{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T18:00:10Z","timestamp":1785261610175,"version":"3.55.0"},"reference-count":64,"publisher":"BMJ","funder":[{"name":"Open Research Funds of the Guangdong Provincial Key Laboratory of Ophthalmology Visual Science","award":["SZ2025KF01"],"award-info":[{"award-number":["SZ2025KF01"]}]},{"name":"Guangdong Basic Research Center of Excellence for Major Blinding Eye Diseases Prevention and Treatment","award":["304010207, 304020158"],"award-info":[{"award-number":["304010207, 304020158"]}]},{"name":"Guangdong E Fund Charity Foundation, the National Natural Science Foundation of China","award":["82371021"],"award-info":[{"award-number":["82371021"]}]},{"name":"2025 Sports, Health, and Aesthetic Education Program of Zhongshan Ophthalmic Center","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Effective Intervention Coverage Rates and Environmental Risk Factors for Common Eye Diseases in the Elderly and Children","award":["102131250630000000002"],"award-info":[{"award-number":["102131250630000000002"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,7,17]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis summarised the distribution of outdoor time among children and adolescents and examined its temporal trends and associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Web of Science and Embase for studies published between 2005 and 2025 that reported the distribution and associated factors of outdoor time among children and adolescents aged 3\u201318 years. The risk of bias in the included studies was assessed using the Effective Public Health Practice Project tool. Meta-analysis was performed for major factors associated with outdoor time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 35 studies involving 131\u2009091 participants were included. The overall mean outdoor time was 123.1\u2009min\/day (95%\u2009CI 109.9 to 136.2). Regionally, the higher mean value was observed in Africa (200.9\u2009min\/day, 95%\u2009CI 44.4 to 467.7), followed by South America (190.5\u2009min\/day, 95%\u2009CI 57.6 to 323.4), Oceania (129.4\u2009min\/day, 95%\u2009CI 3.2 to 466.4), Europe (128.0\u2009min\/day, 95%\u2009CI 108.4 to 147.5) and North America (116.4\u2009min\/day, 95%\u2009CI 79.9 to 152.8), while Asia showed the lowest estimates (99.7\u2009min\/day, 95%\u2009CI 79.7 to 119.6). Outdoor time was generally lower among girls, myopic individuals, urban areas and on weekdays. In terms of time trends, outdoor time has shown a declining tendency during the 2010s. The associated factors of outdoor time span multiple levels, including individual, family, school, societal and environmental factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In regions and populations with a higher prevalence of myopia, outdoor time is also relatively short. It is recommended to further promote initiatives to increase outdoor activity time in order to achieve better myopia control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251088008.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-329191","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:20:25Z","timestamp":1785259225000},"page":"bjo-2025-329191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Distribution and associated factors of outdoor time among children and adolescents: a systematic review and meta-analysis"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4101-1123","authenticated-orcid":false,"given":"Jiayi","family":"Wang","sequence":"first","affiliation":[{"name":"Zhongshan Ophthalmic 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