Play, Learn, and Teach Outdoors-Network (PLaTO-Net): terminology, taxonomy, and ontology

The Associations Between Parental-Reported and Device-Based Measured Outdoor Play and Health Indicators of Physical, Cognitive, and Social-Emotional Development in Preschool-Aged Children

PURPOSE

Examine in preschool-aged children: (1) the associations between parental-reported and device-measured outdoor play (OP) and health indicators of physical, cognitive, and social-emotional development and (2) whether associations were independent of outdoor moderate- to vigorous-intensity physical activity (MVPA).

METHODS

This cross-sectional study included 107 participants. Children's OP was measured via a parental questionnaire and the lux feature of accelerometers. Children's growth, adiposity, and motor skills were assessed as physical development indicators. Visual-spatial working memory, response inhibition, and expressive language were assessed as cognitive development indicators. Sociability, prosocial behavior, internalizing, externalizing, and self-regulation were assessed as social-emotional development indicators. Regression models were conducted that adjusted for relevant covariates. Additional models further adjusted for outdoor MVPA.

RESULTS

Parental-reported total OP, OP in summer/fall months, and OP on weekdays were negatively associated (small effect sizes) with response inhibition and working memory. After adjusting for outdoor MVPA, these associations were no longer statistically significant. OP on weekdays was negatively associated with externalizing (B = -0.04; 95% confidence interval, -0.08 to -0.00; P = .03) after adjusting for outdoor MVPA. A similar pattern was observed for device-based measured total OP (B = -0.49; 95% confidence interval, -1.05 to 0.07; P = .09).

CONCLUSIONS

Future research in preschool-aged children should take into account MVPA and contextual factors when examining the association between OP and health-related indicators.

Stranger danger or good Samaritan? A cross-sectional study examining correlates of tolerance of risk in outdoor play among Canadian parents

BACKGROUND

Negative parental perceptions of risk may restrict children's opportunities for outdoor play. Excessively minimizing children's exposure to risks in their environment may have a range of developmental consequences. The purpose of this cross-sectional study was to assess correlates of parental tolerance of risk among a large sample of Canadian parents.

METHODS

In this cross-sectional study, a sample of 2,291 parents of 7-12 year olds completed online questionnaires assessing a range of potential individual (e.g., gender), social (e.g., neighbourhood cohesion), and environmental (e.g., walkability) correlates of parental tolerance of risk. Logistic regressions were created to examine associations between these factors and odds of being in the most risk averse quartile. The logistic regression was built in hierarchal steps relying on the Akaike information criterion (AIC) and pseudo R2 for model progression.

RESULTS

The final model had a pseudo R2 of 0.18. Five out of seventeen correlates were associated with risk aversion in parents. Concerns about stranger danger were associated with a higher odds of risk aversion (OR = 2.33, 95%CI[1.93, 2.82]). A higher number of children in the home was associated with lower odds of risk aversion in parents (OR = 0.80, 95%CI[0.69, 0.92], and parents of children born outside of Canada had higher odds of being risk adverse when compared to parents born in Canada (OR = 2.13, 95%CI[1.54, 2.94]). Finally, being very concerned with COVID-19 increased the odds of risk aversion (OR = 3.07, 95%CI[1.93, 5.04], while having a household income of > 100,000 lowered the odds of risk aversion (OR = 0.56, 95%CI[0.36, 0.87]).

CONCLUSIONS

Tailored interventions that reframe perceptions of risk for parents are needed. Such interventions could reframe concerns about stranger danger which persist despite occurrences of stranger abduction being extremely rare. Interventions could also be targeted to immigrant families and those with fewer children as they appear to be more averse to risk. A complementary focus on examining how cultural background influences risk perceptions is needed in future research.

Environmental pediatric physiotherapy and risky play: making the case for a perfect match

Environmental physiotherapy is epistemologically anchored in the critical recognition that physiotherapeutic practice is fundamentally embedded within a planetary ecological framework, demanding a holistic, systemically integrated approach to professional practice. This perspective article highlights and underscores the value of risky play for child health and the commonalities with environmental pediatric physiotherapy. The article starts with a discussion of current challenges in child health around the globe, often resulting from a lack of physical activity of children, and claims finding new, promising and sustainable ways that are able to attract children and their parents to playfully increase the time that children are physically active. Followed by an overview of physiotherapists' roles and responsibilities in child public health, the authors point to the need to move beyond an isolated profession-centric approach when tackling the existing, concerning issues in child health worldwide. Foundational information about risky play underpinned with scientific results and its acknowledgment by other health professions is then presented. By including a perspective of what children want, the authors identify a gap between the world's children's actual needs and current societal offers. The benefits of risky play for child health are presented in detail, along with a discussion of various considerations pertaining to child safety. Concluding, this perspective article demonstrates how physiotherapists can contribute to better child health by including risky play in physiotherapy theory and practice.

Exploring the Interplay Between Climate Change, 24-Hour Movement Behavior, and Health: A Systematic Review

BACKGROUND

Given the emergence of climate change and health risks, this review examined potential relationships between varying indicators of climate change, movement behaviors (ie, physical activity [PA], sedentary behavior, and sleep), and health.

METHODS

Seven databases were searched in March 2020, April 2023, and April 2024. To be included, studies must have examined indicators of climate change and at least one of the movement behaviors as either an exposure or a third variable (ie, mediator/moderator), and a measure of health as outcome. Evidence was summarized by the role (mediator/moderator) that either climate change or movement behavior(s) has with health measures. Relationships and directionality of each association, as well as the strength and certainty of evidence were synthesized.

RESULTS

A total of 79 studies were eligible, representing 6,671,791 participants and 3137 counties from 25 countries (40% low- and middle-income countries). Of 98 observations from 17 studies that examined PA as a mediator, 34.7% indicated that PA mediated the relationship between climate change and health measure such that indicators of adverse climate change were associated with lower PA, and worse health outcome. Of 274 observations made from 46 studies, 28% showed that PA favorably modified the negative association between climate change and health outcome. Evidence was largely lacking and inconclusive for sedentary behavior and sleep, as well as climate change indicators as an intermediatory variable.

CONCLUSIONS

PA may mitigate the adverse impact of climate change on health. Further evidence is needed to integrate PA into climate change mitigation, adaptation, and resilience strategies.

Development and validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in 14 countries: study protocol

INTRODUCTION

Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high-income countries (HICs) lacking sociocultural adaptation, especially in low- and middle-income countries (LMICs); under-representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross-fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app-based Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) among 8-17 years old in 14 LMICs and HICs representing all continents; and generate the 'first available data' on active play in most participating countries.

METHODS AND ANALYSIS

Our study involves eight stages: (1) systematic review of psychometric properties of existing PA questionnaires for children and adolescents; (2) development of the GAC-PAQ (first version); (3) content validity assessment with global experts; (4) cognitive interviews with children/adolescents and parents in all 14 countries; (5) development of a revised GAC-PAQ; (6) development and adaptation of the questionnaire app (application); (7) pilot-test of the app-based GAC-PAQ; and, (8) main study with a stratified, sex-balanced and urban/rural-balanced sample of 500 children/adolescents and one of their parents/guardians per country. Participants will complete the GAC-PAQ twice to assess 1-week test-retest reliability and wear an ActiGraph wGT3X-BT accelerometer for 9 days to test concurrent validity. To assess convergent validity, subsamples (50 adolescents/country) will simultaneously complete the PA module from existing international surveys.

ETHICS AND DISSEMINATION

Approvals from research ethics boards and relevant organisations will be obtained in all participating countries. We anticipate that the GAC-PAQ will facilitate global surveillance of PA in children/adolescents. Our project includes a robust knowledge translation strategy sensitive to social determinants of health to inform inclusive surveillance and PA interventions globally.

Healthy childhood development through outdoor risky play: Navigating the balance with injury prevention

Free play is essential for children's development and for their physical, mental, and social health. Opportunities to engage in outdoor free play-and risky play in particular-have declined significantly in recent years, in part because safety measures have sought to prevent all play-related injuries rather than focusing on serious and fatal injuries. Risky play is defined by thrilling and exciting forms of free play that involve uncertainty of outcome and a possibility of physical injury. Proponents of risky play differentiate "risk" from "hazard" and seek to reframe perceived risk as an opportunity for situational evaluation and personal development. This statement weighs the burden of play-related injuries alongside the evidence in favour of risky play, including its benefits, risks, and nuances, which can vary depending on a child's developmental stage, ability, and social and medical context. Approaches are offered to promote open, constructive discussions with families and organizations. Paediatricians are encouraged to think of outdoor risky play as one way to help prevent and manage common health problems such as obesity, anxiety, and behavioural issues.

Le développement sain de l'enfant par le jeu risqué extérieur : un équilibre à trouver avec la prévention des blessures

Le jeu libre est essentiel pour le développement de l'enfant, de même que pour sa santé physique, mentale et sociale. Les occasions de se livrer au jeu libre extérieur, et au jeu risqué en particulier, ont considérablement diminué ces dernières années, en partie parce que les mesures de sécurité ont visé à prévenir toutes les blessures liées aux jeux plutôt que seulement les blessures graves et fatales. Le jeu risqué désigne des formes passionnantes et stimulantes de jeu libre dont l'issue est incertaine et qui comportent une possibilité de blessure physique. Les promoteurs du jeu risqué distinguent le « risque » du « danger » et aspirent à recadrer la perception du risque pour qu'il devienne une occasion d'évaluer une situation et de favoriser le développement personnel. Dans le présent document de principes, les auteures soupèsent le fardeau des blessures liées au jeu par rapport aux données probantes en appui au jeu risqué, notamment les avantages, les risques et les nuances, qui peuvent varier en fonction de l'étape de développement de l'enfant, de ses aptitudes et du contexte social et médical. Elles proposent des approches pour promouvoir des échanges ouverts et constructifs avec les familles et les organisations. Les pédiatres sont invités à percevoir le jeu risqué extérieur comme un moyen de contribuer à prévenir et à gérer des problèmes de santé courants tels que l'obésité, l'anxiété et les problèmes de comportement.

Exploring the world of active play: A comprehensive review of global surveillance and monitoring of active play based on the global matrix data

A valid assessment tool that measures active play is not yet available due to the sporadic and spontaneous nature of play, as well as the potential differences in how active play is understood and measured across different age groups, cultures, and contexts. The purpose of this review was to identify the scope and gaps in the measurement of active play based on data gathered from 68 countries that participated in the Global Matrix (GM) initiative, led by the Active Healthy Kids Global Alliance (AHKGA). GM is the global-level, biennial evaluation system of physical activity related behaviors among children and youth, including the Active Play indicator, and the sources of influence using letter grades (ranging between "A" and "F"). Based on the identified scope and gaps, this study offers recommendations for future research dedicated to the measurement/surveillance of active play. Out of the 68 countries involved in the previous GM (2014-22), 55% of the grades remained unassigned due to insufficient data on the Active Play indicator. The high number of unassigned grades, combined with the absence of valid measurement tool, highlight a need for a standardized measurement tool for improved global data generation of active play among children and youth. Our findings emphasize the need to address challenges in measuring active play. This review offers future considerations, research recommendations specific to the GM initiative, and two sets of age- and location-specific (indoor and outdoor settings) questionnaire items along with guidelines for its use. Together, these elements provide a roadmap for guiding future research and evaluation efforts on active play.

Associations between outdoor play features and children's behavior and health: A systematic review

The decline of children's opportunities to play outdoors raises a new concern about the quality of outdoor play environments, and their developmental and well-being benefits for children. This systematic review aims to synthesize the associations between outdoor play features and children's behavior and health. PRISMA guidelines were followed (2021). The inclusion criteria were studies with children aged between 5 and 12 (Population); that addressed presence, absence or disposition of equipment, natural elements, loose parts, resources availability, type of terrain and space modifications (Intervention or Exposure); in pre-post intervention or between groups (Comparison); related to health and behavior in different domains (Outcomes); with an experimental, observational, descriptive or longitudinal design (Study design). Indoor context, adult-led activities and structured activities were excluded. A literature search of five databases (PubMed, Web of Science, ERIC, Scopus, and PsycINFO) was concluded in March 2022. After identifying 28,772 records, duplicates and irrelevant titles were removed, and abstracts and full-text articles were screened in duplicate. The remaining 51 eligible articles (45 primary studies) were assessed for risk of bias with QualSyst. A narrative synthesis of the results was conducted. The most frequent behavioral or health outcome addressed was physical activity. Included studies focused on the following space features: fixed structures, space naturalness, floor markings, loose parts/equipment, area available, and the combination of factors. Although some positive effects were found, the heterogeneity between studies did not allow to draw firm conclusions on the effects of each environmental feature on primary children's health and behavior. Systematic review registration: PROSPERO CRD42020179501.

Parent and early childhood educator perspectives of unstructured nature play for young children: A qualitative descriptive study

Nature play is growing in popularity, with many early childhood settings transforming their outdoor play environments to incorporate more natural elements. Current research highlights the benefits of engaging in unstructured nature play for children's health and development; yet little is known about the experiences of key nature play end-users such as parents and early childhood educators, even though they directly impact the application of nature play within early childhood settings. This study aimed to address this knowledge gap by exploring parent and early childhood educator (ECE) perspectives to gain an understanding about their experiences with nature play. Using a qualitative descriptive approach, semi-structured in-person and telephone interviews were conducted with 18 ECE and 13 parents across four early childhood centres (from various socio-economic regions) across metropolitan Adelaide, South Australia during 2019-2020. Interviews were audio-recorded and transcribed verbatim. Thematic analysis identified five main themes; positive affirmations of nature play, factors influencing nature play engagement, defining nature play, outdoor play space design and risky play. Children's connection to the natural world, learning about sustainability, emotional regulation, and children discovering their own capabilities were perceived advantages of engaging in nature play. Despite the benefits, ECE's described institutional barriers such as resourcing, adhering to policies and scheduling conflicts, whereas, parents described time, getting dirty and proximity to nature play spaces as barriers to nature play engagement. Parents and ECEs alike described adults as gatekeepers for play, especially when other daily tasks compete for their time, or when faced with weather-imposed barriers (cold, rain, extreme heat in summer). The findings suggest that parents and ECEs may need additional resources and guidance on how to engage with nature play and how to overcome barriers within early childhood settings and the home environment.

Scoping review of adult-oriented outdoor play publications in Canada

INTRODUCTION

Since 2015, there has been growing interest in Canada and beyond on the benefits of outdoor play for physical, emotional, social and environmental health, wellbeing and development, for adults as well as children and youth.

METHODS

This scoping review aims to answer the question, "How, and in what context, is adult-oriented outdoor play being studied in Canada?" We conducted an electronic search for peer-reviewed articles on outdoor play published in English or French after September 2015 by authors from Canadian institutions or about Canadian adults. The 224 retrieved articles were organized according to eight priorities: health, well-being and development; outdoor play environments; safety and outdoor play; cross-sectoral connections; equity, diversity and inclusion; professional development; Indigenous Peoples and land-based outdoor play; and COVID-19. We tallied the study designs and measurement methods used.

RESULTS

The most common priority was outdoor play environments; the least common were COVID-19 and Indigenous Peoples and land-based outdoor play. Cross-sectional studies were the most common; no rapid reviews were identified. Sample sizes varied from one auto-ethnographic reflection to 147 000 zoo visitor datapoints. More studies used subjective than objective measurement methods. Environmental health was the most common outcome and mental/emotional development was the least.

CONCLUSION

There has been a staggering amount of articles published on adult-oriented outdoor play in Canada since 2015. Knowledge gaps remain in the relationship between outdoor play and adult mental/emotional development; the connections between environmental health and Indigenous cultures and traditions; and how to balance promoting outdoor unstructured play with protecting and preserving natural spaces.

Changes in social interaction, social relatedness, and friendships in Education Outside the Classroom: A social network analysis

Introduction

Social interaction is associated with many effects on the psychological level of children such as mental health, self-esteem, and executive functions. Education Outside the Classroom (EOtC) describes regular curricular classes/lessons outside the school building, often in natural green and blue environments. Applied as a long-term school concept, EOtC has the potential to enable and promote social interaction. However, empirical studies on this topic have been somewhat scant.

Methods

One class in EOtC (N  = 24) and one comparison class (N = 26) were examined in this study to explore those effects. Statistical Actor-Oriented Models and Exponential Random Graph Models were used to investigate whether there are differences between EOtC and comparison class regarding changes over time in social interaction parameters; whether a co-evolution between social interaction during lessons and breaks and attendant social relatedness and friendships exists; whether students of the same gender or place of residence interact particularly often (homophily).

Results

Besides inconsistent changes in social interaction parameters, no co-evolutional associations between social interaction and social relatedness and friendships could be determined, but grouping was evident in EOtC. Both classes showed pronounced gender homophily, which in the case of EOtC class contributes to a fragmentation of the network over time.

Discussion

The observed effects in EOtC could be due to previously observed tendencies of social exclusion as a result of a high degree of freedom of choices. It therefore seems essential that in future studies not only the quality of the study design and instruments should be included in the interpretation - rather, the underlying methodological-didactic concept should also be evaluated in detail. At least in Germany, it seems that there is still potential for developing holistic concepts with regards to EOtC in order to maximize the return on the primarily organizational investment of implementing EOtC in natural environments.

Determinants of Outdoor Time in Children and Youth: A Systematic Review of Longitudinal and Intervention Studies

Spending more time outdoors can improve children's social and cognitive development, physical activity, and vision. Our systematic review summarized the determinants of outdoor time (OT) based on the social-ecological model. We searched nine databases: MEDLINE, APA PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, SPORTDiscus, ERIC, SocINDEX, and ProQuest Dissertations and Theses. To be included, studies needed to be quantitative and longitudinal, include ≥1 potential determinant of OT among 0- to 17-year-olds, and be published in English, French, Japanese, or Spanish. We extracted the authors, publication year, country, design, sample size, OT measures, follow-up period, potential determinants, main results, and potential moderators or mediators. Fifty-five studies examining 119 potential determinants met the inclusion criteria. OT was consistently higher in warmer seasons and among participants reporting more OT at baseline. All three interventions that included both parent sessions and additional resources to promote OT (e.g., specific advice and community guides) were effective. COVID-19 restrictions and sun safety interventions discouraging midday outdoor activities led to less OT. The quality of evidence was rated as weak for 46 studies. Most potential determinants were examined in ≤3 studies; thus, more longitudinal studies are needed to enable stronger conclusions about the consistency of evidence and meta-analyses.

Scoping review of children's and youth's outdoor play publications in Canada

INTRODUCTION

Since 2015, interest in the benefits of outdoor play for physical, emotional, social and environmental health, well-being and development has been growing in Canada and elsewhere.

METHODS

This scoping review aims to answer the question, "How, and in what context, is children's and youth's outdoor play being studied in Canada?" Included were studies of any type on outdoor play published after September 2015 in English or French by authors from Canadian institutions or assessing Canadian children and/or youth. Articles retrieved from MEDLINE, CINAHL and Scopus by March 2021 were organized according to eight priority areas: health, well-being and development; outdoor play environments; safety and outdoor play; cross-sectoral connections; equity, diversity and inclusion; professional development; Indigenous Peoples and land-based outdoor play; and COVID-19. Within each priority, study design and measurement method were tallied.

RESULTS

Of the 275 articles included, the most common priority area was health, wellbeing and development (n = 239). The least common priority areas were COVID-19 (n = 9) and Indigenous Peoples and land-based outdoor play (n = 14). Cross-sectional studies were the most common; the least common were rapid reviews. Sample sizes varied from one parent's reflections to 999 951 data points from health databases. More studies used subjective than objective measurement methods. Across priorities, physical health was the most examined outcome, and mental/emotional development the least.

CONCLUSION

A wealth of knowledge on outdoor play in Canada has been produced since 2015. Further research is needed on the relationship between outdoor play and mental/emotional development among children and youth.

Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders’ top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children’s and adolescents’ PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0

Background: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. Methods: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). Results: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. Conclusions: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.

Global Matrix 4.0 physical activity report cards grades for children and adolescents: A comparison among 15 Asian countries and regions

Background

/Objective: This paper aimed to compare the report card grades among 15 Asian jurisdictions participating in the Global Matrix 4.0, and to explore differences in regional cultural and policy factors related to physical activity behaviors.

Methods

All participating jurisdictions followed a harmonized process to develop a country report card. Ten required common indicators were assessed, including five behavioral indicators (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, Sedentary Behavior), four sources of influence indicators (Family and Peers, School, Community and Environment, and Government), and an outcome indicator (Physical Fitness). Letter grades, ranging from A+ to F or incomplete (INC), were assigned to the indicators based on the predefined benchmarks and grading rubric, and were converted to numerical scale for analyses.

Results

The country average scores ranged from F (Indonesia) to B- (Japan), with C+/C/C- the most prevalent grades. The mean behavioral score (D+) was lower than sources of influence score (C+). Poor grades (D or F) were observed for Overall Physical Activity among 73.3% (11/15) of the jurisdictions. Government was the indicator with the highest proportion of A or B grades (66.7%), followed by School (53.3%). Physical Fitness (n = 10) and Active Play (n = 8) were two indicators with the largest number of INC grades.

Conclusions

Poor grades for physical activity and sedentary behavior were generally found in Asian jurisdictions. The better, though modest, grades on the sources of influence have not been translated into favorable behaviors among children and adolescents. The findings also suggested surveillance gaps for physical fitness, active play, and organized sport participation. National-level investments and action plans are needed to ensure physical activity interventions are developed, effectively implemented, and regularly evaluated in multiple settings.

Results from Brazil's 2022 Report Card on Physical Activity for Children and Adolescents

This research aims to summarize the process and results of the 2022 Report Card on Physical Activity for Brazilian children and adolescents. A group of experts led by 10 PhD researchers gathered the best possible evidence on physical activity indicators. The Report Card Brazil 2022 included the top 10 indicators of physical activity and sleep, obesity, and poor mental health variables, which made up four dimensions: (I) Daily Behaviors; (II) Settings and Sources of Influence; (III) Government Strategies and Investments; and (IV) Health Outcomes. Comprehensive searches, including peer-reviewed and gray literature searches, were performed for each indicator. Data were considered from systematic reviews, local and national surveys, websites, and official information from the Brazilian Federal Government. Grades from the indicators ranged from F (Active Play) to B (School). In addition, the results found for each indicator were Overall Physical Activity (D), Organized Sport Participation (C-), Active Transportation (C), Sedentary Behaviors (D), Sleep (C), Family and Peers (C-), Community and Environment (C), Government (D+), Physical Fitness (D+), Obesity (11.7%), and Poor Mental Health (37.8%). Successfully strategies for increasing physical activity among Brazilian children and adolescents should look at the different indicators presented in this report.