A systematic review and meta-analyses of the relationships between active outdoor play and 24-hour movement behaviors
Bibliographic record
Abstract
ABSTRACT Background Few individuals meet the 24-h movement guidelines for physical activity (PA), sedentary behavior, and sleep. Active outdoor play (AOP) may support healthier movement patterns, though its role is not yet established. The objective of this study was to synthesize evidence on associations between AOP and movement behaviors. Methods A systematic review and meta-analyses were conducted using 5 databases from inception to September 2025. Studies examining AOP and movement behaviors were included with no restriction on age, ability, or geographic location. Screening and data extraction were completed in duplicate. Narrative syntheses, random-effects meta-analyses, and The Grading of Recommendations Assessment, Development, and Evaluation assessments were conducted. Results Of 28,092 records, 61 studies met inclusion criteria, spanning 25 countries with participants aged 1.6–15.5 years. Most were cross-sectional ( n = 46), with some longitudinal ( n = 8), quasi-experimental ( n = 5), and randomized trials ( n = 3). AOP was consistently associated with greater PA, especially moderate-to-vigorous PA; meta-analysis showed a moderate positive correlation with high heterogeneity ( r = 0.60, 95% confidence interval (95%CI): 0.34–0.78, p = 0.0004; I 2 = 99.2%). AOP was also linked to less sedentary behavior: children were sedentary 38% of the time outdoors vs. 67% indoors. Meta-analyses showed a small, significant negative correlation with sedentary time ( r = –0.05, 95%CI: –0.07 to -0.02, p < 0.0043; I 2 = 7.0%) and a small, non-significant correlation with screen time ( r = –0.19, 95%CI: –0.38 to 0.02, p = 0.0638; I 2 = 98.9%). Evidence on sleep was mixed, with no adverse associations found. Certainty of evidence was low to very low. Conclusion AOP may support healthier movement behaviors in children and youth. More longitudinal and intervention research is needed to confirm causality and guide policy and practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".