A growing body of research is exploring the potential added health benefits of exercise when performed outdoors in nature versus indoors. This systematic review aimed to compare the effects of exercise in outdoor environments versus indoor environments on psychological health, physical health, and physical activity behaviour. We searched nine databases from inception to March 2021 for English language, peer-reviewed articles: MEDLINE, Embase, PubMed, Scopus, Web of Science, CINAHL, SportsDiscus, GreenFile, and CENTRAL. We included randomized and non-randomized trials that compared multiple bouts of exercise in outdoor versus indoor environments, and that assessed at least one outcome related to physical health, psychological health, or physical activity behaviour. Due to minimal outcome overlap and a paucity of studies, we performed a narrative synthesis. We identified 10 eligible trials, including 7 randomized controlled trials, and a total of 343 participants. Participant demographics, exercise protocols, and outcomes varied widely. In the 10 eligible studies, a total of 99 comparisons were made between outdoor and indoor exercise; all 25 statistically significant comparisons favoured outdoor exercise. Interpretation of findings was hindered by an overall high risk of bias, unclear reporting, and high outcome heterogeneity. There is limited evidence for added health or behaviour benefits of outdoor exercise versus indoor exercise. Rigorous randomized controlled trials are needed with larger samples and clear reporting.

Early childhood is an opportune time to develop physical literacy, acquire movement skills, and promote physical activity. Little is known about early childhood educators’ competence (ECEs) and confidence in physical literacy knowledge and its application to practice. The purpose of this research was to examine the competence and confidence of ECEs in physical literacy, and to determine whether exposure to information in this area influences their confidence level. A total of 85 participants completed an online survey. Physical activity knowledge was high; however, error detection and correction knowledge was lower, with high variability in responses. Mean confidence rating (out of 10) was lowest for locomotor skill error detection and correction (6.4 ± 1.8) and highest for physical activity promotion (7.7 ± 1.6). Confidence in movement skill development decreased significantly pre- to post-survey (p < 0.001); highlighting a potential ‘topic exposure’ effect. These findings demonstrate the need for physical literacy training for ECEs.

Childcare is a critical target for promoting children’s physical activity (PA) and physical literacy (PL). With emerging evidence about the efficacy of policy and capacity-building strategies, more information about how to bring these strategies to scale is needed. This paper describes implementation at scale of Appetite to Play (ATP), a capacity-building intervention for childcare providers, and examines the implementation and impact on early years providers’ capacity to address PA. The ATP implementation evaluation was a natural experiment that utilized a mixed methods concurrent parallel design framed within the Reach, Effectiveness, Adoption, Implementation, Maintenance framework (RE-AIM). Workshop and website tracking assessed reach and adoption. Surveys and interviews with workshop participants and stakeholders assessed satisfaction, implementation, and maintenance. Training reached 60% of British Columbia municipalities and 2700 early years providers. Significant changes in participants’ knowledge and confidence to promote PA and PL were achieved (p > 0.01–0.001). Childcare level implementation facilitators as reported by early years providers included appropriate resources, planning, indoor space, and equipment, whereas weather and space were reported barriers. The stakeholder advisory group viewed the stakeholder network and Active Play policy as facilitators and adjustments to recent shifts in childcare funding and previous initiatives as barriers to implementation. ATP was scalable and impacted provider knowledge, confidence, and intentions. The impact on actual policies and practices, and children’s PA needs to be assessed along with sustainability.

Menstrual function is an integral component of the overall health and well-being of cyclically menstruating athletes, impacted by and affecting their participation in sport and athletic training. This review used the coach–athlete relationship to examine the sport environment for factors that facilitate or hinder healthy sport participation for cyclically menstruating athletes with respect to their menstrual cycles. Four databases were searched until June 30, 2023, for studies that explored the experiences, perceptions and knowledge related to the menstrual cycle among athletes training under a coach and coaches of cyclically menstruating athletes. The search produced 2511 studies, which, following screening for relevance and eligibility, resulted in 34 studies of moderate-to-high quality. Thematic synthesis and integration of qualitative and quantitative data from 7558 athletes and coaches from elite to amateur level uncovered 4 main themes pertaining to the coach–athlete relationship and the menstrual cycle that constituted barriers (menstruation taboo, lack of knowledge and awareness, and lack of communication among stakeholders) and facilitators (presence of female coaches, positive experiences of communicating about the menstrual cycle, and trust) to healthy sport participation. A final theme summarised the needs of athletes and coaches related to the menstrual cycle. Greater education, representation of females in sporting roles, and improved collaboration among the various stakeholders emerged as the primary factors for driving a culture-shift in the sporting environment, in order to abolish the taboo against menstruation and promote healthy sport participation for cyclically menstruating athletes.

Exercise and nature exposure are independently recognised for their positive relationship with health, but their combined effects are not fully understood. The present review summarises the evidence that compares physiological and perceptual differences of a single bout of exercise performed outdoors versus indoors. Nine databases were searched for articles published before March 2021 which utilised controlled designs to assess at least one physiological outcome during or after a single acute bout of outdoor exercise. When appropriate, quantitative analyses were completed. Quality of articles was assessed using the Cochrane Risk of Bias Assessment Tool. The findings of 38 articles (Total N = 1168) were examined. Participants were primarily healthy. Summarised outcomes included objective exercise intensity, perceived exertion, performance, neuroendocrine and metabolic responses, cardiovascular responses, thermoregulation, enjoyment, intention for future exercise, and perceptions of the environment. Outdoor environments increased enjoyment (N = 234, K = 10, g = 1.24, 95% CI = [0.59, 1.89], p < 0.001). Findings for remaining outcomes were non-significant or inconclusive and challenging to interpret due to high risk of bias. Overall, outdoor exercise appears to feel more enjoyable than indoor exercise when matched for intensity, with equivocal physiological benefit.