PLAY+ (Play, Land, Animals, You and +) framework: The role of active outdoor play in advancing One Health

Lee EY, Kim YB, Cheng J, Carbone M, Abu-Omar K, Bisung E, Ding D, Hallal PC, Jeon JY, Kangmennaang J, Klopp JM, Lâm S, de Lannoy L, Manyanga T, Morrison SA, Silva DAS, Spence JC, Wachira LJ, Yi KJ, Tremblay MS (2026)

Publication Type: Journal article, Review article

Publication year: 2026

Book Volume: 18

Article Number: 100172

DOI: 10.1016/j.horiz.2025.100172

Abstract

There has been growing recognition of the interconnections between human health, environmental sustainability, and ecosystem resilience. Positioning active outdoor play as a potential catalyst and ally in advancing human, animal, and environmental health, this study developed and validated a framework linking active outdoor play and One Health. The framework development followed a structured, multi-step process incorporating a scoping review, conceptual mapping, and expert consultations. Based on the results of the scoping review, a conceptual mapping exercise was undertaken to visually represent the interconnections between active outdoor play and One Health, which was then validated by key informants (n = 16) selected based on their expertise and leadership in the relevant topic areas. A total of 23 scholarly articles addressed the potential interconnectedness of active outdoor play, human-animal relationships, and environmental responsibility. Three themes emerged: 1) outdoor play environments and climate resilience (n = 6), 2) human-animal interactions and public health (n = 10), and 3) environmental stewardship and responsibility toward planetary health (n = 7). Nine policy documents were identified, of which eight did not make direct references to active outdoor play. Informed by the evidence, the PLAY+ (Play, Land, Animals, You and +) framework was created. Insights from an expert survey further refined the framework. While the framework highlights the interconnected benefits of active outdoor play across human, animal and environmental health domains, it is equally important to recognize associated risks and unintended consequences. As such, the framework should be views as conceptual, heuristic tool that encourages precautionary approaches, continued empricial evaluation, and context-sensitive implementation.

Authors with CRIS profile

Karim Abu-Omar Lehrstuhl für Sportwissenschaft mit der Ausrichtung Gesundheitsförderung/Public Health/Sozialwissenschaften des Sports

Involved external institutions

University of Alberta CA Canada (CA) Queen's University CA Canada (CA) Kenyatta University / Chuo Kikuu cha Kenyatta KE Kenya (KE) McMaster University CA Canada (CA) University of Sydney (USYD) AU Australia (AU) University of Illinois at Urbana-Champaign US United States (USA) (US) Yonsei University KR Korea, Republic of (KR) Columbia University US United States (USA) (US) International Livestock Research Institute (ILRI) KE Kenya (KE) Outdoor Play Canada CA Canada (CA) University of Northern British Columbia (UNBC) CA Canada (CA) NUS Yong Loo Lin School of Medicine SG Singapore (SG) Federal University of Santa Catarina / Universidade Federal de Santa Catarina (UFSC) BR Brazil (BR) Children's Hospital of Eastern Ontario (CHEO) / Centre hospitalier pour enfants de l'est de l'Ontario CA Canada (CA)

How to cite

APA:

Lee, E.Y., Kim, Y.B., Cheng, J., Carbone, M., Abu-Omar, K., Bisung, E.,... Tremblay, M.S. (2026). PLAY+ (Play, Land, Animals, You and +) framework: The role of active outdoor play in advancing One Health. , 18. https://doi.org/10.1016/j.horiz.2025.100172

MLA:

Lee, Eun Young, et al. "PLAY+ (Play, Land, Animals, You and +) framework: The role of active outdoor play in advancing One Health." 18 (2026).

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