Table 3.
Summary of the determinants of outdoor time in children and youth.
| Variable | Level of Influence | Number of Studies | Positive (%) | Negative (%) | Mixed (%) | Null (%) | Summary Code |
|---|---|---|---|---|---|---|---|
| Child sex (male) | Individual | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Child gender (boy) | Individual | 11 | 5 (45.5%) | 0 (0%) | 1 (9%) | 5 (45.5%) | (+) |
| Child age (older) | Individual | 20 | 6 (30%) | 5 (25%) | 5 (25%) | 4 (20%) | Equivocal |
| Child ethnicity (dominant vs. other) | Individual | 2 | 0 (0%) | 1 (50%) | 0 (0%) | 1 (50%) | N/A |
| Birth weight (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Preterm birth (yes vs. no) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child weight status (overweight/higher BMI vs. normal weight) | Individual | 2 | 0 (0%) | 1 (50%) | 0 (0%) | 1 (50%) | N/A |
| Child moderate- to vigorous-intensity PA (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child screen time (higher) | Individual | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Number of age-appropriate toys (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Frequency of visits to play spaces (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Outdoor tendencies score (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | N/A |
| Indoor tendencies score (higher) | Individual | 1 | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) | N/A |
| OP at baseline (higher) | Individual | 3 | 3 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | + |
| Child-perceived neighbourhood danger (greater danger) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child autonomy (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child-perceived pros and cons of OP (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child-perceived social support for OP (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Child-perceived social modelling of OP (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child-perceived self-efficacy for OP (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Child-perceived habit strength for OP (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Child planning skills for OP (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Child-perceived barriers to OP (higher) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child enjoyment of OP (higher) | Individual | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Child likely to develop myopia in the future (yes vs. no) | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Child sleep patterns | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Participation in a child-centred play therapy intervention | Individual | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived neighbourhood safety (safer) | Interpersonal | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Parental education (higher vs. lower) | Interpersonal | 6 | 2 (33.3%) | 1 (16.7%) | 1 (16.7%) | 2 (33.3%) | Equivocal |
| Household income (higher) | Interpersonal | 3 | 1 (33.3%) | 0 (0%) | 0 (0%) | 2 (66.7%) | 0 |
| Father’s occupation (service workers/unemployed vs. higher class) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parental occupation | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Family size | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Changes in household income (increase) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Changes in household size (increase) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Changes in the number of children in household (increase) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Type of housing (apartment vs. other) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Number of people per bedroom (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Number of “inappropriate” media (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Limiting screen time (more restriction) | Interpersonal | 2 | 0 (0%) | 2 (100%) | 0 (0%) | 0 (0%) | N/A |
| Rules and restrictions related to OP (more vs. less) | Interpersonal | 2 | 1 (50%) | 0 (0%) | 0 (0%) | 1 (50%) | N/A |
| Parental concern with child’s PA (more concern) | Interpersonal | 1 | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) | N/A |
| Parental attitude towards child’s PA (more positive) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parental and family attitude towards OP (more positive) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Perceived difficulty of increasing OP (higher) | Interpersonal | 1 | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) | N/A |
| Parental habit strength to improve OP (higher) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parental intention to improve OP (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | N/A |
| Parental encouragement of OP (more encouragement) | Interpersonal | 2 | 0 (0%) | 1 (50%) | 1 (50%) | 0 (0%) | N/A |
| Parent participation in PA with children (higher) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parent OT (higher) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parent age (higher) | Interpersonal | 2 | 0 (0%) | 0 (0%) | 1 (50%) | 1 (50%) | N/A |
| Parent BMI (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent race/ethnicity (dominant vs. other) | Interpersonal | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Social opportunities score (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | N/A |
| Dog ownership (yes vs. no) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Number of siblings (higher) | Interpersonal | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Home PA opportunities (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental belief that child must be supervised when playing outside (higher agreement) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent report that there are no adults to supervise child while playing outside after school (higher agreement) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | N/A |
| Perceived influence of peer groups (i.e., partner, friends, mother, and family) on child’s nutrition, TV time, and PA (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for access to nearby amenities (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for high level of neighbourhood upkeep (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for large back or front yard (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for living in a cul-de-sac vs. on a through street (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for low traffic on neighbourhood streets (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for parks and open spaces nearby (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for sidewalks throughout neighbourhood (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for lots of interaction among neighbours or lots of people out and about in the neighbourhood (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for low crime rate in neighbourhood (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental preference for a safe neighbourhood for kids to play (higher) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parental monitoring, not specific to OP (higher) | Interpersonal | 2 | 1 (50%) | 0 (0%) | 0 (0%) | 1 (50%) | N/A |
| Parental monitoring of PA (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived responsibility for child PA (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parental pressure for child to be active (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Number of myopic parents (1 or 2 vs. 0) | Interpersonal | 1 | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) | N/A |
| Farmworker parent (yes vs. no) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Pregnancy depression score | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Pregnancy screen time (higher) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Recent parental weight loss surgery (yes vs. no) | Interpersonal | 1 | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) | N/A |
| Sessions with parents with additional resources (e.g., specific advice and community guide) promoting OP (yes vs. no) | Interpersonal | 3 | 3 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | + |
| Newsletter or booklet intervention on healthy eating and PA (yes vs. no) | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Counselling intervention to reduce TV viewing (yes vs. no) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Lifestyle Triple P intervention (focused on nutrition, PA, and positive parenting strategies; yes vs. no) a | Interpersonal | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Intervention—structured weekend outdoor activities and incentives for children to increase steps counts via pedometers (yes vs. no) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 1 (100%) | 0 (0%) | N/A |
| Intervention—parent-based prevention program after parental bariatric surgery (yes vs. no) | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Intervention—pediatrician outdoor PA prescription | Interpersonal | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived interactions among neighbours (higher) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived change in interactions among neighbours (increase) | Community | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Parent-perceived people out and about in the neighbourhood or changes in the number of people out and about (more) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived low crime rate in neighbourhood (increase) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived change in crime rate in neighbourhood (lower) | Community | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| School type (private vs. public) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| School shift (afternoon vs. morning) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived social capital (higher) | Community | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Youth-perceived neighbourhood support (higher) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived neighbourhood friendliness or attractiveness for children (higher) | Community | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| School-based sun safety intervention discouraging outdoor activities at certain times of the day (yes vs. no) | Community | 3 | 0 (0%) | 2 (66.7%) | 0 (0%) | 1 (33.3%) | - |
| Preschool interventions focused on health behaviours and stress management/self-regulation (yes vs. no) | Community | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| School curriculum intervention to increase OP (yes vs. no) | Community | 3 | 1 (33.3%) | 0 (0%) | 0 (0%) | 2 (66.7%) | 0 |
| Parent-perceived access to local destinations for PA (higher or increase over time) | Built environment | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Parent-perceived neighbourhood upkeep (higher or increase over time) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived back or front yard size (larger) | Built environment | 2 | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | N/A |
| Parent-perceived change in large back or front yard size (increase) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Living in a cul-de-sac vs. on a through street (or moving to a cul-de-sac) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived traffic on neighbourhood streets (low or decrease) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived parks and open spaces nearby (higher or increase) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived sidewalks through neighbourhood (higher or increase) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived neighbourhood functionality (higher) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived neighbourhood attractiveness (higher) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Parent-perceived traffic safety (higher) | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Living in suburban vs. traditional neighbourhood | Built environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Living in an urban vs. rural area | Built environment | 1 | 0 (0%) | 1 (100%) | 0 (0%) | 0 (0%) | N/A |
| Ambient ozone concentration (higher) | Natural environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Season (warmer) b | Natural environment | 7 | 7 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | + |
| Weather perceived as a barrier by parent (higher) | Natural environment | 1 | 0 (0%) | 0 (0%) | 0 (0%) | 1 (100%) | N/A |
| Time of the week (weekdays vs. weekend days) | Chronosystem | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| Street closure intervention (yes vs. no) | Policy | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
| COVID-19 restrictions (adoption) | Policy | 3 | 0 (0%) | 3 (100%) | 0 (0%) | 0 (0%) | - |
| COVID-19 restrictions (removal) | Policy | 1 | 1 (100%) | 0 (0%) | 0 (0%) | 0 (0%) | N/A |
Note: BMI: body mass index; OP: outdoor play; OT: outdoor time; PA: physical activity. a The intervention effect was significant at 12 months and close to significance at 4 months (p = 0.063; Cohen’s d = 0.56) [60], so the intervention effect was deemed positive. b Sääkslahti et al. [45] also found significant difference between spring and fall seasons, but it is not included in this table because it was not clear which season was warmer. Due to the small number of studies that were not rated as “weak” based on the Effective Public Health Practice Project tool (see Table 5), the risk of bias remains high for most potential determinants.