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Background A recent dialogue in the field of play, learn, and teach outdoors (referred to as “PLaTO” hereafter) demonstrated the need for developing harmonized and consensus-based terminology, taxonomy, and ontology for PLaTO. This is important as the field evolves and diversifies in its approaches, contents, and contexts over time and in different countries, cultures, and settings. Within this paper, we report the systematic and iterative processes undertaken to achieve this objective, which has built on the creation of the global PLaTO-Network (PLaTO-Net). Methods This project comprised of four major methodological phases. First, a systematic scoping review was conducted to identify common terms and definitions used pertaining to PLaTO. Second, based on the results of the scoping review, a draft set of key terms, taxonomy, and ontology were developed, and shared with PLaTO members, who provided feedback via four rounds of consultation. Third, PLaTO terminology, taxonomy, and ontology were then finalized based on the feedback received from 50 international PLaTO member participants who responded to ≥ 3 rounds of the consultation survey and dialogue. Finally, efforts to share and disseminate project outcomes were made through different online platforms. Results This paper presents the final definitions and taxonomy of 31 PLaTO terms along with the PLaTO-Net ontology model. The model incorporates other relevant concepts in recognition that all the aspects of the model are interrelated and interconnected. The final terminology, taxonomy, and ontology are intended to be applicable to, and relevant for, all people encompassing various identities (e.g., age, gender, culture, ethnicity, ability). Conclusions This project contributes to advancing PLaTO-based research and facilitating intersectoral and interdisciplinary collaboration, with the long-term goal of fostering and strengthening PLaTO’s synergistic linkages with healthy living, environmental stewardship, climate action, and planetary health agendas. Notably, PLaTO terminology, taxonomy and ontology will continue to evolve, and PLaTO-Net is committed to advancing and periodically updating harmonized knowledge and understanding in the vast and interrelated areas of PLaTO.

Summary Objective Studies examining associations between movement behaviours (i.e. physical activity, sedentary behaviour and sleep duration) and obesity focus on average values of these movement behaviours, despite important within‐country and between‐country variability. A better understanding of movement behaviour inequalities is important for developing public health policies and behaviour‐change interventions. The objective of this ecologic analysis at the country level was to determine if inequality in movement behaviours is a better correlate of obesity than average movement behaviour volume in children from all inhabited continents of the world. Methods This multinational, cross‐sectional study included 6,128 children 9–11 years of age. Moderate‐to‐vigorous physical activity (MVPA), total sedentary time (SED) and sleep period time were monitored over 7 consecutive days using waist‐worn accelerometry. Screen time was self‐reported. Inequality in movement behaviours was determined using Gini coefficients (ranging from 0 [complete equality] to 1 [complete inequality]). Results The largest inequality in movement behaviours was observed for screen time (Gini of 0.32; medium inequality), followed by MVPA (Gini of 0.21; low inequality), SED (Gini of 0.07; low inequality) and sleep period time (Gini of 0.05; low inequality). Average MVPA (h d−1) was a better correlate of obesity than MVPA inequality (r = −0.77 vs. r = 0.00, p = 0.03). Average SED (h d−1) was also a better correlate of obesity than SED inequality (r = 0.52 vs. r = −0.32, p = 0.05). Differences in associations for screen time and sleep period time were not statistically significant. MVPA in girls was found to be disproportionally lower in countries with more MVPA inequality. Conclusions Findings from this study show that average MVPA and SED should continue to be used in population health studies of children as they are better correlates of obesity than inequality in these behaviours. Moreover, the findings suggest that MVPA inequality could be greatly reduced through increases in girls' MVPA alone.

BACKGROUND: It is unknown whether moderate-to-vigorous physical activity (MVPA) thresholds for obesity should be adapted depending on level of sedentary behaviour in children.OBJECTIVE: The objective of the study is to determine the MVPA thresholds that best discriminate between obese and non-obese children, by level of screen time and total sedentary time in 12 countries.METHODS: This multinational, cross-sectional study included 6522 children 9-11 years of age. MVPA and sedentary time were assessed using waist-worn accelerometry, while screen time was self-reported. Obesity was defined according to the World Health Organization reference data.RESULTS: Receiver operating characteristic curve analyses showed that the best thresholds of MVPA to predict obesity ranged from 53.8 to 73.9 min d-1in boys and from 41.7 to 58.7 min d-1in girls, depending on the level of screen time. The MVPA cut-offs to predict obesity ranged from 37.9 to 75.9 min d-1in boys and from 32.5 to 62.7 min d-1in girls, depending on the level of sedentary behaviour. The areas under the curve ranged from 0.57 to 0.73 ('fail' to 'fair' accuracy), and most sensitivity and specificity values were below 85%, similar to MVPA alone. Country-specific analyses provided similar findings.CONCLUSIONS: The addition of sedentary behaviour levels to MVPA did not result in a better predictive ability to classify children as obese/non-obese compared with MVPA alone.

Background: Globally, the high prevalence of overweight and low levels of physical activity among children has serious implications for morbidity and premature mortality in adulthood. Various parental factors are associated with childhood overweight and physical activity. The objective of this paper was to investigate relationships between parental education or overweight, and (i) child overweight, (ii) child physical activity, and (iii) explore household coexistence of overweight, in a large international sample. Methods: Data were collected from 4752 children (9–11 years) as part of the International Study of Childhood Obesity, Lifestyle and the Environment in 12 countries around the world. Physical activity of participating children was assessed by accelerometry, and body weight directly measured. Questionnaires were used to collect parents' education level, weight, and height. Results: Maternal and paternal overweight were positively associated with child overweight. Higher household coexistence of parent-child overweight was observed among overweight children compared to the total sample. There was a positive relationship between maternal education and child overweight in Colombia 1.90 (1.23–2.94) [odds ratio (confidence interval)] and Kenya 4.80 (2.21–10.43), and a negative relationship between paternal education and child overweight in Brazil 0.55 (0.33–0.92) and the USA 0.54 (0.33–0.88). Maternal education was negatively associated with children meeting physical activity guidelines in Colombia 0.53 (0.33–0.85), Kenya 0.35 (0.19–0.63), and Portugal 0.54 (0.31–0.96). Conclusions: Results are aligned with previous studies showing positive associations between parental and child overweight in all countries, and positive relationships between parental education and child overweight or negative associations between parental education and child physical activity in lower economic status countries. Relationships between maternal and paternal education and child weight status and physical activity appear to be related to the developmental stage of different countries. Given these varied relationships, it is crucial to further explore familial factors when investigating child overweight and physical activity. Refereed/Peer-reviewed