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A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.

[...]I use the Cardalis (Ceva Animal Health) app to measure patients' respiratory rates, while the stopwatch is a handy way to measure patients' heart rates.

Purpose This study investigated the risk factors associated with insufficient engagement of Chinese early school-aged children in outdoor activities, including play and physical activities. Methods Data were gathered from two waves of parent-proxy surveys. The analysis involved 1612 children (46.15% girls; mean age = 7.83 years) who had participated in outdoor activities. Responses were analyzed using Generalized Estimating Equations to identify relevant correlates impacting children’s outdoor play or outdoor physical activities. Children were assessed on their outdoor activities’ levels, and variables were analyzed for their impact on these levels. Results Maternal outdoor activity (< 1 h/day) and less clear requirements for outdoor activity are correlated with children’s outdoor play time (< 2 h/day) ( p  < 0.05). The number of outdoor playfields was also significantly associated with insufficient outdoor play, particularly on weekends ( p  < 0.05). For outdoor physical activities (< 1 h/day), the male gender of the child was a protective factor (OR = 0.33, p  < 0.001), while paternal outdoor activity time (< 1 h/day) and unclear outdoor activity requirements were risk factors ( p  < 0.01). Conclusions The risk factors of insufficient engagement of Chinese early school-aged children in outdoor pursuits included the lack of time parents spend on outdoor activities, their unclear requirements, and the limited availability of outdoor spaces. Specifically, mothers’ outdoor activities time is linked to children’s outdoor play, while the male gender of the child and fathers’ outdoor activities are associated with children’s outdoor physical activities participation.

Children’s right to play is enshrined in Article 31 of the United Nations Convention on the Rights of the Child (Office of the United Nations High Commissioner for Human Rights, 1990). The early childhood period is a time when children’s values and dispositions towards outdoor play and environments are formed. Children have an intrinsic drive and natural curiosity to explore the world around them and outdoor environments are a key context for this exploration.  Outdoor play and learning provide significant benefits for all aspects of children’s development - physical, cognitive, social and emotional (Brussoni et al., 2015).

Nature prescription programs have emerged to address the high burden of chronic disease and increasingly sedentary and screen-based lifestyles. This study examines the base of evidence regarding such programs. We conducted a narrative review of published literature using four electronic databases. We included case studies, research design articles, and empirical studies that discussed any type of outdoor exposure or activities initiated by a health-care provider from an outpatient clinic. We examined articles for information on target populations, health outcomes, and structural and procedural elements. We also summarized evidence of the effectiveness of nature prescription programs, and discussed needs and challenges for both practice and research. Eleven studies, including eight empirical studies, have evaluated nature prescription programs with either structured or unstructured formats, referring patients either to nearby parks or to formal outdoor activity programs. Empirical studies evaluate a wide variety of health behaviors and outcomes among the most at-risk children and families. Research is too sparse to draw patterns in health outcome responses. Studies largely tested program structures to increase adherence, or patient follow-through, however findings were mixed. Three published studies explore providers’ perspectives. More research is necessary to understand how to measure and increase patient adherence, short and long-term health outcomes for patients and their families, and determinants of provider participation and participation impacts on providers’ own health.

The study aimed to investigate the impact of COVID-19 restrictions on children’s access to the outdoors in early childhood education and care (ECEC) settings. An online survey comprised of a standardised scale and questions used in previous related studies was completed by 143 early childhood educators across Australia. Participants were asked to report children’s time spent outdoors, access to outdoor space, and restrictions imposed on children’s play during the pandemic compared to the pre-pandemic period. The survey responses were imported into SPSS for descriptive, correlation, and ordinal regression analyses. We examined the relationship between children’s outdoor time, space, restrictions imposed on children’s play, and educators’ characteristics, such as qualifications, professional development, and tolerance of risk or staff–child ratios during the pandemic in Australia. Most educators reported that children’s outdoor time and access to outdoor space remained the same compared to before the pandemic, while imposed restrictions on children’s outdoor play increased. The results of ordinal regressions indicated that educators with a higher tolerance of risk were less likely to impose additional restrictions on children’s outdoor play. The findings contribute to the understanding of how educators’ tolerance of risk influences children’s outdoor play opportunities and provide directions for future risk-reframing interventions.

AimTo reassess the association between near work, outdoor exposure and myopia in children through an objective approach.MethodsEighty-six children (10.13±0.48 years) were asked to wear Clouclip, a newly developed wearable device that is able to measure working distance and eye-level illuminance, for a complete week to obtain information on near work and outdoor exposure. The mean daily Clouclip wearing time was 11.72±1.14 hour. The spherical equivalent refraction was determined by cycloplegic autorefraction.ResultsThe myopic children were found to be exposed to light intensities >3000 lux (0.68±0.50 hour vs 1.02±0.53 hour, p=0.012) and >5000 lux (0.42±0.35 hour vs 0.63±0.31 hour, p=0.004) for shorter durations on average each day than the non-myopic children. Additionally, the myopic children spent more time on average each day on activities at a distance of <20 cm than non-myopic children (1.89±0.61 hour vs 1.52±0.77 hour, p=0.019). In the multivariate logistic analysis, the time spent with a higher light intensity (>3000 lux (OR=0.27, 95% CI: 0.10 to 0.72, p=0.009); >5000 lux (OR=0.11, 95% CI: 0.02 to 0.56, p=0.008)) and a working distance of <20 cm (in a circumstance of >3000 lux (OR=1.17, 95% CI: 1.09 to 1.86, p=0.038) or in that of >5000 lux (OR=1.12, 95% CI: 1.03 to 1.77, p=0.046)) were the independent protective factors and risk factors, respectively.ConclusionThe current study provides novel evidence, based on objective data, to support the association between the intensity of near work, light intensity and myopia. However, the causality and the dose-effect relationship need to be investigated further.

Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed by 826 children (aged 10–13 years) and their parents from 12 schools (four each urban, suburban and rural) from a large county in Ontario, Canada. Five multilevel regression models, controlling for any school clustering effect, examined associations between outdoor play time per week and variable sets representing five prevalent factors cited in the literature as influencing children’s outdoor play (OP). Models predicted that younger children and boys were more likely to spend time playing outdoors; involvement in organized physical activities, other children nearby to play with, higher perception of benefits of outdoor play, and higher parental perceptions of neighborhood social cohesion also predicted more time in outdoor play. Time outdoors was less likely among children not allowed to play beyond home without supervision, felt they were ‘too busy’ with screen-based activities, and who reported higher fears related to playing outdoors. Study findings have important implications for targeting environmental, cultural and policy changes to foster child-friendly communities which effectively support healthy outdoor play.

Educators have used outdoor space to support learning throughout history. Over the past several years, the COVID-19 pandemic has compelled institutions of higher education to make innovations toward planning and constructing outdoor learning spaces on campus as a necessary measure for promoting student health and safety. This scoping literature review explores the landscape of research on use of campus space developed for outdoor learning in higher education around the world. In this review, we synthesize relevant research based on descriptive characteristics, research interests, supporting theories and frameworks, technology use, and learning outcomes. Our search uncovered a range of developed (i.e., constructed) outdoor space design guidelines, outdoor learning activities, and theoretical frameworks that expand our understanding of outdoor spatial use on college and university campuses. This scoping review offers qualitative and descriptive quantitative findings and offers practical implications for higher education stakeholders as they explore possibilities for developing outdoor space on their campuses for teaching and learning.