Currently submitted to: JMIR Research Protocols
Date Submitted: Apr 27, 2026
Open Peer Review Period: Apr 28, 2026 - Jun 23, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Outdoor Free Play in Children Aged 0–12 Years: Protocol for a Systematic Review of Intervention Effects and Implementation Characteristics
ABSTRACT
Background:
Outdoor free play is associated with benefits for children’s health, yet opportunities have declined and intervention approaches remain heterogeneous. A clearer understanding is needed of which interventions are effective and under what implementation conditions.
Objective:
This systematic review aims to synthesize interventions related to outdoor free play in children aged 0–12 years, evaluate their effects on child health and developmental outcomes, and characterize intervention components, delivery strategies, and implementation features.
Methods:
We will search MEDLINE, Embase, CINAHL, Scopus, CENTRAL, and Web of Science. Eligible studies will use experimental or quasi-experimental designs to examine interventions related to outdoor free play, defined as child-directed play outdoors that is not structured by adults. Interventions will include but not be limited to modifications to environments, policies, supervision, or resources. The primary outcome will be any quantitative child health or developmental outcome. Studies must provide sufficient detail to identify core components, delivery format, target population, and setting. Two reviewers will independently screen studies, extract data, and assess risk of bias using Cochrane Risk of Bias 2 tool and ROBINS-I. Intervention characteristics and implementation factors will be synthesized descriptively using TIDieR and RE-AIM. Where appropriate, meta-analyses will be conducted using random-effects models, with subgroup analyses by age and setting, and sensitivity analyses restricted to studies at low risk of bias.
Results:
Funded in Decembre 2025, search strategy ran in April 2026 and title and abstracts screening started as of April 2026.
Conclusions:
This review will identify which outdoor free play interventions are effective and feasible. By clarifying key components and implementation features, it will support decisions on selecting, adapting, and scaling interventions within local contexts. Clinical Trial: PROSPERO no CRD420261376414; https://www.crd.york.ac.uk/PROSPERO/view/CRD420261376414
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.