Facilitators and barriers to outdoor time among children aged 3-18 years: A systematic scoping review

This scoping review systematically identified and mapped facilitators of and barriers to outdoor time among children, guided by the framework of the social-ecological model (SEM) to examine factors across individual, relationship, community, and societal dimensions. Electronic databases (PubMed, MEDLINE, SPORTDiscus, Embase, CNKI, and Wanfang) were searched for relevant studies published between January 1, 2000, and December 31, 2024. Empirical quantitative and qualitative studies reporting at least one barrier or facilitator to outdoor time among children aged 3-18 years were included. The data were coded and analyzed using a thematic analysis framework. Data were coded and analyzed into SEM dimensions. A total of 72 studies and 69,984 children were included in this review. More than half of the studies were conducted in either China, the U.S., or the UK. Almost all studies (95%) employed quantitative designs, while only six studies (10%) used objective assessments, and most adopted questionnaires. Overall, there were 30 facilitators and 23 barriers extracted from the included studies. Five factors, including age, gender, ethnicity, screen time, and socioeconomic status, showed inconsistency across studies. Children's outdoor time is influenced by multi-level factors involving individuals, families, schools, communities, and policy-makers. This scoping review provides a comprehensive evidence base to inform targeted interventions aimed at increasing outdoor time in children and underscores the need for context-specific strategies.