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The outdoor environment and children's health: A multilevel approach


Nature, open areas, and pathways in outdoor environments are positively linked to children’s health

The concept of affordance provides a framework for this study. Affordances are elements of the environment that indicate possibilities for action. This study explored the relationship between characteristics of the outdoor environment — which can serve as affordances — and children’s health by examining children’s well-being and physical activity in different outdoor environments at early childhood centers in Norway. The aim of the study was to gain a better understanding of how the physical outdoor environments at early childhood education institutions can influence children’s health.

Eight Early Childhood Education and Care (ECEC) institutions in Norway participated in this study. These institutions represented variations in size, age, location and physical environment. Researchers collected physical activity and well-being data on five girls and five boys from each institution.  The participating children were randomly selected among the 3- and 4-year-old children. The data collection process included systematic and randomized video observations of the children in their outdoor environment during free play, meaning times when the children could decide what they wanted to do, where they wanted to be, and with whom they wanted to be.  The sample included 471 video observations (of approximately 122 seconds each) of the 80 participating children. Measures used in analyzing the data focused on the children’s well-being and physical activity, as well as the place of activity and materials used during the activity.  The Leuven Well-Being Scale was used to measure well-being in the physical environment. This scale measures children’s subjective and emotional well-being on a scale from one to five. A score of 1 is used when a child shows clear signs of discomfort; a score of 5 when a child shows signs of being happy, relaxed, or lively. The Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used to measure physical activity (PA). A score of 1 on this scale indicates that the child is stationary; a score of 5 indicates fast movement on the part of the child.

Areas of the outdoor environment in which children tended to be more active were pathways and open areas. Fixed playground equipment, wheeled toys, loose parts (e.g., outdoor toys, nature materials and open-ended materials) and being in nature were associated with less PA. Playing versus not playing and being in nature were associated with increased well-being.

The overall findings of this study highlight the importance of play for children’s health. This research also indicates that nature, open areas, and pathways may promote positive health outcomes. Wheeled toys, fixed playground equipment, and loose parts, on the other hand, were negative predictors of physical activity. As this negative association contradicts findings of some earlier studies, more nuanced research is recommended.


Sando, O.J., (2019). The outdoor environment and children's health: A multilevel approach. International Journal of Play, 8(1), 39-52.


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