Exploring the physical contexts of physical activity in children and adolescents across countries using GPS, GIS, and accelerometry – a systematic review

Purpose This systematic review aimed to identify where children and adolescents are physically active using studies combining GPS, GIS, and accelerometry, and to examine how physical activity (PA) contexts vary by age and across countries. Methods A systematic search was conducted across four databases. Observational studies objectively assessing PA contexts in children and adolescents were included. Records were screened using AI-assisted active learning by two independent reviewers. Data extraction and study quality assessment were conducted independently by two reviewers, and findings were synthesized narratively by age group and country. Results Thirty-five studies from 12 countries were included. Children accumulated PA across a broad range of contexts, including recreational areas, home, and school, whereas adolescents’ PA was more concentrated in school and home settings. Studies including mixed-age samples often reported higher PA in residential and recreational areas, partly reflecting differences in spatial definitions and classification. Across all age groups, school and home environments consistently contributed to PA, while commercial locations contributed little. Cross-country synthesis showed variation in dominant PA contexts, with residential areas appearing more prominent in the United States, school-based activity in Denmark and Switzerland, and more distributed patterns in countries such as the Netherlands and the United Kingdom. Conclusion Children and adolescents are physically active across multiple contexts, but the relative importance of these settings varies by age and country and is influenced by methodological differences. Distinguishing age groups and improving consistency in spatial definitions are essential for accurately identifying PA contexts and informing context-specific interventions.