and leadership [68, 73]. These experiences, especially when scaffolded within educational programs, can promote autonomy, risk negotiation, and collaborative problem-solving, which are central to adolescent development [127]. In adulthood, active outdoor play continues to serve learning opportunities [131, 132]. For example, a scoping review on older adults’ participation in outdoor adventure activities found that they not only developed new skills and competencies but also gained knowledge about nature and sustainability [132].

Evidence statement 8: indoor time

This evidence is consistent with and builds on the evidence used for the 2015 Position Statement [1]. Prolonged indoor time often leads to more sedentary behavior and digital screen use, both of which are independently linked to increased risk for all-cause mortality, cardiovascular disease, and other chronic conditions [133135]. These risks are compounded by limited opportunities for physical activity, particularly in the outdoors, as sedentary routines often dominate indoor environments in both occupational and domestic settings [136138]. More alarmingly, higher levels of sedentary behavior have been associated with greater risks for disease incidence and premature death, even among individuals who meet recommended physical activity guidelines [139].

Beyond displacing opportunities for physically engaging and reinvigorating outdoor play, indoor environments may also expose individuals to a range of environmental health hazards, including indoor air pollutants, allergens, and infectious agents [140, 141]. These exposures can originate from various sources such as combustion appliances, volatile organic compounds from household products, tobacco smoke, dust mites, mold, and inadequate ventilation systems [141]. Indoor air quality has long been identified as a critical determinant of respiratory health, particularly among children, older adults, and individuals with pre-existing conditions. According to the World Health Organization [142], household air pollution is responsible for the premature deaths of over three million individuals annually. Among these, approximately 32% are attributed to ischaemic heart disease, 23% to stroke, 21% to lower respiratory infections, 19% to chronic obstructive pulmonary disease, and 6% to lung cancer. In children under the age of five, household air pollution accounts for nearly half of all pneumonia-related deaths. In addition to these established health outcomes, growing evidence indicates that household air pollution may also be associated with a range of other adverse health conditions, including low birth weight, stillbirth, asthma, ear and upper respiratory infections, tuberculosis, cataracts, and cancers of the nasopharynx, larynx, and cervix [140, 142].

It is important to acknowledge that environmental hazards are not confined to indoor spaces. Outdoor environments also contain pollutants—such as traffic-related air pollution, industrial emissions, and seasonal allergens—that pose risks to human health [143145]. However, the magnitude of exposure risk indoors could be amplified by the sheer amount of time people spend within enclosed spaces. According to global estimates, individuals in both high- and low-income settings now spend approximately 90% of their time indoors—whether in homes, schools, workplaces, or transportation [140]. This prolonged time spent indoors can intensify the cumulative effects of indoor air quality on health over time, compared to that of ambient air pollution [140142].

Therefore, while outdoor spaces are not without environmental risks (e.g., ambient air pollution, wildfire smoke), the predominance of indoor living environments in modern societies demands a critical public health response. In line with the 2015 Position Statement, we maintain the position that regular engagement in active outdoor play can counterbalance the risks associated with extended time spent indoors daily [1]. Outdoor environments typically provide greater opportunities for movement and play, thereby facilitating higher levels of moderate-to-vigorous physical activity and helping individuals reduce sedentary time [2, 31]. Active outdoor play can also reduce cumulative exposure to indoor air pollutants and infectious diseases and offer restorative effects associated with natural environments—benefits that often surpass those gained through indoor activities [52, 146].

The 2025 Position Statement (Fig. 1) also presents some key questions where interdisciplinary research, policy innovation, and practical implementation could emerge to shape the future landscape of active outdoor play. As the field of active outdoor play continues to evolve, emerging and pressing questions are challenging conventional paradigms, stimulating critical inquiry, and revealing new opportunities for advancing research and practice.

AOP10 Steering committee group consultation

To ensure that the 2025 Position Statement reflected both current evidence and the collective vision of the AOP10 initiative, two iterative rounds of consultation were conducted with members of the global AOP10 Steering Committee. This internal consultation served as an essential step to build consensus among core contributors and ensure alignment on the foundational principles, framing, and direction of the 2025 Position Statement and key evidence statements.

A total of 139 members were invited via email to complete the Round 1 survey, of which we received 130 responses. Of those, 64% (84 respondents) provided complete responses. We also received qualitative feedback across the three major sections (i.e., Position Statement, Evidence, Recommendations). For Round 2, we received responses from 111 of the 139 members. Of those, 97 respondents completed at least 50% of the survey questions. Primary country of residence/workplace and sectoral representation (collected only during Round 1) of 88 respondents are illustrated in Fig. 2a and b, respectively.

Fig. 2.

Fig. 2

AOP10 Steering Committee Group that participated in consultation (n = 88). Note: Other Global North countries included Finland, France, Greece, Japan, Poland, Portugal, Serbia, Slovakia, Slovenia, Spain, Taiwan; Other Global South countries included Nepal and South Africa. Other sectors included childhood disability, play provision, urban planning and design, design, and funder. NGO: Non-governmental organization

Table 2 (Round 1 and Round 2) reports on three key measures—clarity, agreement, and alignment—for each section of the draft 2025 Position Statement. In Round 1, 98% of valid respondents agreed the 2025 Position Statement draft was clear and 95% agreed with its overall message. These figures remained high in Round 2, with 98% agreeing with the clarity and 98% agreeing with the message. The Play-amble was only introduced in Round 2 and received 98% agreement across all three measures based on valid respondents, indicating strong initial endorsement. For the Evidence sections, the largest increases from Round 1 to Round 2 were observed for Evidence 3: “Risky Play” on its clarity (78% to 98%), agreement (73% to 97%), and alignment (78% to 98%). Improvements were also observed for Evidence 1: “Movement Behaviors”, Evidence 2: “Health and Well-being”, and Evidence 7: “Learning”, which suggest that the revised contents in Round 2 strongly resonated with the Steering Committee and addressed previous concerns. Support for clarity (94% to 90%), agreement (95% to 89%), and alignment (96% to 92%) dropped slightly for Evidence 6: “Social Capital”; however, overall, strong consensus was achieved. Identified as an important thematic addition, “Emerging Areas” also received strong support in both rounds (95%−98%), showing strong interest in including forward-looking, novel areas of research.

Table 2.

Assessment of the 2025 Position Statement (AOP10) through a three rounds of consultation process

AOP10 Steering Committee Group Global Collaboration Group
Survey Round Round 1 Round 2 Round 3
N (n)a 139 (84) 139 (76) 308 (182)
Clarityb Agreementb Alignmentb Clarityb Agreementb Alignmentb Clarityb Agreementb Alignmentb
Play-amble NA NA NA 98% (99%) 98% (99%) 98% (99%) 95% (97%) 95% (97%) 95% (97%)
Position Statement 98% (98%) 95% (94%) NA 97% (97%) 96% (96%) 96% (97%) 95% (96%) 95% (96%) 93% (94%)
 Evidence 1: Movement behaviors 90% (90%) 84% (86%) 90% (88%) 98% (99%) 96% (96%) 96% (96%) 97% (97%) 95% (96%) 97% (97%)
 Evidence 2: Health and Well-being 93% (92%) 89% (88%) 95% (95%) 98% (99%) 97% (97%) 98% (99%) 97% (97%) 96% (97%) 97% (97%)
 Evidence 3: Risky Play 78% (79%) 73% (75%) 78% (82%) 98% (99%) 97% (97%) 98% (96%) 98% (98%) 97% (97%) 96% (96%)
 Evidence 4: One Health 89% (90%) 88% (89%) 92% (93%) 98% (95%) 96% (91%) 96% (93%) 97% (96%) 96% (97%) 94% (96%)
 Evidence 5: Nature and the Environment 90% (90%) 90% (90%) 90% (92%) 95% (96%) 94% (96%) 95% (95%) 96% (97%) 95% (96%) 97% (96%)
 Evidence 6: Social Capital 94% (94%) 95% (95%) 96% (96%) 90% (99%) 89% (96%) 92% (97%) 97% (97%) 96% (94%) 96% (95%)
 Evidence 7: Learning 91% (92%) 89% (90%) 90% (92%) 98% (99%) 96% (97%) 96% (96%) 96% (97%) 94% (96%) 95% (94%)
 Evidence 8: Indoor Time NA NA NA 95% (91%) 92% (89%) 93% (91%) 96% (96%) 96% (96%) 95% (95%)
 Emerging Areas NA 97% (98%) NA 98% (97%) 95% (99%) 97% (99%) 97% (97%) 97% (97%) 98% (98%)
 Cultural and global considerations NA 96% NA NA NA NA NA NA NA
Recommendations (Round 2 [detailed] and Round 3 [overall] only)
 Overall NA NA NA NA NA NA 97% (97%) 97% (98%) 96% (96%)
 Recommendations–Sectors NA NA NA 89% (99%) 86% (99%) 89% (96%) NA NA NA
 Education and Schools NA NA NA 97% (99%) 97% (96%) 96% (97%) NA NA NA
 Urban and Community Planning NA NA NA 98% (97%) 98% (96%) 96% (97%) NA NA NA
 Public Awareness NA NA NA 97% (99%) 93% (96%) 96% (97%) NA NA NA
 Media NA NA NA 97% (96%) 95% (95%) 97% (95%) NA NA NA
 Research Monitoring NA NA NA 98% (97%) 95% (96%) 96% (97%) NA NA NA
 Recommendations–Individuals NA NA NA 94% (99%) 92% (97%) 93% (97%) NA NA NA
 Educators and Community Leaders NA NA NA 97% (99%) 95% (97%) 96% (97%) NA NA NA
 Health Professionals NA NA NA 97% (97%) 95% (96%) 96% (95%) NA NA NA
 Researchers NA NA NA 98% (99%) 97% (99%) 97% (97%) NA NA NA
 Society NA NA NA 97% (99%) 96% (97%) 95% (99%) NA NA NA
Is update important to… (Round 1 and Round 3 only)
Yes Unsure No Yes Unsure No
Public Health 98% (99%) 2% (1%) 0% (0%) NA NA NA 99% (99%) 1% (1%) 0% (0%)
Global and Planetary Health 78% (76%) 20% (23%) 2% (1%) NA NA NA 91% (91%) 6% (6%) 2% (2%)
UN SDGs 86% (87%) 13% (12%) 1% (1%) NA NA NA 89% (89%) 10% (10%) 1% (1%)
You and your job 94% (95%) 5% (5%) 1% (0%) NA NA NA 95% (95%) 4% (4%) 1% (1%)
The country you reside in 98% (98%) 2% (2%) 0% (0%) NA NA NA 93% (93%) 5% (5%) 2% (2%)

NA Not available (the section was not included or evaluated in that round), UN SDGs United Nations Sustainable Development Goals

aN = Number of invitations sent; (n) = number of responses received

bThe first percentage represents the total of"Strongly agree"and"Somewhat agree"responses based on the total valid responses (the number in parentheses represents the total of"Strongly agree"and"Somewhat agree"responses based on the respondents with complete data only)

The consultation data during this stage indicated a high degree of consensus on the core components of the 2025 Position Statement and its supporting evidence statements, with most sections showing steadily high or increased support from Round 1 to Round 2. The extensive feedback helped fine-tune key content areas, particularly for Evidence 1: “Movement behaviors”, Evidence 3: “Risky Play” and Evidence 4: “One Health”. Finally, only asked during Round 1, nearly all Steering Committee members felt the update was important for public health (98%), their own work (94%), and their country (98%). A majority also recognized its relevance to global and planetary health (78% with 20% “Unsure” responses) and the UN Sustainable Development Goals (SDGs; 86% with 13% “Unsure” responses). During Round 2, clarity, agreement, and alignment were also assessed for both sector-specific and individual-targeted recommendations, which generally received a high level of consensus (ranging from 86 to 98%). Qualitative feedback highlighted concerns about repetition across different aspects of the recommendations. In response, we revised and streamlined the content for the subsequent survey round (see Appendix C for complete details of qualitative responses received).

Global collaboration group consultation

Survey Round 3 extended the consultation process to an even broader international audience through the Global Collaboration Group, with a specific emphasis on global relevance, cultural adaptability, and the incorporation of diverse knowledge systems. Respondents were asked to evaluate draft sections of the Statement, suggest additions or revisions, and provide written input. The Survey was open between March 21 to April 2, 2025. The survey link was opened 308 times, from which we received 221 responses. Primary country of residence/workplace and sectoral representation of 196 respondents are illustrated in Fig. 3a and b, respectively.

Fig. 3.

Fig. 3

Global Collaboration Group that participated in consultation (n = 197; 38 countries). Note: Other Global North countries included Czeck Republic (n = 1), France (n = 2), Finland (n = 1), Germany (n = 2), Ireland (n = 1), Italy (n = 1), Japan (n = 2), Netherlands (n = 1), Poland (n = 1), Portugal (n = 2), Slovenia (n = 2), Spain (n = 1), Sweden (n = 1), Other Global South countries included Columbia (n = 1), Fiji (n = 1), Indonesia (n = 1), Kenya (n = 1), Mexico (n = 1), Nepal (n = 1), Philippines (n = 1), Qatar (n = 1), Serbia (n = 1), South Africa (n = 1), Turkey (n = 1), United Arab Emirates (n = 1), and Uruguay (n = 1). Other sectors included outdoor sports and education, horticulture/organic farming, teacher education, finance and banking, childcare licencing, or camp/outdoor education. NGO: Non-governmental organization

Similar to the previous consultation process, clarity, agreement, and alignment for each section of the draft 2025 Position Statement were asked (Table 2, Round 3). The overall response rate was strong, reflecting global interest and engagement in shaping the 2025 Position Statement and corresponding evidence base. Across all components (Play-amble, Position Statement, eight evidence statements, emerging areas, and recommendations), respondents reported 94%−98% on clarity, 94%−97% on agreement, and 93%−98% on alignment with their understanding, research, and/or practice.

In terms of the perceived importance of the AOP10 update across five domains (i.e., Public Health, Global and Planetary Health, UN SDGs, You and Your Job, and the Country You Reside In), respondents consistently recognized the importance of the AOP10 update across all domains. The perceived relevance to public health and individual professional roles remained high and stable, with 98–99% of respondents affirming its importance. Notably, there was a substantial increase in the perceived relevance to global and planetary health, rising from 78% in Round 1 to 91% in Round 3, accompanied by a sharp decline in uncertainty (from 20 to 6%). Perceptions of alignment with the UN SDGs also improved modestly (86% to 89%), with a corresponding decrease in the proportion of respondents who were unsure. While the AOP10 project was consistently viewed as important to respondents'countries of residence (98% in Round 1), a slight decrease was observed in Round 3 (93%), possibly reflecting the survey extended reach to additional regions.

Discussion

The objective of this paper was to explain and present the updated 2025 Position Statement on Active Outdoor Play and its release, along with the new evidence that has informed its development, actionable recommendations, and its validation process based on the phased consultation process that involved the AOP10 Steering Committee and Global Collaboration Group. The 2025 Position Statement and its supporting content received strong support from the global community, indicating its broader global relevance while maintaining strong international and sectoral support. The system-focused recommendations and inclusion of new evidence areas were well-received, suggesting that the Statement is both timely and relevant across local and global contexts.

A notable expansion in the 2025 Position Statement is the recognition of active outdoor play as an important right and opportunity across the lifespan. The importance of active outdoor play for children’s development is well-established [13]. Nevertheless, adults of all ages, often overlooked in discussions of play, also experience considerable health and social benefits from playful outdoor engagement, even if it may look different in its presentation from that of children. Research highlighted how outdoor play spaces, when designed to be age-friendly, inclusive, and culturally relevant, reduce social isolation, enhance cognitive function, and promote physical activity [54, 80, 81, 85]. Another key expansion in the 2025 Position Statement is the framing of active outdoor play as a scalable solution that can be advanced through individual-level behavioral change. In the face of converging global crises—including climate change, sedentary lifestyles, zoonotic diseases, and social isolation—active outdoor play offers a timely and actionable entry point for multi-sectoral collaboration and public health promotion. This aligns well with the One Health approach, which recognizes the interdependence of human, animal, and environmental health [86]. Global momentum supporting this movement is rapidly growing. AOP10's six world-region evidence reviews have demonstrated how the 2015 Position Statement and subsequent regional efforts have galvanized communities of research and practice [8893]. These collective efforts highlight some global inequities and the need for further global collaboration, partnership, and knowledge exchange, as attempted through the AOP10 project, to advance policies and practices that support outdoor play in diverse cultural and ecological contexts.

In addition to the broader expansions, a critical advancement in the 2025 Position Statement was the explicit and intentional centering of equity as a guiding principle for active outdoor play research, policy, and practice. The 2025 Position Statement and associated recommendations call for a shift from viewing equity merely as access, to understanding it as a valued process of structural change. It is increasingly recognized that addressing individual-level barriers to participation is not enough to make sustainable, systems-wide change. To this end, the 2025 Position Statement demands that environments, programs, and policies must be co-created with, and accountable to, those who have been historically excluded or marginalized. Equitable outdoor play spaces are not simply physical or logistical; they are culturally affirming, socially responsive, age inclusive, and structurally just spaces [54, 125]. Importantly, the 2025 Position Statement intentionally takes an inclusive approach to defining outdoor play environments, recognizing that not all communities, particularly in low-resource or densely urbanized areas, have equitable access to safe, nature-rich spaces. Limiting the focus to such environments risks reinforcing existing inequities. By validating a broad spectrum of outdoor settings including open spaces, built environments, and informal urban areas, this Position Statement promotes a globally relevant and equity-informed vision for active outdoor play. Accordingly, we emphasize the value of all types of play spaces—from biodiverse parks and nature-rich environments to urban cul-de-sacs, manufactured playgrounds, and informal open spaces. Moreover, non-green natural landscapes such as snow-covered areas, deserts, coastal regions, and tundra are equally important and culturally meaningful sites for active outdoor play.

As part of the efforts to ensure the 2025 Position Statement was more inclusive of diverse cultures and ways of knowing, Indigenous knowledge systems related to outdoor play have been intentionally integrated from the project’s start. A forthcoming global scoping review by McRae and colleagues [95] highlights the epistemological foundations of Indigenous outdoor play, emphasizing relational, land-based, and intergenerational paradigms [9598]. Here, land-based includes those connected to nearby water bodies such as rivers, lakes, wetlands, and other bodies of water as part of a holistic relationship with the environment. These perspectives position outdoor play as a holistic and lifelong practice (‘a way of life’) that fosters intergenerational learning, cultural continuity, and shared responsibilities for conservation partnerships and Indigenous sovereignty [9598]. Such relational worldviews challenge dominant Euro-Western constructs of play as discrete or child-centric and instead allows us to frame play as a practice of caretaking, healing, and social connection for sustainability [147]. Integrating Indigenous perspectives into outdoor play research, policy, and practice requires a decolonizing lens—one that centers Indigenous sovereignty, self-determination, and lived experience in shaping how, where, and why we play.

Consistent with the 2015 Position Statement [1], we assert that the evidence base supports policies that facilitate, rather than restrict, opportunities for risky play [3, 57, 69]. This assertion does not entail a disregard for safety, but rather a recalibration of adult roles, including parents, guardians, childcare providers, and teachers, and an investment in built and natural environments that allow for hazard-free uncertainty [69]. The 2025 Position Statement pivots from framing risky play “with its risks” to emphasizing the developmental value of risk-taking itself. This shift reflects both evolving evidence and an intentional reframing of risk as an opportunity for growth, resilience, and learning such as developing risk assessment skills [148], rather than a liability to be avoided. Even for adults, perceived risk is not the opposite of safety; it is an opportunity for developing stress-coping skills, fostering personal growth, encouraging pro-environmental behavior, and facilitating learning [82, 83]. During the consultation process, risky play emerged as a consistently contested concept. While some survey respondents expressed concerns regarding our strong advocacy for risky play for children due to issues around physical safety, liability, and potential injury, there is growing consensus within the research and practitioner communities that exposure to age- and ability-appropriate risk is not only safe when well-managed, but developmentally essential [69]. In recent work investigating risky or thrill-seeking play from an evolutionary perspective, with a monkey bar as a metaphor, which is typically considered as a public health hazard, indicated that children’s innate need for risky play is a result of selective pressures from the history of primate evolution [79]. Building on the momentum of the 2015 Position Statement [1] and the subsequent support for risky play—including the Risky Outdoor Play Position Statement published by the Canadian Paediatric Society in 2024 [149] and Active Outdoor Play Position Statement from the Council of Chief Medical Officers of Health [150]—the 2025 Position Statement continues, deliberately, to shift mindsets toward recognizing the developmental value of age- and ability-appropriate risk, “outweighing the occasional costs of injury [79].”

Another area of debate in the development of the 2025 Position Statement centered on the framing of indoor environments. While it is true that excessive time indoors can contribute to sedentary behavior, reduced contact with nature and the community, and increased exposure to indoor pollutants and allergens, the intent is not to portray all indoor environments as inherently harmful. Rather, the 2025 Position Statement calls for a more balanced and integrated daily routine of balanced indoor and outdoor experiences. Consistent with the 2015 Position Statement [1], the 2025 Position Statement reaffirms that outdoor environments offer unique restorative and holistic health benefits that surpass those provided by indoor activities [36, 48, 52, 53, 66]. While cautioning against reductive thinking that frames one environment as inherently'good'and the other'bad,'the 2025 Position Statement deliberately calls for increased time spent outdoors to counterbalance the disproportionate amount of time people now spend indoors. With this, the focus should be on increasing access for active, nature-based outdoor play, especially in urban and underserved communities where access to safe, green outdoor spaces remains limited and unequal [151, 152]. Table 3 summarizes key benefits and potential risks associated with active outdoor play across the lifespan, alongside practical mitigation strategies. This synthesis highlights the complex interplay between promoting planetary health and well-being through active outdoor play while addressing safety and environmental challenges in diverse contexts.

Table 3.

Benefits and potential risks associated with active outdoor play across the lifespan and practical mitigation strategies

Aspect Benefits Risks/Hazards Mitigation Strategies
Physical Health Enhances motor skills, physical literacy, fitness, resilience, and risk perception Acute injuries from falls, bumps, scrapes Design play spaces with varied challenges; supervision balanced to allow safe risk-taking
Cognitive & Emotional Health Builds confidence, problem-solving skills, stress coping, and mental well-being across the lifespan Anxiety from mismatch between innate risk-taking and overly safe play environments Support nurturing social environments; promote autonomy and age-appropriate challenges
Social & Behavioral Health Fosters agency, social connection, creativity, and pro-environmental behaviors, with potential behavioral spillover effects Exposure to unsafe environments or social conflicts Community engagement, education on social safety; inclusive and culturally affirming spaces
Environmental Health Encourages environmental stewardship, eco-sensitivity, and lifelong connection to nature Climate change impacts: extreme weather, environmental toxins, reduced access to safe play Promote local, low-impact active outdoor play; climate adaptation strategies; minimize travel emissions
Exposure Considerations Reduces sedentary indoor time and exposure to indoor air pollutants Outdoor pollutants (air pollution, allergens, wildfire smoke) Monitor air quality; plan play times to avoid high pollution; create diverse play environments including non-green
Across Lifespan Supports healthy development in children, active aging, and functional mobility in older adults Physical limitations or safety concerns, especially in young children, older adults, and people with disability Adapt play environments to abilities; promote safe but stimulating challenges; encourage inclusive programming

As the evidence on active outdoor play evolves, we recognized that several urgent questions remain—for example, how can outdoor play be integrated into national and global strategies for climate resilience and adaptation? What does culturally safe, land-based play look like in different cultural and geographical settings? How can inclusive play be co-designed with communities facing structural inequities? These questions call for partnership and collaboration across disciplines and sectors, and for greater opportunities for leadership from Indigenous, racialized, and other equity-deserving communities. The future of active outdoor play lies in building systems that are not only health-promoting but also just, sustainable, and reflective of diverse ways of knowing, being, and playing. Based on our findings, we offer a set of recommendations aimed at driving systems-level change (Fig. 1)—targeting the societal actions, policies and legislations, institutional practices, health systems, infrastructures, and cultural norms that shape how, where, and for whom active outdoor play is possible. These recommendations move beyond individual-level behavior change to address the structural conditions necessary to create equitable, sustainable, and play-enabling environments across diverse communities.

Strengths and limitations

This work presents the 2025 Position Statement, which advances the field in several ways. One of its primary strengths is the expanded age range, expanded content, and global scope, building on the foundation of the 2015 Position Statement [1]. By acknowledging the importance of active outdoor play not only for childhood but across the lifespan, the new Position Statement takes a more inclusive and holistic perspective. The Statement also situates active outdoor play within broader societal and environmental contexts, highlighting its potential to be part of a solution for emerging global challenges such as social and health inequities, climate change, and reduced access to natural spaces. In doing so, reviews conducted to directly inform the 2025 Position Statement critically examined how active outdoor play can be integrated into daily life, policy, and practice. Collectively these reviews call for multi-sectoral, multi-level, and systems changes. A further strength lies in the rigorous, inclusive, and participatory development process. Three rounds of consultation were conducted with both the international AOP10 Steering Committee and the broader Global Collaboration Group, enabling iterative refinement and ensuring clarity, agreement, and alignment across diverse interested individuals and parties. Finally, a commitment to accessibility and inclusion for global community participation was demonstrated through the translation of the survey materials into the six official UN languages in an effort to enhance representation and empowerment from diverse linguistic and cultural backgrounds.

Despite its strengths, this work is not without limitations. The development process and participant representation remained largely Global North-centric, with a particularly strong Canadian influence. This geographic skew may affect the contextual relevance and applicability of the recommendations in underrepresented regions, especially across the Global South. In addition, notable evidence gaps persisted in the inclusion of research and practice related to outdoor play among individuals with disabilities [123, 125]. Future iterations of the Statement—especially those tailored for local or regional contexts—must intentionally center historically excluded voices and knowledge systems, particularly those rooted in Indigenous and non-Western worldviews. While broad consensus was achieved, consultation survey participants were primarily professionals already supportive of outdoor play, which may have limited opportunities for critical dissent or alternative perspectives that could have further enriched the final outputs. We hope the 2025 Position Statement on Active Outdoor Play serves as a stepping stone towards overcoming these limitations.

Future research directions

Although our efforts to develop the new 2025 Position Statement with an expanded scope were succinct, we received valuable qualitative feedback that can guide future research to address current evidence gaps. Building on survey feedback, we propose five key research directions that will contribute to a deeper understanding of outdoor play across various populations and contexts.

In addition to this, the “Emerging Areas” and “Recommendations” sections of the Position Statement (Fig. 2) offer further insights into research and practical opportunities. A more complete list of research priorities, including those submitted by survey respondents, is provided in Appendix C.

First, future studies should explore how active outdoor play is perceived and experienced across the entire age spectrum. Research could examine the applicability of existing outdoor play frameworks to adults, older adults, and individuals with varying abilities. Understanding how different age and ability groups conceptualize and integrate outdoor play into their lives would help refine policies and interventions aimed at fostering outdoor engagement for all generations. Such an attempt was made [125] in one of the reviews conducted as part of the AOP10 Project; however, more deliberate research is needed to build upon these findings.

Second, future studies should examine how language used in promoting active outdoor play, such as phrases like “sit less,” impacts inclusion for people with disabilities or other diverse needs. Investigating how different terminologies influence perceptions and participation in active outdoor play across various populations would help create more inclusive communication strategies. Additionally, exploring how inclusive language can be integrated into play promotion for all abilities and age groups is essential for engaging underrepresented communities.

Third, further research is needed to understand how specific environmental design features—such as those related to natural elements, safety, and accessibility—affect active outdoor play. Studies could focus on how the quality and characteristics of outdoor spaces influence participation, particularly in urban areas where environmental conditions may limit opportunities. This research could also inform guidelines for creating more inclusive, stimulating, and accessible play environments, across different age groups.

Fourth, while the connection between active outdoor play and environmental stewardship is widely acknowledged as evidenced in a recent review [103], more research is needed to establish causality on the mechanisms of how outdoor play experiences contribute to long-term environmental engagement and vice versa, such as pro-environmental behavior and spillover effects into other sustainable behaviors [153155]. Existing research has shown that engagement in outdoor play, particularly nature-based or risky play, can foster a sense of environmental responsibility and promote eco-friendly behaviors [106, 156, 157].

Fifth, future research should investigate the emerging hazards associated with outdoor play, especially in areas with high pollution or traffic, and those experiencing the impacts of climate change. This research would need to weigh the benefits of outdoor engagement against potential environmental hazards. Additionally, exploring how factors such as weather, geographical location, and societal norms influence the frequency and types of active outdoor play would provide important insights for tailoring interventions in diverse contexts.

Lastly, as we continue to advance into the digital age, it is important to explore the relationship between technology, including AI (artificial intelligence), and active outdoor play. Specifically, research could examine how digital tools, AI-powered platforms, and robotics can be utilized to enhance or facilitate outdoor engagement. In particular, the integration of robotics in physical rehabilitation, such as for post-stroke patients [158], offers promising opportunities to support mobility and movement in outdoor settings. Investigating how these technologies can be used to encourage participation in active outdoor play and rehabilitation could provide valuable insights into improving health outcomes and promoting greater engagement in nature-based activities.

Knowledge Translation and Mobilization (KTM)

Tenets of implementation science and KTM emphasize the importance of sustained interaction and mutual engagement among researchers, decision-makers and practitioners [159, 160]. This reflects the emerging acceptance that traditional dissemination approaches, which typically involve one-way communication, have largely been ineffective at changing policy and practice. In our effort to maximize impact, we considered KTM early in the AOP10 project. Planned KTM activities were deliberate and dynamic between knowledge users and the research team to discuss the results and present the overall findings. This was performed alongside more traditional dissemination practices (end-of-grant KTM) such as presentations at scholarly meetings and peer-reviewed publications.

Our integrative KTM plan followed three main steps.

  • Stage 1: Identifying key messages – The proposed work generated evaluation findings and practical information. Ongoing challenges will be in translating these findings into information that will bring about systemic changes in practices and programs. The Steering Committee will play a key role in this process.

  • Stage 2: Identifying and engaging knowledge users – The AOP10 Leadership Team worked with the Steering Committee to identify target audiences for KTM products (e.g., partners in research, education, public health, environment sectors).

  • Stage 3: Developing KTM products – The Leadership Team developed a suite of assets that are action-oriented and tailored to our knowledge users across research, policy, and practice sectors. To create welcoming and inclusive material, a Sex- and Gender-Based Analysis Plus lens [161] will be applied across all materials. Further, the 2025 Position Statement is available in all six UN official languages (i.e., Arabic, Chinese, English, French, Russian, and Spanish). See Fig. 4 for a high-level overview of the KTM Logic Model for the AOP10 project.

Fig. 4.

Fig. 4

Knowledge Translation and Mobilization Model for the 2025 Position Statement (AOP10) Project

The 2025 Position Statement on Active Outdoor Play was officially launched on September 25, 2025 at the 2025 Breath of Fresh Air Summit, marking a key milestone in the project’s public engagement and policy influence efforts. Promotional activities will continue to be carried out through several key platforms and events. ParticipACTION, a Canadian not-for-profit organization that promotes healthy living and physical activity across the country, provided support for the project’s outreach and promotion efforts, leveraging their established communication channels and audience engagement strategies to amplify reach. Features about the Position Statement, shared as blog posts, infographics, whiteboard videos, and the full-length and summary report are included on the Outdoor Play Canada website, and targeted posts made across Outdoor Play Canada and PLaTO-Net’s social media channels (e.g., Instagram, Facebook, LinkedIn, and BlueSky). Similar amplification efforts were made through the Leadership Team and Steering Committee connections and networks around the world. These KTM efforts aim not only to share research findings but also to strengthen intersectoral collaboration, build capacity across sectors, and influence future policy and practice.

As the AOP10 project was conceived to elevate the visibility and influence of the outdoor play sector, its dissemination strategies reflect a strong commitment to multi-sectoral collaboration and knowledge mobilization. Per the team’s well-established networks nationally and internationally, we believe the proposed KTM activities will maximize the reach and uptake of this work.

Commitment to Justice, Equity, Diversity, and Inclusion (JEDI)

The JEDI principles have guided this project since its inception in 2023, shaping both the composition of the AOP10 Leadership Group and our intentional expansion from the 2015 Position Statement [1] to include all ages and a global community. In developing the main Position Statement, we also made a deliberate decision to prioritize equity rather than adopt broader terms like inclusion, as suggested by some survey respondents. This choice is rooted in our commitment to systemic change and accountability to those historically excluded or marginalized from outdoor play opportunities, which also have been reflected in our sector-directed recommendations. While inclusion is important, it often centers on inviting individuals into existing systems without questioning or altering the structures themselves, but rather focussing on creating a welcoming environment for everyone [162]. In contrast, equity more directly calls for the dismantling of systemic barriers, a rebalancing of power, and an honest reckoning with historical injustices to ultimately achieve fair outcomes [162]. It requires that environments, policies, and practices be fundamentally (re)assessed, implemented, and reimagined to foster just, sustainable participation for all in varying contexts [163166]. Access to active outdoor play and nature must go beyond physical and/or logistical availability; it must be about creating culturally affirming, socially responsive, age- and ability-inclusive, and structurally just spaces. In our KTM efforts, we also took intentional steps to ensure our processes and outputs are inclusive, accessible, and representative of diverse experiences and worldviews. For example, the global survey and KTM materials are available in all six official UN languages and adhere to international accessibility standards to help broader engagement and equitable access to information. We will continue to uphold our commitment in all future KTM efforts to ensure that JEDI principles remain at the core of our work as we move forward.

Conclusions

This paper serves as both a reflection on the progress made over the past decade since the 2015 Position Statement and a roadmap for the future. As we navigate a world increasingly shaped by climate change, sedentary, indoor-centered lifestyles, social fragmentation, and widening inequities, active outdoor play emerges as more than just a lifestyle choice but an important strategy for advancing the holistic health and well-being of human, animals, and the planet. The 2025 Position Statement renews our collective commitment to the right to play for all, while focusing on improving equity, recognizing that access to nature and quality outdoor spaces remain unequal, and calls for rethinking the systems and structures that sustain exclusion and disadvantage. Through this renewed commitment, we are advocating for a world where all individuals can move freely, play safely, and thrive in nature-rich environments amid complex challenges we face as a species. Furthermore, the 2025 Position Statement calls on us to engage with diverse knowledge systems, particularly Indigenous perspectives, that have long recognized outdoor play as land-based, relational, and intergenerational. We must also embrace a balanced, lifelong, and community-centered approach to active outdoor play. Active outdoor play is not only essential for the holistic health and well-being of individuals but could also serve as an important mechanism for addressing environmental and societal challenges we face. Aligning with the recommendations made, our future depends not just on research and policy, but on partnership, collaboration, and collective action. The time to create equitable, inclusive, and play-enabling environments for all, across all settings and generations, is now.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Appendix A (407KB, pdf)
Appendix B (1.8MB, pdf)
Appendix C (562.7KB, xlsx)

Acknowledgements

We sincerely thank everyone who participated in the surveys and the experts who assisted with the survey and the 2025 Position Statement translations.

AOP10 Steering committee group:

1. Alethea Jerebine, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Australia.

2. Alison Amero, Sport3, Canada.

3. Arlene M McGarty, School of Health & Wellbeing, University of Glasgow, Scotland.

4. Ashley McCurdy, University of Alberta, Canada.

5. Avril Johnstone, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland.

6. Carla Gull, Merry Lea Environmental Learning Center of Goshen College, USA.

7. Christine Alden, Lawson Foundation, Canada.

8. Colin Harris, Take Me Outside, Canada.

9. Colleen A. Kiselyk, Nature Alive Adventures, Canada.

10. Dané Coetzee, Physical Activity, Sport and Recreation (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

11. David W. Chorney, University of Alberta, Canada.

12. Diego Augusto Santos Silva, Department of Physical Education, Federal University of Santa Catarina, Brazil.

13. Ellen Beate Hansen Sandseter, Queen Maud University College, Norway.

14. Erica Phipps, Canadian Partnership for Children’s Health and Environment (CPCHE), Canada.

15. Erin Wentzell, The George Washington University, USA.

16. Franz Plangger, Outdoor Council of Canada.

17. Frederico Lopes, Laboratory of Motor Behavior, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.

18. Gemma Goldenberg, Institute for the Science of Early Years and Youth, England.

19. Helen F Dodd, School of Public Health and Sport Sciences, University of Exeter, UK.

20. Hyunshik Kim, Faculty of Sports Sciences, Sendai University, Japan.

21. Jane Cawley, School of Health and Human Performance, Dalhousie University, Canada.

22. Janet Omstead, Play for Life, Canada.

23. Jasper Schipperijn, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.

24. Javier Brazo-Sayavera, Department of Sports and Computer Science, Universidad Pablo de Olavide, Spain.

25. Justin J. Lang, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Canada.

26. Justin Jeon, Department of Sport Industry, Yonsei University, South Korea.

27. Kamil Maciaszek, GratoSfera Foundation, Poland.

28. Kelly P Arbour-Nicitopoulos, Faculty of Kinesiology and Physical Education, University of Toronto.

29. Kimberly Squires, Department of Family Relations and Applied Nutrition, University of Guelph, Canada.

30. Konstantina Rentzou, Department of Early Years Learning and Care, University of Ioannina, Greece.

31. Kyoung June Yi, Department of Kinesiology, McMaster University, Canada.

32. Lauren McNamara, Recess Project Canada.

33. Lauren Turner, Norquest College, Canada.

34. Lisa M Barnett, Institute for Physical Activity and Nutrition, Deakin University, Australia.

35. Lucy-Joy Wachira, Department of Physical Education, Exercise and Sport Science, Kenyatta University, Kenya.

36. Mairi Ferris, Inspiring Scotland, Scotland.

37. Mallory J. Donaldson, Alumnus of the Canadian Centre for Outdoor Play Fellowship program, Canada.

38. Mariana Brussoni, Human Early Learning Partnership, Department of Pediatrics, School of Population and Public Health, University of British Columbia, Canada.

39. Marjaana Kangas, University of Lapland, Finland.

40. Mark Leather, School of Education, Plymouth Marjon University, UK.

41. Maxwell Hartt, Department of Geography and Planning, Queen's University, Canada.

42. Megan Zeni, Room to Play Consulting, Canada.

43. Michael J. A. Down, School of Education, University of Notre Dame Australia, Australia.

44. Michelle Stone, School of Health and Human Performance, Dalhousie University, Canada.

45. Narayan Subedi, Nepal Development Society, Nepal.

46. Nevin J. Harper, Faculty of Health, University of Victoria, Canada.

47. Nicola Kemp, Academy for Susstainable Futures, Canterbury Christ Church University, UK.

48. Peter Bakalár, Faculty of Sports, University of Prešov, Slovakia.

49. Peter Bentsen, Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark.

50. Rachel A Jones, School of Education, Early Start, University of Wollongong, Australia.

51. Rachel Franz, Fairplay, USA.

52. Rachel Ramsden, Department of Pediatrics, University of British Columbia, Canada.

53. Rebecca Forte, Education Consultant, Canada.

54. Richard Larouche, Faculty of Health Sciences, University of Lethbridge, Canada.

55. Rita Cordovil, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal.

56. Robert Wallis, The Nature School, Toronto and Region Conservation Authority, Canada.

57. Ryan Fahey, Physical and Health Education Canada, Canada.

58. Salomé Aubert, Active Healthy Kids Global Alliance, France.

59. Seiyeong Park, Institute of Sport Science, Seoul National University, South Korea.

60. Shawnda A. Morrison, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

61. Sitong Chen, Centre for Mental Health, Shenzhen University, China.

62. Son Truong, School of Health and Human Performance, Dalhousie University, Canada.

63. Søren Præstholm, Nationalpark Skjoldungernes Land, Denmark.

64. Steph N. Dean, Clemson University, USA.

65. Stephanie A. Prince, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Canada.

66. Steven Lam, International Livestock Research Institute, Kenya.

67. Suryeon Ryu, Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee Knoxville, USA.

68. Susan Paudel, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Australia.

69. Suzanne Levenson Goldstein, USA.

70. Tanya Halsall, University of Ottawa Institute of Mental Health Research, Canada.

71. Taru Manyanga, Division of Medical Sciences, University of Northern British Columbia, Canada.

72. Tim Gill, Play Safety Forum, UK.

73. Trish Tucker, School of Occupational Therapy, Western University, Canada.

74. Ulises Charles-Rodriguez, Cumming School of Medicine, University of Calgary, Canada.

75. Valerie Carson, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Canada.

Abbreviations

AI

Artificial Intelligence

AOP10

10-Year update of the 2015 Position Statement on Active Outdoor Play

ChatGPT

Chat Generative Pre-trained Transformer

JEDI

Justice, Equity, Diversity, and Inclusion

KTM

Knowledge Translation and Mobilization

PLaTO-Net

Play, Learn, and Teach Outdoors Network

SDGs

Sustainable Development Goals

UN

United Nations

Authors’ contributions

E-YL: Conceptualization, Methodology, Validation, Formal Analysis, Investigation, Supervision, Visualization, Writing – Original Draft; LDL: Conceptualization, Methodology, Validation, Formal Analysis, Investigation, Supervision, Writing – Review & Editing, Project Administration; Y-BK: Investigation, Data Curation, Writing – Original Draft; AR, BN, OL: Formal Analysis, Investigation, Data Curation, Writing – Review & Editing; MEJ: Methodology, Validation, Formal Analysis, Investigation, Writing – Review & Editing; LMV: Conceptualization, Methodology, Validation, Formal Analysis, Investigation, Visualization, Writing – Review & Editing; DAB, MIADB, SD, LM, RMM, P-YW: Conceptualization, Methodology, Validation, Formal Analysis, Investigation, Writing – Review & Editing; MST: Conceptualization, Methodology, Validation, Formal Analysis, Investigation, Supervision, Writing – Review & Editing, Funding Acquisition; AOP10 Steering Committee Group: Methodology, Validation, Writing – Review & Editing.

Funding

We are grateful to the Lawson Foundation for support provided to the larger Active Outdoor Play Position Statement 10th anniversary update project, through which partial support for this project was received. The funder had no role in the design, analysis, interpretation, or writing of this research.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

Mark S. Tremblay reports financial support was provided by the Lawson Foundation; Louise de Lannoy and Mallory J. Donaldson report a relationship with Outdoor Play Canada that includes: employment; Kelly P Arbour-Nicitopoulos, Mariana Brussoni, Richard Larouche, Eun-Young Lee, Mark S. Tremblay, and Megan Zeni report a relationship with Outdoor Play Canada that includes: board membership; Jasper Schipperijn has received financial support by KOMPAN, a playground and fitness equipment company; Helen Dodd reports a relationship with Play England that includes: Trustee.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Change history

11/14/2025

The original article has been updated.

Change history

11/20/2025

A Correction to this paper has been published: 10.1186/s12966-025-01854-0

Contributor Information

Eun-Young Lee, Email: eunyoung.lee@queensu.ca.

AOP10 Steering Committee Group:

Alethea Jerbine, Alison Amero, Arlene M. McGarty, Ashley McCurdy, Avril Johnstone, Carla Gull, Christine Alden, Colin Harris, Colleen A. Kiselyk, Dané Coetzee, David W. Chorney, Diego Augusto Santos Silva, Ellen Beate Hansen Sandseter, Erica Phipps, Erin Wentzell, Franz Plangger, Frederico Lopes, Gemma Goldenberg, Helen F. Dodd, Hyunshik Kim, Jane Cawley, Janet Omstead, Jasper Schipperijn, Javier Brazo-Sayavera, Justin J. Lang, Justin Jeon, Kamil Maciaszek, Kelly P. Arbour-Nicitopoulos, Kimberly Squires, Konstantina Rentzou, Kyoung June Yi, Lauren McNamara, Lauren Turner, Lisa M. Barnett, Lucy-Joy Wachira, Mairi Ferris, Mallory J. Donaldson, Mariana Brussoni, Marjaana Kangas, Mark Leather, Maxwell Hartt, Megan Zeni, Michael J. A. Down, Michelle Stone, Narayan Subedi, Nevin J. Harper, Nicola Kemp, Peter Bakalár, Peter Bentsen, Rachel A. Jones, Rachel Franz, Rachel Ramsden, Rebecca Forte, Richard Larouche, Rita Cordovil, Robert Wallis, Ryan Fahey, Salomé Aubert, Seiyeong Park, Shawnda A. Morrison, Sitong Chen, Son Truong, Søren Præstholm, Steph N. Dean, Stephanie A. Prince, Steven Lam, Suryeon Ryu, Susan Paudel, Suzanne Levenson, Tanya Halsall, Taru Manyanga, Tim Gill, Trish Tucker, Ulises Charles-Rodriguez, and Valerie Carson

References

  • 1.Tremblay MS, Gray C, Babcock S, Barnes J, Bradstreet CC, Carr D, et al. Position statement on active outdoor play. Int J Environ Res Public Health. 2015;12(6):6475–505. 10.3390/ijerph120606475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Gray C, Gibbons R, Larouche R, Sandseter EB, Bienenstock A, Brussoni M, et al. What is the relationship between outdoor time and physical activity, sedentary behaviour, and physical fitness in children? A systematic review. Int J Environ Res Public Health. 2015;12(6):6455–74. 10.3390/ijerph120606455. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.M Brussoni R Gibbons C Gray T Ishikawa EB Sandseter A Bienenstock et al 2015 What is the relationship between risky outdoor play and health in children? A systematic review Int J Environ Res Public Health 12 6 6423 6454 10.3390/ijerph120606423
  • 4.Charan GS, Kalia R, Khurana MS, Narang GS. From screens to sunshine: rescuing children’s outdoor playtime in the digital era. J Indian Assoc Child Adolesc Ment Health. 2024;20(1):11–7. 10.1177/09731342241229845. [Google Scholar]
  • 5.Lee E-Y, de Lannoy L, Li L, de Barros MIA, Bentsen P, Brussoni M, et al. Play, learn, and teach outdoors-network (PLaTO-Net): terminology, taxonomy, and ontology. Int J Behav Nutr Phys Act. 2022;19(1):66. 10.1186/s12966-022-01294-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Sum KK, Cai S, Law E, Cheon B, Tan G, Loo E, et al. COVID-19-related life experiences, outdoor play, and long-term adiposity changes among preschool- and school-aged children in Singapore 1 year after lockdown. JAMA Pediatr. 2022;176(3):280–9. 10.1001/jamapediatrics.2021.5585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Liu JJ, Wyver S, Chutiyami M. Impacts of COVID-19 restrictions on young children’s outdoor activity: a systematic review. Children (Basel). 2022. 10.3390/children9101564. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Lee E-Y, Kim YB, Goo S, Oyama O, Lee J, Kim G, et al. Physical activity in the era of climate change and COVID-19 pandemic: results from the South Korea’s 2022 report card on physical activity for children and adolescents. J Exerc Sci Fit. 2023;21(1):26–33. 10.1016/j.jesf.2022.10.014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.de Lannoy L, Barbeau K, Seguin N, Tremblay MS. Scoping review of children’s and youth’s outdoor play publications in Canada. Health Promot Chronic Dis Prev Can. 2023;43(1):1–13. 10.24095/hpcdp.43.1.01. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.de Lannoy L, Barbeau K, Seguin N, Tremblay MS. Scoping review of adult-oriented outdoor play publications in Canada. Health Promot Chronic Dis Prev Can. 2023;43(3):139–50. 10.24095/hpcdp.43.3.04. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Lee E-Y, Bains A, Hunter S, Ament A, Brazo-Sayavera J, Carson V, et al. Systematic review of the correlates of outdoor play and time among children aged 3–12 years. Int J Behav Nutr Phys Act. 2021;18(1):41. 10.1186/s12966-021-01097-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Larouche R, Kleinfeld M, Rodriguez UC, Hatten C, Hecker V, Scott DR, et al. Determinants of outdoor time in children and youth: a systematic review of longitudinal and intervention studies. Int J Environ Res Public Health. 2023. 10.3390/ijerph20021328. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Zong B, Li L, Cui Y, Shi W. Effects of outdoor activity time, screen time, and family socioeconomic status on physical health of preschool children. Front Public Health. 2024;12:1434936. 10.3389/fpubh.2024.1434936. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Fang W-T, Ng E, Chang M-C. Physical outdoor activity versus indoor activity: their influence on environmental behaviors. Int J Environ Res Public Health. 2017;14(7):797. 10.3390/ijerph14070797. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Seo YB, Oh YH, Yang YJ. Current status of physical activity in South Korea. Korean J Fam Med. 2022;43(4):209–19. 10.4082/kjfm.22.0099. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Zisis E, Hakimi S, Lee E-Y. Climate change, 24-hour movement behaviors, and health: a mini umbrella review. Glob Health Res Policy. 2021;6(1):15. 10.1186/s41256-021-00198-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Lee E-Y, Park S, Kim Y-B, Lee M, Lim H, Ross-White A, et al. Exploring the interplay between climate change, 24-hour movement behavior, and health: a systematic review. J Phys Act Health. 2024;21(12):1227–45. 10.1123/jpah.2023-0637. [DOI] [PubMed] [Google Scholar]
  • 18.Silva MF, Leão ALF, O’connor Á, Hallal PC, Ding D, Hinckson E, et al. Understanding the relationships between physical activity and climate change: an umbrella review. J Phys Act Health. 2024;21(12):1263–75. 10.1123/jpah.2024-0284. [DOI] [PubMed] [Google Scholar]
  • 19.Bernard P, Chevance G, Kingsbury C, Baillot A, Romain AJ, Molinier V, et al. Climate change, physical activity and sport: a systematic review. Sports Med. 2021;51(5):1041–59. 10.1007/s40279-021-01439-4. [DOI] [PubMed] [Google Scholar]
  • 20.El Gemayel SM. Childhood and play ‘in-between’: Young Iraqi and Syrian child refugees’ play following armed conflict and forced displacement to the northern suburbs of Beirut. Lebanon: UCL (University College London). 2020. https://discovery.ucl.ac.uk/id/eprint/10102617/. [Google Scholar]
  • 21.Mefleh FA, Mohsen H, Farahat B. Exploring the qualities of child-friendly outdoor spaces: a field study in low income neighbourhoods-case study. Architect Plan J. 2021;27(1):10. 10.54729/2789-8547.1132. [Google Scholar]
  • 22.Veronese G, Cavazzoni F, Fiorini A, Shoman H, Sousa C. Human (in) security and psychological well-being in Palestinian children living amidst military violence: a qualitative participatory research using interactive maps. Child Care Health Dev. 2022;48(1):159–69. 10.1111/cch.12917. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Amornsriwatanakul A, Lester L, Bull FC, Rosenberg M. Ecological correlates of sport and exercise participation among Thai adolescents: a hierarchical examination of a cross-sectional population survey. J Sport Health Sci. 2023;12(5):592–605. 10.1016/j.jshs.2020.04.012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Aquino K, Wise A, Velayutham S, Parry KD, Neal S. The right to the city: outdoor informal sport and urban belonging in multicultural spaces. Ann Leis Res. 2022;25(4):472–90. 10.1080/11745398.2020.1859391. [Google Scholar]
  • 25.Engel-Yeger B. Comparing participation patterns in out-of-school activities between Israeli Jewish and Muslim children. Scand J Occup Ther. 2013;20(5):323–35. 10.3109/11038128.2013.793738. [DOI] [PubMed] [Google Scholar]
  • 26.Lee E-Y, Park S, Kim Y-B, Liu H, Mistry P, Nguyen K, et al. Ambient environmental conditions and active outdoor play in the context of climate change: a systematic review and meta-synthesis. Environ Res. 2025. 10.1016/j.envres.2025.122146. [DOI] [PubMed] [Google Scholar]
  • 27.de Lannoy L, Lee E-Y, Lopes O, Boadi DA, de Barros MIA, Duncan S, et al. 2025 Position Statement on Active Outdoor Play–Process and Methodology. Int J Behav Nutr Phys Act. 2025. 10.04162/s12966-025-01806-8.
  • 28.Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. 10.1016/j.jbi.2008.08.010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Lawlor J, Thomas C, Guhin AT, Kenyon K, Lerner MD, Consortium U, et al. Suspicious and fraudulent online survey participation: introducing the REAL framework. Methodol Innov. 2021;14(3):20597991211050467. 10.1177/20597991211050467. [Google Scholar]
  • 30.Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401–9. 10.1016/j.jclinepi.2013.12.002. [DOI] [PubMed] [Google Scholar]
  • 31.James ME, Lopes O, de Lannoy L, Vanderloo L, Tremblay MS, Sikora L, et al. Systematic review of the association between outdoor play and the 24-hour movement behaviours among children, youth and adults. PROSPERO 2024. Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024517145.
  • 32.Cooper AR, Page AS, Wheeler BW, Hillsdon M, Griew P, Jago R. Patterns of GPS measured time outdoors after school and objective physical activity in English children: the PEACH project. Int J Behav Nutr Phys Act. 2010;7:1–9. 10.1186/1479-5868-7-31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Dunton GF, Liao Y, Intille S, Wolch J, Pentz MA. Physical and social contextual influences on children’s leisure-time physical activity: an ecological momentary assessment study. J Phys Act Health. 2011;8(s1):S103–8. 10.1123/jpah.8.s1.s103. [DOI] [PubMed] [Google Scholar]
  • 34.Raustorp A, Pagels P, Boldemann C, Cosco N, Söderström M, Mårtensson F. Accelerometer measured level of physical activity indoors and outdoors during preschool time in Sweden and the United States. J Phys Act Health. 2012;9(6):801–8. 10.1123/jpah.9.6.801. [DOI] [PubMed] [Google Scholar]
  • 35.Klinker CD, Schipperijn J, Kerr J, Ersbøll AK, Troelsen J. Context-specific outdoor time and physical activity among school-children across gender and age: using accelerometers and GPS to advance methods. Front Public Health. 2014;2:20. 10.3389/fpubh.2014.00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Vanderloo LM, Tucker P, Johnson AM, Holmes JD. Physical activity among preschoolers during indoor and outdoor childcare play periods. Appl Physiol Nutr Metab. 2013;38(11):1173–5. 10.1139/apnm-2013-0137. [DOI] [PubMed] [Google Scholar]
  • 37.Wheeler BW, Cooper AR, Page AS, Jago R. Greenspace and children’s physical activity: a GPS/GIS analysis of the PEACH project. Prev Med. 2010;51(2):148–52. 10.1016/j.ypmed.2010.06.001. [DOI] [PubMed] [Google Scholar]
  • 38.Lu C, Huang G, Corpeleijn E. Environmental correlates of sedentary time and physical activity in preschool children living in a relatively rural setting in the Netherlands: a cross-sectional analysis of the GECKO Drenthe cohort. BMJ Open. 2019;9(5):e027468. 10.1136/bmjopen-2018-027468. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.Nigg C, Niessner C, Nigg CR, Oriwol D, Schmidt SC, Woll A. Relating outdoor play to sedentary behavior and physical activity in youth-results from a cohort study. BMC Public Health. 2021;21:1–12. 10.1186/s12889-021-11754-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Calogiuri G, Nordtug H, Weydahl A. The potential of using exercise in nature as an intervention to enhance exercise behavior: results from a pilot study. Percept Mot Skills. 2015;121(2):350–70. 10.2466/06.PMS.121c17x0. [DOI] [PubMed] [Google Scholar]
  • 41.Kerr J, Sallis JF, Saelens BE, Cain KL, Conway TL, Frank LD, et al. Outdoor physical activity and self rated health in older adults living in two regions of the US. Int J Behav Nutr Phys Act. 2012;9:1–4. 10.1186/1479-5868-9-89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Beyer KM, Szabo A, Hoormann K, Stolley M. Time spent outdoors, activity levels, and chronic disease among American adults. J Behav Med. 2018;41:494–503. 10.1007/s10865-018-9911-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Pearson AL, Liu W, Lin Z, Horton TH, Roberts JD, Chambers T, et al. Outdoor physical activity is not associated with better mental health in a sample of predominantly Black people, but spending time in parks is. Urban For Urban Green. 2024;101:128558. 10.1016/j.ufug.2024.128558. [Google Scholar]
  • 44.Liao Y, Intille SS, Dunton GF. Using ecological momentary assessment to understand where and with whom adults’ physical and sedentary activity occur. Int J Behav Med. 2015;22:51–61. 10.1007/s12529-014-9400-z. [DOI] [PubMed] [Google Scholar]
  • 45.Murata E, Yoshizaki A, Fujisawa TX, Tachibana M, Taniike M, Mohri I. What daily factors affect the sleep habits of Japanese toddlers? J Clin Sleep Med. 2023;19(6):1089–101. 10.5664/jcsm.10508. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Luo J, Cao M, Sun F, Shi B, Wang X, Jing J. Association between outdoor activity and insufficient sleep in Chinese school-aged children. Med Sci Monit. 2020;26:e921617–1. 10.12659/MSM.921617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Murray K, Godbole S, Natarajan L, Full K, Hipp JA, Glanz K, et al. The relations between sleep, time of physical activity, and time outdoors among adult women. PLoS One. 2017;12(9):e0182013. 10.1371/journal.pone.0182013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Pasanen TP, Tyrväinen L, Korpela KM. The relationship between perceived health and physical activity indoors, outdoors in built environments, and outdoors in nature. Appl Psychol Health Well-Being. 2014;6(3):324–46. 10.1111/aphw.12031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 49.Schamilow S, Santonja I, Weitzer J, Strohmaier S, Klösch G, Seidel S, et al. Time spent outdoors and associations with sleep, optimism, happiness and health before and during the COVID-19 pandemic in Austria. Clocks Sleep. 2023;5(3):358–72. 10.3390/clockssleep5030027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.Noseworthy M, Peddie L, Buckler EJ, Park F, Pham M, Pratt S, et al. The effects of outdoor versus indoor exercise on psychological health, physical health, and physical activity behaviour: a systematic review of longitudinal trials. Int J Environ Res Public Health. 2023;20(3):1669. 10.3390/ijerph20031669. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 51.Christiana RW, Besenyi GM, Gustat J, Horton TH, Penbrooke TL, Schultz CL. A scoping review of the health benefits of nature-based physical activity. J Healthy Eat Act Living. 2021;1(3):154. https://pubmed.ncbi.nlm.nih.gov/37799195/. [PMC free article] [PubMed] [Google Scholar]
  • 52.Pasanen TP, Ojala A, Tyrväinen L, Korpela KM. Restoration, well-being, and everyday physical activity in indoor, built outdoor and natural outdoor settings. J Environ Psychol. 2018;59:85–93. 10.1016/j.jenvp.2018.08.014. [Google Scholar]
  • 53.Thompson Coon J, Boddy K, Stein K, Whear R, Barton J, Depledge MH. Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environ Sci Technol. 2011;45(5):1761–72. 10.1021/es102947t. [DOI] [PubMed] [Google Scholar]
  • 54.Hartt M. Expanding the playful city: planning for older adult play. Cities. 2023;143:104578. 10.1016/j.cities.2023.104578. [Google Scholar]
  • 55.Kemple KM, Oh J, Kenney E, Smith-Bonahue T. The power of outdoor play and play in natural environments. Child Educ. 2016;92(6):446–54. 10.1080/00094056.2016.1251793. [Google Scholar]
  • 56.Lee JJ, Flouri E, Jackson Y. The role of timing and amount of outdoor play in emotional dysregulation in preschool children. Child Care Health Dev. 2025;51(1):e70020. 10.1111/cch.70020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 57.Ramsden R, Dodd H, Jerebine A, Brailey G, Hussaina H, Longdon B, et al. What is the relationship between outdoor risky play and health in children? results from a systematic review. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 58.de Lannoy L, James ME, Lopes O, Lee E-Y, Tremblay MS, Vanderloo L, et al. Active outdoor play and health and wellbeing among children, youth, and adults: an umbrella review. PROSPERO 2024. Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024565295.
  • 59.Al-Amin M, Jassi ST, Sultana R, Siddique Prova S. A holistic perspective on children's health: A review on the benefits of nature-based recreational activities. J Outdoor Environ Ed. 2024:1–32. 10.1007/s42322-024-00186-0
  • 60.Thomsen JM, Powell RB, Monz C. A systematic review of the physical and mental health benefits of wildland recreation. J Park Recreat Adm. 2018;36(1). 10.18666/JPRA-2018-V36-I1-8095. [Google Scholar]
  • 61.Pomfret G, Sand M, May C. Conceptualising the power of outdoor adventure activities for subjective well-being: a systematic literature review. J Outdoor Recreat Tourism. 2023;42:100641. 10.1016/j.jort.2023.100641. [Google Scholar]
  • 62.Lackey NQ, Tysor DA, McNay GD, Joyner L, Baker KH, Hodge C. Mental health benefits of nature-based recreation: a systematic review. Ann Leis Res. 2021;24(3):379–93. 10.1080/11745398.2019.1655459. [Google Scholar]
  • 63.Dankiw KA, Tsiros MD, Baldock KL, Kumar S. The impacts of unstructured nature play on health in early childhood development: a systematic review. PLoS One. 2020;15(2):e0229006. 10.1371/journal.pone.0229006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 64.Rosiek MA, Etnier JL, Willoughby MT. A comparison of the effects of outdoor physical activity and indoor classroom-based activities on measures of executive function in preschoolers. Int J Early Child. 2022;54(2):203–15. 10.1007/s13158-022-00318-x. [Google Scholar]
  • 65.Sugiyama M, Tsuchiya KJ, Okubo Y, Rahman MS, Uchiyama S, Harada T, et al. Outdoor play as a mitigating factor in the association between screen time for young children and neurodevelopmental outcomes. JAMA Pediatr. 2023;177(3):303–10. 10.1001/jamapediatrics.2022.5356. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66.Walters G, Dring KJ, Williams RA, Needham R, Cooper SB. Outdoor physical activity is more beneficial than indoor physical activity for cognition in young people. Physiol Behav. 2025. 10.1016/j.physbeh.2025.114888. [DOI] [PubMed] [Google Scholar]
  • 67.Brymer E, Sharma-Brymer V, Willis R, Leach M. Adventure and mental health: an ecological perspective. Front Psychol. 2024. 10.3389/fpsyg.2024.1352352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68.Hornby O, Roderique-Davies G, Heirene R, Thorkildsen E, Bradbury S, Rowlands I, et al. What factors explain extreme sport participation? A systematic review. Front Sports Act Living. 2024. 10.3389/fspor.2024.1403499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69.Brussoni M, Olsen LL, Pike I, Sleet DA. Risky play and children’s safety: balancing priorities for optimal child development. Int J Environ Res Public Health. 2012;9(9):3134–48. 10.3390/ijerph9093134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 70.Sandseter EBH. Risky play and risk management in Norwegian preschools—a qualitative observational study. Saf Sci Monit. 2009;13(1):2. https://oshwiki.osha.europa.eu/en/safety-science-monitor/risky-play-and-risk-management-norwegian-preschools-qualitative. [Google Scholar]
  • 71.Lavrysen A, Els B, Leene L, Lieve S, Anja V, and De Graef P. Risky-play at school. Facilitating risk perception and competence in young children. Eur Early Child Educ Res J. 2017;25(1):89–105. 10.1080/1350293X.2015.1102412
  • 72.Veitch J, Bagley S, Ball K, Salmon J. Where do children usually play? A qualitative study of parents’ perceptions of influences on children’s active free-play. Health Place. 2006;12(4):383–93. 10.1016/j.healthplace.2005.02.009. [DOI] [PubMed] [Google Scholar]
  • 73.McArdle K, T. H, and Harrison D. Does a nurturing approach that uses an outdoor play environment build resilience in children from a challenging background? J Adventure Educ Outdoor Learn. 2013;13(3):238–54. 10.1080/14729679.2013.776862
  • 74.Caldwell HAT, Spencer RA, Joshi N, Branje K, Cawley J, Hobson H, et al. Impact of an outdoor loose parts play intervention on Nova Scotian preschoolers’ physical literacy: a mixed-methods randomized controlled trial. BMC Public Health. 2023;23(1):1126. 10.1186/s12889-023-16030-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 75.Sando OJ, Kleppe R, Sandseter EBH. Risky play and children’s well-being, involvement and physical activity. Child Indic Res. 2021;14(4):1435–51. 10.1007/s12187-021-09804-5. [Google Scholar]
  • 76.Jerebine A, Fitton-Davies K, Lander N, Eyre ELJ, Duncan MJ, Barnett LM. “All the fun stuff, the teachers say, ‘that’s dangerous!’” Hearing from children on safety and risk in active play in schools: a systematic review. Int J Behav Nutr Phys Act. 2022;19(1): 72. 10.1186/s12966-022-01305-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77.Dodd HF, Lester KJ. Adventurous play as a mechanism for reducing risk for childhood anxiety: a conceptual model. Clin Child Fam Psychol Rev. 2021;24:164–81. 10.1007/s10567-020-00338-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 78.Dodd HF, Nesbit RJ, FitzGibbon L. Child’s play: examining the association between time spent playing and child mental heatlh. Child Psychiatry Hum Dev. 2023;54:1678–86. 10.1007/s10578-022-01363-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 79.Fannin LD, Thayer ZM, Dorminy NJ. Commemorating the monkey bars, catalyst of debate at the intersection of human evolutionary biology and public health. Evol Med Public Health. 2024;2024:143–55. 10.1093/emph/eoae017. [Google Scholar]
  • 80.Barber R, Empey-Salisbury M, Hartt M. Planning for play. In: Wanka A, Freutel-Funke T, Andresen S, Oswald F, editors. Linking ages: a dialogue between childhood and ageing research. London, UK: Routledge; 2023.
  • 81.Hartt M, Gryfe M. Age-friendly planning and play: the study of older adult play spaces (SOAPS) observation tool. PPR. 2025;40(1):24–40. 10.1080/02697459.2024.2404744. [Google Scholar]
  • 82.MacIntyre TE, Walkin AM, Beckmann J, Calogiuri G, Gritzka S, Oliver G, et al. An exploratory study of extreme sport athletes’ nature interactions: from well-being to pro-environmental behavior. Front Psychol. 2019;10. 10.3389/fpsyg.2019.01233
  • 83.Krokosz D. Jochimek M. Coping strategies, perception of sport risk and satisfaction with life in men and women practicing extreme sports life in men and women practicing extreme sports Balt J Health Phys Act. 2018;10(4):283–345. 10.29359/BJHPA.10.4.22. [Google Scholar]
  • 84.Zosh JM, Hirsh-Pasek K, Hopkins EJ, Jensen H, Liu C, Neale D, et al. Accessing the inaccessible: redefining play as a spectrum. Front Psychol. 2018. 10.3389/fpsyg.2018.01124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 85.Hartt M, Vincent E. Older adult perceptions of play and play-enabling public space. Cities Health. 2024;8(6):1017–30. 10.1080/23748834.2024.2328953. [Google Scholar]
  • 86.World Health Organization. One Health. World Health Organization. n.d. https://www.who.int/health-topics/one-health#tab=tab_1. Accessed 20 Aug 2023.
  • 87.Lee E-Y, Kim Y-B, Cheng J, et al. PLAY+ (Play, Land, Animals, You and +) Framework: the rols of active outdoor play in advancing One Health. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 88.Mygind L, Johnstone A, Kryeziu A, Billet B, Delisle Nystrom C, Sandseter EB, et al. Outdoor play in Europe: Terminology and state of research, practice, and policy. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 89.Tremblay MS, de Lannoy L, James ME, Vanderloo LM, Tucker P, Larimore R, et al. Outdoor play in the Northern America region: a status update. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 90.Lee E-Y, Oh Y, Baghestani A, Cagas JY, Chen S, Huang WH, et al. Outdoor play in the Asia region: a status update.Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 91.Duncan S, Jerebine A, Jones R, Puddle D, Richards J, Tugu C, et al. Outdoor Play in Oceania: a review of policy, advocacy, and regional priorities. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 92.Abodi D. Outdoor play in the Africa: a status update. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 93.Silva DAS, de Barros MIA, Charles-Rodriguez U, Brazo-Sayavera J. Outdoor play in the Latin America and Caribbean region: a narrative review on the challenges, lessons learned, and recommendations for the future. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025..
  • 94.Winkler AS, Brux MC, Carabin H, das Neves CG, Basler B, Zinsstag J, et al. The Lancet One Health Commission: harnessing our interconnectedness for equitable, sustainable, and healthy socioecological systems. Lancet. 2025. 10.1016/S0140-6736(25)00627-0
  • 95.McRae N, Kira G, Duncan S, de Lannoy L, James ME, Rodriguez UC, et al. ‘The state of play in outdoor play’ - Exploring global Indigenous knowledge of outdoor play: a scoping review. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 96.Riley K, Froehlich Chow A, Wahpepah K, Humbert ML, Brussoni M, Houser N, et al. Etuaptmumk (two-eyed seeing) in nature’s way-our way: braiding physical literacy and risky play through Indigenous games, activities, cultural connections, and traditional teachings. AlterNative. 2023;19(2):426–36. 10.1177/11771801231167881. [Google Scholar]
  • 97.Dender AM, Stagnitti K. Children’s play in the Australian Indigenous context: the need for a contemporary view. Int J Play. 2015;4(1):3–16. 10.1080/21594937.2014.977036. [Google Scholar]
  • 98.Rebonne R. “This Land was Your Land”: Indigenous Engagement and Partnership in the Canadian Outdoor Recreational Landscape [master’s thesis]. Tromsø, Norway: UiT The Arctic University of Norway. 2024. Available from: https://hdl.handle.net/10037/33959. Accessed 29 May 2025.
  • 99.Ludwig S. Women’s transformative experiences while distance running in nature: an intuitive inquiry. Qual Psychol. 2019;6(3):339–58. 10.1037/qup0000137. [Google Scholar]
  • 100.Human N, Steyn BJM. Psychological transformation of the ‘self’ towards eco-sensitivity through high-risk nature-based sports: a South African context. J Adventure Educ Outdoor Learn. 2024;24(4):566–79. 10.1080/14729679.2023.2168711. [Google Scholar]
  • 101.Jensen JL, Sørensen EB. Recreation, cultivation and environmental concerns: exploring the materiality and leisure experience of contemporary allotment gardening. Leis Stud. 2020;39(3):322–40. 10.1080/02614367.2020.1731841. [Google Scholar]
  • 102.Deal PJ, Magyar-Russell GM. A qualitative study of sanctification: how nature becomes sacred for nontheistic environmental activists. Spirit Clin Pract. 2022;9(1):40–54. 10.1037/scp0000285. [Google Scholar]
  • 103.de Lannoy L, Hayhow N, Rodriguez UC, Squires K, Nasrallah B, James ME, et al. A mixed-methods systematic review of the association between active outdoor play and environmental stewardship outcomes among children, youth, and adults. PROSPERO 2024. Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024552064.
  • 104.Guzmán CAF, Aguirre AA, Astle B, Barros E, Bayles B, Chimbari M, et al. A framework to guide planetary health education. Lancet Planet Health. 2021;5(5):e253–5. 10.1016/S2542-5196(21)00110-8. [DOI] [PubMed] [Google Scholar]
  • 105.Hahn ER. The developmental roots of environmental stewardship: childhood and the climate change crisis. Curr Opin Psychol. 2021;42:19–24. 10.1016/j.copsyc.2021.01.006. [DOI] [PubMed] [Google Scholar]
  • 106.Rosa CD, Profice CC, Collado S. Nature experiences and adults’ self-reported pro-environmental behaviors: the role of connectedness to nature and childhood nature experiences. Front Psychol. 2018;9(101550902):1055. 10.3389/fpsyg.2018.01055. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 107.Intergovernmental Panel on Climate Change. Synthesis Report of the IPCC Sixth Assessment Report - Longer Report: Intergovernmental Panel on Climate Change. 2023. https://www.ipcc.ch/report/ar6/syr/downloads/report/IPCC_AR6_SYR_LongerReport.pdf
  • 108.Dodd W, Scott P, Howard C, Scott C, Rose C, Cunsolo A, et al. Lived experience of a record wildfire season in the Northwest Territories, Canada. Can J Public Health. 2018;109(3):327–37. 10.17269/s41997-018-0070-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 109.Evers C, Phoenix C. Relationships between recreation and pollution when striving for wellbeing in blue spaces. Int J Environ Res Public Health. 2022;19(7):4170. 10.3390/ijerph19074170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 110.Woolley H, Kinoshita I. Space, people, interventions and time (SPIT): a model for understanding children’s outdoor play in post-disaster contexts based on a case study from the triple disaster area of Tohoku in north-east Japan. Child Soc. 2015;29(5):434–50. 10.1111/chso.12072. [Google Scholar]
  • 111.Lee E-Y, Tremblay MS. Unmasking the political power of physical activity research: Harnessing the “apolitical-ness" as a catalyst for addressing the challenges of our time. J Phys Act Health. 2023:1–3. 10.1123/jpah.2023-0280
  • 112.Siefken K, Abu-Omar K. Striking a balance: Physical activity and planetary health. J Phys Act Health. 2023;20(12):1081–3. 10.1123/jpah.2023-0581. [DOI] [PubMed] [Google Scholar]
  • 113.Gelius P, Messing S, Tcymbal A, Birkholz L, Abu-Omar K. Physical activity as a victim, a perpetrator, or part of the solution to the climate crisis? J Phys Act Health. 2024;21(12):1220–2. 10.1123/jpah.2024-0522. [DOI] [PubMed] [Google Scholar]
  • 114.Sharifi A, Pathak M, Joshi C, He B-J. A systematic review of the health co-benefits of urban climate change adaptation. Sustain Cities Soc. 2021;74:103190. 10.1016/j.scs.2021.103190. [Google Scholar]
  • 115.Ding D, Luo M, Infante MFP, Gunn L, Salvo D, Zapata-Diomedi B, et al. The co-benefits of active travel interventions beyond physical activity: a systematic review. Lancet Planet Health. 2024;8(10):e790–803. 10.1016/S2542-5196(24)00201-8. [DOI] [PubMed] [Google Scholar]
  • 116.Park S, de Lannoy L, Down M, Jerebine A, Loebach J, Manyanga T, et al. Systematic review and qualitative meta-synthesis on (active) outdoor play and social capital: Relationships and impacts. PROSPERO 2024. Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024568624.
  • 117.Rivas-Quarneti N, Viana-Moldes I, Veiga-Seijo S, Canabal-López M, Magalhaes L. Politicizing Children’s Play: A Community Photovoice Process to Transform a School Playground. Am J Occup Ther. 2024;78(7):1–10. 10.5014/ajot.2024.050435. [Google Scholar]
  • 118.Sterman JJ, Naughton GA, Bundy AC, Froude E, Villeneuve MA. Mothers supporting play as a choice for children with disabilities within a culturally and linguistically diverse community. Scand J Occup Ther. 2020;27(5):373–84. 10.1080/11038128.2019.1684556. [DOI] [PubMed] [Google Scholar]
  • 119.Wheatley CM, Davies EL, Dawes H. Unspoken playground rules discourage adolescent physical activity in school: a focus group study of constructs in the prototype willingness model. Qual Health Res. 2017;28(4):624–32. 10.1177/1049732317744534. [DOI] [PubMed] [Google Scholar]
  • 120.Smith AL, Troped PJ, McDonough MH, DeFreese JD. Youth perceptions of how neighborhood physical environment and peers affect physical activity: a focus group study. Int J Behav Nutr Phys Act. 2015;12: 80. 10.1186/s12966-015-0246-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 121.Puhakka R. University students’ participation in outdoor recreation and the perceived well-being effects of nature. J Outdoor Recreat Tour. 2021;36:1–9. 10.1016/j.jort.2021.100425. [Google Scholar]
  • 122.Perry M, Cotes L, Horton B, Kunac R, Snell I, Taylor B, et al. Enticing" but not necessarily a “space designed for me": experiences of urban park use by older adults with disability. Int J Environ Res Public Health. 2021;18(2):552. 10.3390/ijerph18020552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 123.Capone AM, Arbour-Nicitopoulos K, de Lannoy L, Deliscar S, Taylor LG, Tucker P, et al. Active play among young children (0–4 years) with disabilities: a scoping review. OSF registration 2024. Available from: 10.17605/OSF.IO/GWPSD.
  • 124.Moogoor A, Mocnik S, Yuen B. Neighbourhood environmental influences on older adults' physical activities and social participation in Singapore: A photovoice study. Social science & medicine (1982). 2022;310(ut9, 8303205):115288. 10.1016/j.socscimed.2022.115288
  • 125.Abungin L, Saravanan S, Carbone M, Leo J, Arbour-Nicitopoulos K, Ross T, et al. Places and spaces for play among children and youth with disabilities: an umbrella review. OSF registration 2024. Available from: 10.17605/OSF.IO/ZJ6US.
  • 126.Satija A, Khandpur N, Satija S, Mathur Gaiha S, Prabhakaran D, Reddy KS, et al. Physical activity among adolescents in India: a qualitative study of barriers and enablers. Health Educ Behav. 2018;45(6):926–34. 10.1177/1090198118778332. [DOI] [PubMed] [Google Scholar]
  • 127.Dean SN, Bakalár P, Chorney DW, Kačúr P, Landreth S, Larson DM, et al. Teacher implementation of active outdoor play-based learning: A systematic review of pedagogical models and practices. Available from: https://www.outdoorplaycanada.ca/aop10-full-length-research-manuscripts-and-reports/. Accessed 1 July 2025.
  • 128.Burson SL, Castelli DM. How elementary in-school play opportunities relate to academic achievement and social-emotional well-being: systematic review. J Sch Health. 2022;92(10):945–58. 10.1111/josh.13217. [DOI] [PubMed] [Google Scholar]
  • 129.Molyneux TM, Zeni M, Oberle E. Choose your own adventure: promoting social and emotional development through outdoor learning. Early Child Educ J. 2023;51(8):1525–39. 10.1007/s10643-022-01394-3. [Google Scholar]
  • 130.Miller N, Saravana K, L. PK, Baldock KL. The perceived benefits of and barriers to nature-based play and learning in South Australian public primary schools: a cross-sectional study. J Adventure Educ Outdoor Learn. 2022;22(4):342–54. 10.1080/14729679.2022.2100431
  • 131.Walter P. Greening the net generation. Adult Learning. 2013;24(4):151–8. 10.1177/1045159513499551. [Google Scholar]
  • 132.Smith ES, Dalmer NK. Understanding older adults’ participation in outdoor adventure activities: a scoping review. J Adventure Educ Outdoor Learn. 2023:1–22. 10.1080/14729679.2023.2295842
  • 133.Wu J, Fu Y, Chen D, Zhang H, Xue E, Shao J, et al. Sedentary behavior patterns and the risk of non-communicable diseases and all-cause mortality: a systematic review and meta-analysis. Int J Nurs Stud. 2023;146: 104563. 10.1016/j.ijnurstu.2023.104563. [DOI] [PubMed] [Google Scholar]
  • 134.Xu C, Furuya-Kanamori L, Liu Y, Færch K, Aadahl M, A. Seguin R, et al. Sedentary behavior, physical activity, and all-cause mortality: dose-response and intensity weighted time-use meta-analysis. J Am Med Dir Assoc. 2019;20(10):1206–12.e3. 10.1016/j.jamda.2019.05.001
  • 135.Young DR, Hivert M-F, Alhassan S, Camhi SM, Ferguson JF, Katzmarzyk PT, et al. Sedentary behavior and cardiovascular morbidity and mortality: a science advisory from the American Heart Association. Circulation. 2016;134(13):e262–79. 10.1161/CIR.0000000000000440. [DOI] [PubMed] [Google Scholar]
  • 136.Dzakpasu FQS, Carver A, Brakenridge CJ, Cicuttini F, Urquhart DM, Owen N, et al. Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis. Int J Behav Nutr Phys Act. 2021;18(1): 159. 10.1186/s12966-021-01191-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 137.Leask CF, Harvey JA, Skelton DA, Chastin SFM. Exploring the context of sedentary behaviour in older adults (what, where, why, when and with whom). Eur Rev Aging Phys Act. 2015;12(1): 4. 10.1186/s11556-015-0146-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 138.Wachira L-J. Lifestyle transition towards sedentary behavior among children and yuth in Sub-Saharan Africa: a narrative review. In: Marques A, Gouveia ÉR, editors. Sedentary Behaviour - A Contemporary View. Rijeka: IntechOpen; 2021.
  • 139.Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults. Ann Intern Med. 2015;162(2):123–32. 10.7326/M14-1651. [DOI] [PubMed] [Google Scholar]
  • 140.Pillarisetti A, Ye W, Chowdhury S. Indoor air pollution and health: bridging perspectives from developing and developed countries. Annu Rev Environ Resour. 2022;47:197–229. 10.1146/annurev-environ-012220-010602. [Google Scholar]
  • 141.World Health Organization. Air quality, energy and health. n.d. https://www.who.int/teams/environment-climate-change-and-health/air-quality-energy-and-health/sectoral-interventions/household-air-pollution/health-risks.
  • 142.World Health Organization. Household air pollution burden of disease. 2022. https://www.who.int/data/gho/data/indicators/indicator-details.
  • 143.Zhang Q, Meng X, Shi S, Kan L, Chen R, Kan H. Overview of particulate air pollution and human health in China: evidence, challenges, and opportunities. Innovation. 2022;3(6):100312. 10.1016/j.xinn.2022.100312. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 144.WHO. Ambient (outdoor) air pollution. WHO. 2022. https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health.
  • 145.Watts N, Amann M, Ayeb-Karlsson S, Belesova K, Bouley T, Boykoff M, et al. The lancet countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet. 2018;391(10120):581–630. 10.1016/S0140-6736(17)32464-9. [DOI] [PubMed] [Google Scholar]
  • 146.Cardinali M, Balderrama A, Arztmann D, Pottgiesser U. Green walls and health: an umbrella review. Nature-Based Solutions. 2023;3:100070. 10.1016/j.nbsj.2023.100070. [Google Scholar]
  • 147.Mazzocchi F. A deeper meaning of sustainability: insights from indigenous knowledge. Anthropol Rev. 2020;7(1):77–93. 10.1177/2053019619898888. [Google Scholar]
  • 148.Brussoni M, Han CS, Lin Y, Jacob J, Pike I, Bundy A, et al. A web-based and in-person risk reframing intervention to influence mothers’ tolerance for, and parenting practices associated with, children’s outdoor risky play: randomized controlled trial. J Med Internet Res. 2021;23(4):e24861. 10.2196/24861. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 149.Beaulieu E, Beno S, Canadian Paedatric Society , Injury Prevention Committee. Healthy childhood development through outdoor risky play: Navigating the balance with injury prevention. Paediatr Child Health. 2024;29(4):255–61. https://cps.ca/en/documents/position/outdoor-risky-play.
  • 150.The Council of Chief Medical Officers of Health. Active outdoor play statement from the Council of Chief Medical Officers of Health. Pan-Canadian Public Health Network, Pan-Canadian Public Health Network. https://www.phn-rsp.ca/en/position-statements/active-outdoor-play-statement.html. Accessed 18 April 2025.
  • 151.Sonti NF, Campbell LK, Svendsen ES, Johnson ML, Auyeung DSN. Fear and fascination: Use and perceptions of New York City’s forests, wetlands, and landscaped park areas. Urban For Urban Green. 2020;49:126601. 10.1016/j.ufug.2020.126601. [Google Scholar]
  • 152.Sreetheran M, Van Den Bosch CCK. A socio-ecological exploration of fear of crime in urban green spaces–a systematic review. Urban For Urban Green. 2014;13(1):1–18. 10.1016/j.ufug.2013.11.006. [Google Scholar]
  • 153.Carrico AR. Climate change, behavior, and the possibility of spillover effects: recent advances and future directions. Curr Opin Behav Sci. 2021;42:76–82. 10.1016/j.cobeha.2021.03.025. [Google Scholar]
  • 154.Maki A, Carrico AR, Raimi KT, Truelove HB, Araujo B, Yeung KL. Meta-analysis of pro-environmental behaviour spillover. Nat Sustain. 2019;2(4):307–15. 10.1038/s41893-019-0263-9. [Google Scholar]
  • 155.Lee E-Y, Khan A. Prevalence and clustering patterns of pro-environmental behaviors among Canadian households in the era of climate change. Sustainability. 2020;12(19):8218. 10.3390/su12198218. [Google Scholar]
  • 156.Teixeira A, Gabriel R, Martinho J, Santos M, Faria A, Oliveira I, et al. Pro-environmental behaviors: relationship with nature visits, connectedness to nature and physical activity. Am J Health Promot. 2023;37(1):12–29. 10.1177/08901171221119089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 157.Keith RJ, Given LM, Martin JM, Hochuli DF. Environmental self-identity partially mediates the effects of exposure and connection to nature on urban children’s conservation behaviours. Curr Res Ecol Soc Psychol. 2022. 10.1016/j.cresp.2022.100066. [Google Scholar]
  • 158.Poli P, Morone G, Rosati G, Masiero S. Robotic technologies and rehabilitation: new tools for stroke patients’ therapy. BioMed Res Int. 2013;2013(1):153872. 10.1155/2013/153872. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 159.Manske S. Explaining knowledge use among clients of the Program Training & Consultation Centre Toronto. ON: University of Toronto; 2001. [Google Scholar]
  • 160.Lee RG, Garvin T. Moving from information transfer to information exchange in health and health care. Soc Sci Med. 2003;56(3):449–64. https://www.sciencedirect.com/science/article/abs/pii/S027795360200045X. [DOI] [PubMed] [Google Scholar]
  • 161.Goverment of Canada. Sex- and Gender-Based Analysis Plus in Action at Health Canada. n.d. https://www.canada.ca/en/health-canada/corporate/transparency/sex-gender-based-analysis-action.html. Accessed 14 Sept 2024.
  • 162.Kelly C, Dansereau L, Sebring J, Aubrecht K, FitzGerald M, Lee Y, et al. Intersectionality, health equity, and EDI: what’s the difference for health researchers? Int J Equity Health. 2022;21(1):182. 10.1186/s12939-022-01795-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 163.Zhao Q, Winters M, Nelson T, Laberee K, Ferster C, Manaugh K. Who has access to cycling infrastructure in Canada? A social equity analysis. Comput Environ Urban Syst. 2024;110: 102109. 10.1016/j.compenvurbsys.2024.102109. [Google Scholar]
  • 164.Kunaratnam V, Schwartz N, Howard A, Mitra R, Saunders N, Cloutier M-S, et al. Equity, walkability, and active school transportation in Toronto, Canada: a cross-sectional study. Transp Res D Transp Environ. 2022;108:103336. 10.1016/j.trd.2022.103336. [Google Scholar]
  • 165.McRae N, Giles A, Hayhurst L. Safe sport for whom? Are national sport organisations addressing the truth and reconciliation commission’s calls to action for sport through safe sport policies? Int J Sport Policy Polit. 2024;16(2):235–53. 10.1080/19406940.2024.2323006. [Google Scholar]
  • 166.Lee E-Y, Alamshahi Y, Cheng J, Vanderloo LM, Faulkner G, Ferguson L, et al. A scoping review of barriers and facilitators of physical activity among equity-denied groups in Canada: An intersectional equity lens. J Immigr Minor Health. 2025. 10.1007/s10903-025-01727-5. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Appendix A (407KB, pdf)
Appendix B (1.8MB, pdf)
Appendix C (562.7KB, xlsx)

Data Availability Statement

No datasets were generated or analysed during the current study.


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