Environmental Determinants of Outdoor Play in Children

A Large-Scale Cross-Sectional Study
  • Marie-Jeanne Aarts
    Address correspondence to: Marie-Jeanne Aarts, MSc, Tilburg University, Faculty of Social and Behavioral Sciences, Department Tranzo, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
    Tilburg University, Faculty of Social and Behavioral Sciences, Department Tranzo, Tilburg, The Netherlands

    National Institute for Public Health and the Environment, Public Health and Health Services Division, Bilthoven, The Netherlands
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  • Wanda Wendel-Vos
    National Institute for Public Health and the Environment, Public Health and Health Services Division, Bilthoven, The Netherlands
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  • Hans A.M. van Oers
    Tilburg University, Faculty of Social and Behavioral Sciences, Department Tranzo, Tilburg, The Netherlands

    National Institute for Public Health and the Environment, Public Health and Health Services Division, Bilthoven, The Netherlands

    WHO, Geneva, Switzerland
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  • Ien A.M. van de Goor
    Tilburg University, Faculty of Social and Behavioral Sciences, Department Tranzo, Tilburg, The Netherlands
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  • Albertine J. Schuit
    National Institute for Public Health and the Environment, Public Health and Health Services Division, Bilthoven, The Netherlands

    VU University Amsterdam, Department of Health Sciences and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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      Outdoor play is a cheap and natural way for children to be physically active.


      This study aims to identify physical as well as social correlates of outdoor play in the home and neighborhood environment among children of different age groups.


      Cross-sectional data were derived from 6470 parents of children from 42 primary schools in four Dutch cities by means of questionnaires (2007–2008). Multivariate sequential Poisson GEE analyses were conducted (2010) to quantify the correlation between physical and social home and neighborhood characteristics and outdoor play among boys and girls aged 4–6 years, 7–9 years, and 10–12 years.


      This study showed that next to proximal (home) environmental characteristics such as parental education (RR=0.93–0.97); the importance parents pay to outdoor play (RR=1.32–1.75); and the presence of electronic devices in the child's own room (RR=1.04–1.15), several neighborhood characteristics were significantly associated with children's outdoor play. Neighborhood social cohesion was related to outdoor play in five of six subgroups (RR=1.01–1.02), whereas physical neighborhood characteristics (e.g., green neighborhood type, presence of water, diversity of routes) were associated with outdoor play in specific subgroups only.


      Neighborhood social cohesion was related to outdoor play among children of different age and gender, which makes it a promising point of action for policy development. Policies aimed at improving physical neighborhood characteristics in relation to outdoor play should take into account age and gender of the target population.
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