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Physical activity and social connectedness interventions in outdoor spaces among children and youth: a rapid review
Abstract
Introduction
The rise in sedentary behaviour, coupled with the decline in overall mental health among Canadian children and youth in recent decades, demonstrates a clear need for applied research that focusses on developing and evaluating cross-disciplinary interventions. Outdoor spaces provide opportunities for physical activity and social connectedness, making them an ideal setting to address these critical health concerns among children and youth.
Methods
We conducted a rapid review of peer-reviewed (n = 3096) and grey literature (n = 7) to identify physical activity and/or social connectedness outdoor space interventions targeted at children and youth (19 years and under) in Australia and New Zealand, Canada, Europe and the United States. We determined if interventions were effective by analyzing their research design, confidence intervals and reported limitations, and then conducted a narrative synthesis of the effective interventions.
Results
We found 104 unique studies, of which 70 (67%) were determined to be effective. Overall, 55 interventions targeted physical activity outcomes, 10 targeted social connectedness outcomes and 5 targeted both. Play (n = 47) and contact with nature(n = 25) were dominant themes across interventions, with most taking place in a school or park. We report on the identifying features, limitations and implications of these interventions.
Conclusion
The incorporation of natural and play-focussed elements into outdoor spaces may be effective ways to improve physical activity and social connectedness. There is a considerable need for more Canadian-specific research. Novel methods, such as incorporating smartphone technology into the design and evaluation of these interventions, warrant consideration.
... The influence of neighbourhoods on the social wellbeing of adolescents is understudied in built environment research. The majority of studies examine physical health outcomes and many concentrate on school or residential settings, leaving sparse evidence on how neighbourhoods facilitate youth social connectedness [16][17][18]. General population studies associate higher levels of social interaction, neighbourhood ties, and sense of belonging with features of "complete communities", where destinations like high quality parks and public spaces, recreational facilities, shops, and services are close to home and easily reached by walking, cycling, or public transit [11,[19][20][21][22][23]. ...
... General population studies associate higher levels of social interaction, neighbourhood ties, and sense of belonging with features of "complete communities", where destinations like high quality parks and public spaces, recreational facilities, shops, and services are close to home and easily reached by walking, cycling, or public transit [11,[19][20][21][22][23]. The limited youth-focused research available reinforces the importance of local destinations and services, freely accessible via safe and active travel [16,17,[24][25][26][27][28][29]. ...
... Several youth voiced how street boulevards, whether equipped with basic benches or simply grass, serve as spaces for impromptu relaxation and interactions with friends and neighbours. While the health benefits of formal green spaces are well-documented [17], we contribute to emerging research on the use and perceived value of non-park green spaces in under-resourced communities, and how these spaces may help level spatial inequities in green space accessibility [75][76][77][78]. Additionally, activating informal green spaces-for example, through bylaws that allow for spontaneous placemaking and seating designed for interaction [64,79]-could be a leverage point for mitigating social inequities, in particular by improving green space accessibility for girls, racialized people, and others who may feel excluded or unsafe in formal public spaces [40,80]. ...
Background
Social isolation and loneliness are a growing public health concern. Inadequacies in neighbourhood social infrastructure can undermine social connectedness, particularly for youth, who are dependent on their local environments yet often marginalized from public spaces and city planning. Integrating citizen science with participatory action research, the Youth.hood study set out to explore how neighbourhood built environments help or hinder social connectedness from the understudied perspective of youth in under-resourced and racialized communities.
Methods
Youth (n = 42) from three neighbourhoods in Vancouver, Canada were recruited to: (1) Assess environmental assets and barriers to connectedness in their neighbourhoods using a digital photovoice app; (2) Analyze and prioritize their collective data into themes; and (3) Design and advocate for environmental improvements through a participatory workshop and forum with residents, city planners, and elected officials. Data on participant characteristics and neighbourhood perceptions were collected via an online survey and analyzed descriptively. Participatory analysis was conducted with youth using methods from thematic analysis, photovoice, and design thinking.
Results
Youth captured 227 environmental features impacting their connectedness. The most frequently reported assets were parks and nature (n = 39, 17%), including formal and informal green spaces, and food outlets (n = 25, 11%). Top barriers included poor neighbourhood aesthetics (n = 14, 6%) and inadequate streets and sidewalks (n = 14, 6%). Thematic analysis with youth underscored four themes: (1) Connecting through mobility: The fun and functionality of getting around without a car; (2) The power of aesthetics: Mediating connections to people and place; (3) Retreating to connect: Seeking out social and restorative spaces for all; and (4) Under-resourced, not under-valued: Uncovering assets for sociocultural connection. Youth described their local environments as affording (or denying) opportunities for physical, emotional, and cultural connection at both an individual and community level.
Conclusion
Our findings extend evidence on key environmental determinants of social connectedness for youth, while highlighting the potential of community design to support multiple dimensions of healthy social development. Additionally, this work demonstrates the resilience and agency of youth in under-resourced settings, and underscores the importance of honouring assets, co-production, and intergenerational planning when working to advance healthy, connected, and youthful cities.
... Eleven reviews examined the association between greenspace or open space and PA. Two were high quality (Lambert et al., 2019;Nordbø et al., 2020), one moderate (Prince et al., 2019), two low (McGrath et al., 2015;Van Hecke et al., 2018), and six critically low (Galvez et al., 2010;Islam et al., 2020;Lachowycz and Jones, 2011;Marzi et al., 2018;Masoumi, 2017;Wray et al., 2020). Among children, there was very low certainty for positive and mixed associations with leisure and total PA, respectively. ...
... Twenty-two reviews examined the association between access/ proximity/number/density of parks/playgrounds and PA. Four were high quality (Audrey and Batista-Ferrer, 2015;Boxberger and Reimers, 2019;Lambert et al., 2019;Smith et al., 2017), three moderate (Prince et al., 2019;Rothman et al., 2014;Stanley et al., 2012), three low (McGrath et al., 2015;Pont et al., 2009;Van Hecke et al., 2018), and twelve critically low (Bancroft et al., 2015;Davison and Lawson, 2006;Ding et al., 2011;Galvez et al., 2010;Lawman and Wilson, 2012;Lee et al., 2015;Marzi et al., 2018;Masoumi, 2017;Oliveira et al., 2014;Timperio et al., 2015;Van Der Van Der Horst et al., 2007;Wray et al., 2020). Among children, there was very low certainty for mixed associations between parent-reported parks and leisure PA. ...
... Fifteen reviews examined the association between general AT infrastructure and PA. Four were high quality (Boxberger and Reimers, 2019;Ikeda et al., 2018a, Ikeda et al., 2018bNational Institute for Health and Care Excellence, 2018;Smith et al., 2017), one moderate (Stanley et al., 2012), three low (D'Haese et al., 2015;Pont et al., 2009;Van Hecke et al., 2018), and seven critically low (Ding et al., 2011;Galvez et al., 2010;Harrison and Jones, 2012;Panter et al., 2008;Sirard and Slater, 2008;Timperio et al., 2015;Wray et al., 2020). Among children, there was low certainty largely from a high quality review of cross-sectional studies for mixed associations with transportation PA, whereas moderate certainty from a low quality review of experimental and cohort studies supported no association with AT to school (mixed for walking, none for cycling). ...
Background:
Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews.
Objective:
Examine the current state and quality of research looking at associations between built environments and total PA and domains of PA (i.e., leisure/recreation, transportation, school) among children and youth (1-18 years).
Methods:
We systematically searched the grey literature and six bibliographic databases from January 2000 to May 2020. Review quality was assessed using the AMSTAR2. Results by age group were synthesized using narrative syntheses and harvest plots, and certainty of the evidence was assessed using a modified GRADE approach.
Results:
This overview included 65 reviews. Most reviews were of very low-to-low quality. High certainty was found for positive associations between transportation PA and walking/cycling/active transportation (AT) infrastructure. There was high certainty for positive associations between streets/play streets and total PA, alongside lower certainty for transportation and leisure PA. Very low-to-moderate certainty supports schoolyards designed to promote PA were positively associated with total PA, but mixed for school PA (except children). Less consistent positive associations were found for forests/trees, greenspace/open space, recreation facilities, street lighting, traffic safety, population/residential density, proximity/access to destinations, neighbourhood characteristics, and home environments. There is very low-to-moderate certainty for negative associations between greater distance to school and traffic volume and domains of PA. Generally, null or mixed associations were observed for aesthetics, parks, AT comfort infrastructure, land-use mix, street connectivity, urban/rural status, and public transit.
Discussion:
There remains a need for high quality systematic reviews and studies to evaluate the effects of environmental changes across the pediatric age spectrum and using a PA domain approach. Given the global physical inactivity crisis the built environment remains and important means to promote PA among children/youth.
... 41 Wray et al confirmed these results by emphasizing that integrating natural and playful elements into outdoor spaces can be an effective way of improving physical activity and social cohesion. 88 With regard to play at school during break time, Jerebine et al produced a socioecological model of the risk and safety factors that influence children's active play at school at five levels (societal, political and institutional, physical environment, interpersonal, and individual). 89,90 For example, the nature and impact of the rules that are in place in a playground are decided at the political and institutional level. ...
... Although we have tried to highlight the salient results identified in reviews of child development, it has to be said that many studies are still very much focused on a vision of health that is reduced to particular individual behaviors (e.g., physical activity), in order to correspond to established individual recommendations (e.g., 60 minutes of activity per day from the WHO) with the aim of reducing the onset of disease (e.g., obesity). 31,39,42,43,45,48,55,56,69,71,81,88,91,102 This applies to all the determinants studied, [116][117][118][119] including the issue of access to nature, which is studied for the most part from the point of view of physical activity. 120 This approach is rather simplistic and contradicts the global and positive approach to health described in the Ottawa Charter. 4 The capacity for self-fulfillment, skills for coping with life's difficulties, social development, and a sense of security, for example, are not sufficiently emphasized, even though action on structural determinants has multiple and combined effects on physical, mental, and social development. ...
Background
Children’s health is shaped by their physical, natural, and socioeconomic environments. The objective of this study is to identify structural urban planning measures that can positively or negatively impact children’s health. Specifically, we aim to explore how urban planning elements, such as housing, neighborhoods, play areas, and green spaces, influence children’s well-being and health outcomes.
Methods
We conducted a scoping review in accordance with the method developed by Arksey and O’Malley, Levac and colleagues’ methodology advancement, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. We explored eight databases, restricting our search to reviews, systematic reviews, and meta-analyses that report on structural measures aimed at modifying urban planning to promote child health.
Results
A total of 41 studies were identified for inclusion in this review. The thematic analysis identified: i) interventions aimed at modifying streets; ii) interventions aimed at modifying play areas; iii) interventions aimed at modifying contact with nature; iv) interventions aimed at modifying deleterious exposures (exposure to tobacco, exposure to school); and v) housing. The second level of analysis enabled us to identify and evaluate the conditions for implementation and effectiveness.
Conclusion
The review highlighted measures that are favorable to children’s health at the level of neighborhood urban planning and questioned the conditions for implementation in a French context.
... Adequate physical activity during the day is an important issue especially for the children and adolescents to reach optimal growth and development. Regular physical activity either moderate or vigorous is usually associated with several benefits for health, including reduced risk of obesity, depression, heart disease, stroke, or cancer [23]. ...
... Areas with naturally created barriers, such as dynamic playscapes, encourage children and adolescents to engage in active, exciting and risky play. Such activities allow adolescents to independently test their abilities and limits, thus contributing to the development of social resilience [23]. ...
Children and adolescents have always been an important part of the future of society and the country. Often, the urban environment is subordinated and adapted to families with children, with playgrounds and infrastructure. However, the desire of adolescents to be out in society, in public spaces and to participate in social interaction is not sufficiently supported. Public space is a 'stage' for adolescents to test themselves, their limits and learn social skills, as well as to explore the norms of society and community. The aim of this article is to provide an insight into the principles of designing environments that are suitable for adolescents, with recommendations for the design process of such public outdoor spaces. Analysing publicly available information on the needs of adolescents and the suitability of outdoor spaces for their outdoor activities, it emerges that often the adaptation of urban environments for children or adults contributes to the isolation of adolescents from society, which in turn results in gatherings in unsuitable areas, vandalism and substance abuse. Introducing with suitable case studies in the design of outdoor spaces for adolescent children, we conclude that in order to mitigate the above risks, it is necessary to understand the developmental processes, emotional and psychological characteristics of adolescents, as well as to raise awareness of the basic principles of democratic upbringing in society, and to develop guidelines for the involvement of adolescents in urban planning, which would help municipalities to involve this specific target group in urban planning, ensuring that adequate public spaces are created for adolescents.
... Outdoor public recreation spaces can provide meeting places for adolescents, and research has shown that adolescents who report having more opportunities for recreation and meeting people in their neighbourhood feel more connected with their neighbours [37]. However, little is known about the relationship between the use of outdoor public recreation spaces and adolescents' social connectedness [38,39]. Among adolescents, previous studies have largely focused on the influence of their experiences of neighbourhood destinations on their well-being [40] and physical activity [41], largely overlooking links with social connectedness [33,42]. ...
... According to the conceptual model of the role of parks for public health by Bedimo-Rung and colleagues [34], parks and outdoor public recreation spaces can support social capital, which is interrelated with social connectedness [7], by providing a venue for people to socially interact and develop social ties. The model proposes that these social health benefits can be obtained in two ways: park visitation and active use of these settings (e.g., physical activity participation alone or with others upon arrival) [34,39]. ...
Background
Outdoor public recreation spaces are important settings for leisure and physical activity. Adolescents’ use of these spaces may contribute to social connectedness via social interaction with peers and the community in these settings. However, research on this topic is limited. This exploratory study examined associations of frequency of visitation and physical activity in outdoor public recreation spaces with social connectedness among adolescents in Melbourne, Australia.
Methods
Adolescents self-reported their frequency of visitation to parks, trails, beach/lake, and sports facilities; frequency of physical activity in a park, local street or path, and their street; and social connectedness. Separate analyses were conducted for visitation (n = 349, 15.4 ± 1.6 years, 58% female) and physical activity (n = 441, 15.4 ± 1.6 years, 59% female) using multilevel linear regression models.
Results
No significant associations were observed for frequency of visitation to a park (B = 0.86, 95% CI = − 0.26, 1.99), trails (B = 0.41, 95% CI = − 0.61, 1.44), beach/lake (B = − 0.44, 95% CI = − 1.46, 0.57), or sports facilities (B = 0.64, 95% CI = − 0.43, 1.70), nor for frequency of physical activity in their street (B = − 0.07, 95% CI = − 0.46, 0.31), local street/path (B = − 0.05, 95% CI = − 0.43, 0.33) or in a park (B = 0.23, 95% CI = − 0.14, 0.60) with adolescents’ social connectedness.
Conclusions
The findings did not support the hypothesis that visiting and being active in outdoor public recreation spaces are associated with adolescents’ social connectedness. Future research should consider the duration and context of outdoor public recreation space use (e.g., sports, socialising, relaxing alone) and whether different types and/or a combination of public spaces are more/less conducive to social connectedness.
... Outdoor greenspaces facilitate social/physical distancing [273][274][275] while enhancing social connectedness [276]. Physical distancing is the primary and widely known strategy in reducing the risk for COVID-19 infection and transmission [274]. ...
... Further, outdoor classrooms reduce the risk of COVID-19 infection transmission by promoting physical distancing while enabling children continued social interactions in the learning process [294,295]. These outdoor settings facilitate social/physical distancing, enhance social connectedness [276,296] and improve mental wellbeing [296]. Outdoor environments promote children's social interactions [297,298] and enhance their health and wellbeing [297]. ...
The intersecting negative effects of structural racism, COVID-19, climate change, and chronic diseases disproportionately affect racial and ethnic minorities in the US and around the world. Urban populations of color are concentrated in historically redlined, segregated, disinvested, and marginalized neighborhoods with inadequate quality housing and limited access to resources, including quality greenspaces designed to support natural ecosystems and healthy outdoor activities while mitigating urban environmental challenges such as air pollution, heat island effects, combined sewer overflows and poor water quality. Disinvested urban environments thus contribute to health inequity via physical and social environmental exposures, resulting in disparities across numerous health outcomes, including COVID-19 and chronic diseases such as cancer and cardiovascular diseases (CVD). In this paper, we build off an existing conceptual framework and propose another conceptual framework for the role of greenspace in contributing to resilience and health equity in the US and beyond. We argue that strategic investments in public greenspaces in urban neighborhoods impacted by long term economic disinvestment are critically needed to adapt and build resilience in communities of color, with urgency due to immediate health threats of climate change, COVID-19, and endemic disparities in chronic diseases. We suggest that equity-focused investments in public urban greenspaces are needed to reduce social inequalities, expand economic opportunities with diversity in workforce initiatives, build resilient urban ecosystems, and improve health equity. We recommend key strategies and considerations to guide this investment, drawing upon a robust compilation of scientific literature along with decades of community-based work, using strategic partnerships from multiple efforts in Milwaukee Wisconsin as examples of success.
... However, eligibility assessments were verified by a second reviewer and the practices employed align with the guidelines for conducting rapid reviews [26]. While rapid review methods were initially utilized to produce evidence to support health policy decision-making in a short period of time, health promotion researchers are increasingly using rapid review methods to share findings in a timely manner [33,[50][51][52]. A review of studies comparing rapid and systematic reviews found that conclusions were similar on comparable topics, and any differences were attributed to included study designs and databases searched [51]. ...
... While rapid review methods were initially utilized to produce evidence to support health policy decision-making in a short period of time, health promotion researchers are increasingly using rapid review methods to share findings in a timely manner [33,[50][51][52]. A review of studies comparing rapid and systematic reviews found that conclusions were similar on comparable topics, and any differences were attributed to included study designs and databases searched [51]. Rapid review methods allowed us to identify and understand how photo-elicitation has been used in health promotion research for children and adolescents with disabilities in a feasible and efficient manner. ...
Purpose:
It is important to directly engage children and adolescents with disabilities (CAWD) in health promotion research to ensure their health needs are met. Arts-based research methods may help CAWD better express their ideas; photo-elicitation is one such technique, using self-captured photographs to enhance verbal descriptions of complex concepts. This review 1) summarizes findings from health promotion studies using photo-elicitation with CAWD; 2) explores benefits and challenges of using photo-elicitation; 3) identifies recommended photo-elicitation practices.
Materials and methods:
A scoping review was conducted using rapid review principles. Four health and social science databases were searched (2009-2019) using terms related to children, adolescents, disability, and photo-elicitation. Articles meeting inclusion criteria were summarized and analyzed thematically.
Results:
Eight studies met inclusion criteria and explored a range of health promotion topics. Benefits of photo-elicitation included the ability to mediate communication and direct participants' focus. Challenges included difficulty operating a camera and understanding instructions about photograph subject matter. Four recommended practices were identified: 1) brainstorming photograph ideas; 2) photograph-taking training; 3) having CAWD select photographs for discussion; 4) limiting the number of photographs CAWD could capture.
Conclusions:
Integrating practices to support CAWD in using photo-elicitation can help researchers more fully understand their health experiences.Implications for RehabilitationThere is a need to directly engage children and adolescents with disabilities to express themselves in health promotion research.The arts-based method of photo-elicitation may help children and adolescents with disabilities convey how they view and experience health.Children and adolescents with disabilities may need supports, including camera training, to participate in photo-elicitation.
... Green social prescribing, as a variant of social prescribing, involves connecting people to nature-based interventions, which are activities, strategies or programmes designed to enhance health and well-being through engagement with nature [24]. Nature-based interventions aim to harness the direct and indirect mental health benefts associated with nature engagement, such as stress reduction [25,26], reduced anxiety and depression [27,28], increased positive afect [29,30] and enhanced social capital [31,32], while conferring environmental cobenefts, such as ecosystem restoration and biodiversity enhancement [33]. Nature-based interventions generally fall into two categories: 'green' activities, which involve engagement with nature in predominantly terrestrial environments to promote health and well-being (e.g., social and therapeutic horticulture, nature conservation activities and exercisefocused activities such as walking), and 'blue' activities, which involve engagement with aquatic environments (e.g., sports-related activities such as fshing and exercise-focused activities such as surfng) [15,34]. ...
There is a strong body of evidence that points to the mental health and well-being benefits of nature alongside a growing evidence based on the health and well-being benefits of green social prescribing. Central to the UK government’s commitment to transform mental health services, seven successful ‘test and learn’ green social prescribing sites were identified across England, including the Humber and North Yorkshire green social prescribing programme. We used a cohort design to compare participants’ mental health and well-being outcomes before and after exposure to nature-based interventions offered via a referral from social prescribing organisations linked to the green social prescribing initiative. Data were collected between February 2022 and March 2023 using before and after questionnaires to determine the impact of green social prescribing on mental health and well-being outcomes using ONS-4 and Hospital and Anxiety Depression scales. In total, two hundred and twenty-three participants from across Humber and North Yorkshire were included in the cohort evaluation. Survey data were analysed quantitatively using descriptive and multivariable analyses. After adjustments for deprivation and health status, larger benefits for improvements in well-being were found to be associated with nature-based activities with durations of nine to 12 weeks compared to those with durations of one to four weeks. Horticultural and care farming activities were also shown to be associated with some improvements in well-being over nature-based sports and exercise activities. We have undertaken the first longitudinal and quantitative evaluation of the NHS England green social prescribing “test and learn” programme across Humber and North Yorkshire. Our evaluation in Humber and North Yorkshire showed green social prescribing is beneficial for mental health and well-being among community-based adults, suggesting potential as a timely and relevant community-based intervention to address the demand for mental health care in an era of high unmet need.
... As atividades físicas na infância são permeadas pelo brincar, que incide sobre as competências motoras das crianças (Wray et al., 2020;Coe, 2020), segundo Velasques (2023, p.80,88) "o movimento nos diz muito sobre a criança" porque ele também é a maneira a qual a criança se comunica e experimenta o mundo, e ao adquirir habilidades motoras "instiga cascatas de desenvolvimento de outras funções, como a social, a emocional e a cognitiva." ...
School is the place where children spend a significant portion of their day, with many staying for up to 10 hours daily. Often, they are confined in artificial environments in early childhood education, deprived of playing with and in Nature, which is a fundamental driver for development in childhood – sensorimotor, cognitive-emotional, and socio-cultural learning. The aim of this study was to conduct a survey in the scientific literature and analyze articles on outdoor childhood learning - playing with and in Nature in early childhood education. We performed a systematic review on the electronic databases of Pubmed and CAPES Journals for studies published in Portuguese and English, from 2018 to 2022, using the descriptors childhood education outdoor / preschool children play outdoor / play outside/ learning outside/ early childhood outdoor education /childhood development nature/ early childhood education nature/childhood learning nature/ play outdoors. The defined context units were analyzed by thematization. Initially, 519 articles were identified, 82 pre-selected, and 23 eligible articles were analyzed. They met the inclusion criteria: (1) the study addresses the learning and development of the child with and in Nature in the daycare/school environment, and outdoor play in early childhood education; (2) the study includes children and early childhood education professionals as participants; (3) empirical study or literature review. The studies show that the essence of childhood learning is play, enhanced by the affective experiences of children playing outdoors with and in Nature. The analysis reveals that school yards and the surroundings of schools need to be rich in Nature to promote healthy integral development in childhood, thus, it is necessary to liberate children in early childhood education from enclosed environments.
... In addition to the mental and physical benefits that green spaces provide to children [19,20], playing outdoors can enhance creative and cooperative social play [21] and improve social connectedness [22]. Indeed, previous research demonstrates a link between green spaces and strong community identity [23] and social cohesion [24]. ...
Research suggests that nature promotes psychological and behavioral health among children. However, children living in low-income urban communities often have less access to green spaces compared to their counterparts living in high-income neighborhoods, and limited research has investigated the impact of nature on well-being and social connectedness in children experiencing marginalization. To address this gap, this mixed-methods study examined the impact of a one-week immersive nature camp on the well-being and social connectedness of 27 children aged 6–12 years referred to a community hub in Ottawa, Canada, for complex psychosocial difficulties. One week prior to and one week after the camp, caregivers completed a survey inquiring about their child’s personal well-being, social contact, loneliness, positive emotional state, and positive outlook. On the first and last days of the camp, children completed the same survey. Children also engaged in an audio-recorded focus group about their experience in the camp to inform the quantitative findings. Quantitative and qualitative responses were analyzed using paired samples t-tests and thematic analysis, respectively. Although not statistically significant, small to medium effect sizes for improved positive emotional state and positive outlook were reported by children (p =.26, d = 0.24; p =.14, d = 0.31) and their caregivers (p =.12, d = 0.37; p =.89, d = 0.03). Qualitative thematic analyses of focus groups revealed nine themes including making friends, acquiring new skills, and connecting with nature. Within the Canadian child health context, exposure to green spaces for children with complex psychological difficulties living in low-income urban communities may be associated with perceived enhancements in social connections and skills. Future research with larger sample sizes is needed.
... As atividades físicas na infância são permeadas pelo brincar, que incide sobre as competências motoras das crianças (Wray et al., 2020;Coe, 2020), segundo Velasques (2023, p.80,88) "o movimento nos diz muito sobre a criança" porque ele também é a maneira a qual a criança se comunica e experimenta o mundo, e ao adquirir habilidades motoras "instiga cascatas de desenvolvimento de outras funções, como a social, a emocional e a cognitiva." ...
A escola é o local onde as crianças ficam boa parte do dia, em muitos casos as crianças permanecem
por até 10 horas diárias. Muitas delas emparedadas em ambientes artificiais na educação infantil,
privadas do brincar com e na Natureza, propulsor fundamental para o desenvolvimento na infância –
aprendizagem sensório-motora, cognitivo-emocional, sócio-cultural. O objetivo desse trabalho foi
realizar um estudo na literatura científica e analisar artigos sobre a aprendizagem infantil ao ar livre -
o brincar com e na Natureza na educação infantil. Efetuamos uma revisão sistemática, nas bases de
dados eletrônicos do Pubmed e Periódicos CAPES para os estudos publicados em português e inglês,
no período de 2018 a 2022, utilizando-se os descritores childhood education outdoor / preschool
children play outdoor / play outside/ learning outside/ educação infantil ao ar livre/desenvolvimento
infantil natureza/ educação infantil natureza/aprendizagem infantil natureza/ brincar ar livre. As
unidades de contexto definidas foram analisadas por tematização. Foram identificados inicialmente
519 artigos, 82 pré-selecionados, e analisados 23 artigos elegíveis que atenderam aos critérios de
inclusão: (1) o estudo abordar a aprendizagem e o desenvolvimento da criança com e na Natureza no
ambiente da creche/escola, e o brincar ao ar livre na educação infantil; (2) o estudo incluir crianças e
profissionais da educação infantil como participantes; (3) estudo empírico ou de revisão da literatura.
Os estudos mostram que a essência da aprendizagem infantil é o brincar, potencializada pelas
experiências afetivas das crianças no brincar ao ar livre com e na Natureza. A análise revela que os
pátios escolares e o entorno das escolas precisam ser ricos em Natureza para promoverem o
desenvolvimento integral saudável na infância, por isso deve-se desemparedar as crianças na educação
infantil.
... The considered publications documented policies and practices that expanded the prescriptive and subject-based curricula in ways that supported students' sense of belonging. We identified policies in education (Government of Nova Scotia, 2019) and practices (CASSA, 2017a;Government of New Brunswick, 2014) that speak to the incorporation of self-regulation initiatives and social-emotional learning, as well as practices that include extra-curricular activities to support students' sense of belonging (Bouchard & Berg, 2017;CASSA, 2010b;Wray et al., 2020). ...
This article reports on a knowledge synthesis study of three questions around Canadian K-12 students’ sense of loneliness and belonging: What are the lived experiences of Canadian students with loneliness and belonging? What factors contribute to students’ sense of loneliness and belonging in Canadian school contexts? What school educational practices and policies foster a sense of belonging in students in Canada? Utilizing a scoping review approach, the study synthesizes published knowledge on these three questions from scholarly peer-reviewedpublications and documents published by Canadian educational organizations, provincial governments, and school board associations. Keywords: loneliness, belonging, well-being, students, K-12 schools, Canada
... Health interventions focused on promoting physical activity in greenspaces (97)(98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109)(110) Walkability and cycling routes Walkability: ease and convenience with which people can walk within a particular environment (111)(112)(113) Nature-based therapy (green care) Also known as green prescription or nature prescription which refers to a recommendation from a health or social professional for a patient to spend a fixed amount of time in a natural setting (22,97,(114)(115)(116)(117)(118)(119)(120)(121)(122)(123) Contact with nature Direct and intentional engagement or interaction between individuals and the natural environment a positive association with physical activity [91]. Insufficient evidence exists to draw conclusions regarding benefits for diabetes and cardiovascular disease [91]. ...
Objectives
Access to greenspaces and contact with nature can promote physical activity and have positive effects on physical and mental health. This scoping literature review aims to examine current evidence linking greenspaces and (a) behaviour change, (b) health outcomes and (c) co-benefits.
Methods
This review was conducted in accordance with the PRISMA scoping review guidelines. Searches were conducted through PubMed and EMBASE databases for studies published between 2000 and March 2023 with a focus on Europe.
Results
122 scientific articles and grey literature reports were identified. Access to greenspaces is positively associated with physical and mental health, and reduced risk of all-cause mortality and some non-communicable diseases. Greenspace quality is associated with increased physical activity and reduced risk of obesity. Nature-based therapies or green prescription are effective in improving mental health outcomes and overall health. Importantly, numerous co-benefits of greenspaces are identified.
Conclusion
Increasing access to greenspaces for populations with particular attention to greenspace quality is important for co-benefits. Responsible governance and use of greenspaces are crucial to minimize public health risks and human disturbance of nature.
... Based on this review, factors such as independent mobility, overweight status, parents' attitudes, concerns, and behavior, peer influence, housing type, and, supporting our findings, proxies for socioeconomic status, all play a role in influencing the amount of time children spend playing outdoors. Intervention efforts have yielded promising results for the efficacy of outdoor play increasing PA among children as well (86). It is worth noting many outdoor play studies and interventions have been conducted with younger children (preschool and Kindergarten), while not as much attention has been given to older children and adolescents. ...
Background
Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas.
Methods
We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019–2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban–rural status, and economic disadvantage.
Results
A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1–3 days (b = 0.25, 95%CI:0.04, 0.46) and 4–7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines.
Conclusion
Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.
... In relation to young adults' mental health, PA provides opportunities for social connections and support that reduce loneliness (Wray et al., 2020). Moreover, the practice of PA is correlated with low levels of anxiety and depressive symptoms and a more positive body image (Caru et al., 2022;Mehnert et al., 2011). ...
Life expectancy among young cancer survivors has increased in the last decades. Unfortunately, young cancer survivors might still experience mental and physical issues due to cancer treatment. Moreover, although physical activity is a valid tool for increasing social support and reducing the risk of obesity, sedentary behaviour is very common among young cancer survivors. Therefore, the current pilot study aims to estimate lack of social support impact on physical activity practice on mental health and quality of life. A sample of 69 Italian young cancer survivors (60% females) were included in the study and physical activity, anxiety, depression and quality of life were assessed by self‐reported questionnaires. The results showed that a lack of social support for exercising was connected to higher depressive symptoms, while no influence was detected on anxiety. Concerning quality of life, the analysis of variance model showed a significant effect of the lack of social support on physical mobility but not on self‐care, usual activities, pain and discomfort and general health. In conclusion, integrating physical activity in young cancer survivors' lifestyle, considering cancer‐related side effects, might enhance their mental health and quality of life by providing social support at the same time. Healthcare professionals should evaluate the feasibility and support adapted physical activity programmes for young cancer survivors, to reduce the risk of depression and obesity, among others.
... In most adolescents, play is a vital element of PA interventions, and the integration of play-centered activities in the outdoors is likely to be an effective method for increasing the level of PA and improving social connections. Indeed, encouraging adolescents to participate in active, stimulating, and adventurous play could enable them to test their abilities independently, thus improving social resilience [27][28][29]. Therefore, it is crucial to increase the degree to which physical activities are perceived as pleasurable [30]. ...
Background
Depression is a common psychological problem in adolescents worldwide. Although the World Health Organization recommends physical activity to reduce depressive symptoms in this population, compliance with this recommendation is often low. Furthermore, although behavioral activation therapy (BAT) is recommended as a treatment for adolescents with depression, the reported effect size is small. Compared with traditional exercises, gamified physical activities (GPA) can be particularly appealing to adolescents because they are considered to be enjoyable experiences. Thereby, they often have good uptake in adolescent populations. In this study, we integrated BAT and GPA to create behavioral activation play therapy (BAPT). We designed a clinical trial to investigate the feasibility, acceptability, and effectiveness of this treatment in adolescents with depression.
Methods
The study is a randomized controlled trial (RCT) with a single-blind, two-arm design, conducted to validate the effectiveness and applicability of BAPT for adolescent depression. On the basis of conventional treatment and care, we will compare the outcomes of BAPT and BAT. The intervention group and control group will receive nine sessions of BAPT or BAT, respectively. The number of adolescents recruited will be 200, with a 1:1 distribution ratio.
Discussion
This is the first RCT to explore the effectiveness and adaptability of BAPT in adolescents with depression. This study will provide evidence that may help to decrease depressive symptoms in adolescents, and will demonstrate the treatment effectiveness in terms of increasing levels of physical activity, reducing the rate of non-suicidal self-injury behaviors, and improving sleep quality. We also hope to assess other possible clinical effects of BAPT.
Trial registration
Chinese Clinical Trial Register Center, ChiCTR2300072671. Registered on 20 June 2023.
... In recent years, increased screen exposure and sedentary time among children and adolescents have been associated with poor mental health, increased obesity, and behavioral problems in several studies (1). This situation has created a clear need for research and practices focused on developing and evaluating multidisciplinary interventions. ...
Spending more time outdoors improves children's social and cognitive development, physical activity, and vision. Regular moderate-intensity physical activity is linked to many health benefits, including a reduced risk of high blood pressure, obesity, heart disease, stroke, cancer, and depression. Besides physical health indicators, physical activity has also been associated with higher academic and cognitive performance, and higher self-esteem. Since children's outdoor activities are primarily in public areas, there is a need for improvement studies to make these areas suitable for all children, including special child groups, and to supervise them. There are some special preparations and points to be considered during the activity when nature activities are desired to be held with child groups with chronic diseases such as epilepsy, diabetes, asthma, autism, or with atopic structure. With this review, we wanted to share some of the information needed to ensure that nature activities start and end happily with both special and healthy child groups.
... This scoping review examines children's perspectives of play in playgrounds. Other research considers play from different perspectives, particularly its use to foster physical activity, or social and motor development [3][4][5][6]. This instrumental view of play has been critically discussed by scholars from multiple disciplines, including play-work, education, and health professionals, such as occupational therapists [7][8][9][10][11], who emphasise moving beyond such a perspective [11] and taking a reflective stance on how professionals value and utilize play through practice and research [8,10]. ...
For children, playgrounds are important environments. However, children’s perspectives are often not acknowledged in playground provision, design, and evaluation. This scoping review aimed to summarize the users’ (children with and without disabilities) perspectives on environmental qualities that enhance their play experiences in community playgrounds. Published peer-reviewed studies were systematically searched in seven databases from disciplines of architecture, education, health, and social sciences; 2905 studies were screened, and the last search was performed in January 2023. Included studies (N = 51) were charted, and a qualitative content analysis was conducted. Five themes were formed which provided insights into how both physical and social environmental qualities combined provide for maximum play value in outdoor play experiences. These multifaceted play experiences included the desire for fun, challenge, and intense play, the wish to self-direct play, and the value of playing alone as well as with known people and animals. Fundamentally, children wished for playgrounds to be children’s places that were welcoming, safe, and aesthetically pleasing. The results are discussed in respect to social, physical, and atmospheric environmental affordances and the adult’s role in playground provision. This scoping review represents the valuable insights of children regardless of abilities and informs about how to maximise outdoor play experiences for all children.
... Feeling connected to one's environment is a key component of health behavior change theories and plays an important role in PA motivation, engagement, and adherence in all populations, including adolescents (Ryan and Deci, 2000;McNeill et al., 2006;Davis et al., 2015;Wray et al., 2020). Connectedness can manifest from both school and virtual environments (Perkins et al., 2021;Hertz et al., 2022). ...
The purpose of this study was to examine the associations of connectedness and parental behaviors with adolescent physical activity (PA) and mental health during COVID-19. Participants were a representative sample of US high school students who completed the 2021 Adolescent Behaviors and Experiences Survey (ABES; N = 7705; 50.4% female). ABES was completed online during the spring of 2021 and data were analyzed during the spring of 2022. Independent variables were items asking about perceived school and virtual connectedness, parental emotional abuse, and parental monitoring. Latent variables represented both PA and mental health. Two weighted structural equation models tested the associations between connectedness, parental behaviors, and mental health mediated through PA (Model 1) and between connectedness, parental behaviors, and PA mediated through mental health (Model 2) with indirect effect confidence intervals obtained using Monte Carlo simulations. School connectedness directly associated with better mental health in Model 1 (β = 0.17, p < 0.001) and with higher PA in Model 2 (β = 0.19, p < 0.001) while virtual connectedness directly associated with higher PA in Model 2 (β = 0.08, p < 0.001). Parental emotional abuse directly associated with poorer mental health in Model 1 (β = −0.43, p < 0.001). Standardized indirect effects to better mental health mediated through higher PA were observed for school connectedness (IE = 0.017, p < 0.001) and virtual connectedness (IE = 0.007, p < 0.001) and indirect effects to lower PA mediated through poorer mental health were observed for parental emotional abuse (IE = -0.050, p < 0.001). Perceptions of school and virtual connectedness and parental emotional abuse both directly and indirectly impacted adolescent PA and mental health during the COVID-19 pandemic.
... For adolescents and young adults (aged 13-19 years), a rapid review observed that adding more natural elements and opportunities for play in outdoor spaces was associated with increased social connectedness. 59 A systematic review looking at the fear of crime in urban green spaces found that vandalised or run-down parks are associated with higher levels of crime, and that this fear of crime in poorly maintained green spaces disproportionately affects women, girls and ethnic minorities in terms of their mobility and feelings of safety. 60 In the workshops, adolescents and young people emphasised the opportunity of parks for exposure to, and interaction with, different communities and generations: ...
Background
Research suggests that increasing neighbourhood social cohesion can prevent mental health problems, including depression and anxiety. However, it is unknown whether this is the case for adolescents and young adults.
Aims
To investigate whether neighbourhood social cohesion can prevent depression and anxiety, and identify interventions that can increase neighbourhood cohesion in young people.
Method
We conducted a rapid review for an overview of the available literature. PubMed, Campbell Collaboration, KSR Ltd and grey literature databases were searched from inception up to 10 July 2020. When synthesising the results, we applied a hierarchy of evidence, prioritising study designs that allowed for the most ability to infer causality. Risk of bias was assessed with the ROBIS tool and Joanna Briggs Institute risk-of-bias assessment. A narrative review and two workshops with young people were conducted to inform what future interventions may look like.
Results
Forty-two peer-reviewed publications, including two systematic reviews, 13 longitudinal studies and 27 cross-sectional studies, were identified. Prospective longitudinal studies found that neighbourhood social cohesion factors (safety, trust, positive social connections, helping others and a lack of crime and violence) were associated with fewer depressive symptoms. Future interventions to increase neighbourhood cohesion should involve creating safe and attractive community centres, accessible and safe outdoor spaces, community activity groups and online communities.
Conclusions
Neighbourhood social cohesion has the potential to protect mental health. The next step is to conduct intervention studies to evaluate the effects on onset prevention. Clinicians should consider the impact cohesion can have on mental health, and signpost to community initiatives.
... The psychosocial and physiological health outcomes of green exercise (i.e., MVPA in natural settings such as parks, forests, or lakes) in children and adolescents should not be overlooked. Outdoor exercise helps youth use their imagination, socialize with others, and interact with nature (47). Exercising outside also provides a needed break from screens such as smartphones and video www.acsm-healthfitness.org games and an opportunity for some sun exposure. ...
By reading this feature article, readers will learn: • Insufficient physical activity is associated with ill-mental health in youth. • Physical activity is an acceptable, feasible, and non-stigmatizing intervention that can be helpful in improving mental health in children and adolescents. • Effective teaching strategies and physical activity practices can be used to promote mental health literacy in youth fitness programs.
... Natural environments are thought to benefit health and wellbeing directly and indirectly. Nature exposure, including passive nature exposure (i.e., viewing or being in nature, but not engaging in an activity), quasi-passive nature exposure (i.e., exploring nature, such as touching and smelling plants) and active nature exposure (i.e., actively engaging with the natural environment), may lead to health benefits through improving affect [12,13] and cognitive functioning [14,15], facilitating recovery from stress [16,17], and enhancing well-being through the generation of social connectedness [18,19]. ...
The importance of natural environments in supporting health and wellbeing has been well evidenced in supporting positive mental and physical health outcomes, including during periods of crisis and stress. Given the disproportionate impacts of the COVID-19 pandemic have been greatest for those who are most vulnerable, understanding the role of natural environment and alternative forms of nature engagement in supporting health and wellbeing for vulnerable groups is important. This study explored how nature engagement supported health and wellbeing in those with a pre-existing health condition during the first UK lockdown. Semi-structured interviews were conducted with 17 adults with a pre-existing health condition and analysed using Interpretative Phenomenological Analysis (IPA). Four themes were identified: COVID-19 versus nature; Nature as an extension and replacement; Nature connectedness; and Therapeutic nature. The findings show the importance of nature in supporting health and wellbeing in those with a pre-existing health condition through engagement with private and public natural environments, micro-restorative opportunities, nature connection as an important pathway, and the therapeutic benefits of nature engagement. The present research extends the evidence-base beyond patterns of nature engagement to a deeper understanding of how those with existing health conditions perceived and interacted with nature in relation to their health and wellbeing during the first UK lockdown. Findings are discussed in relation to health supporting environments, micro-restorative opportunities, and policy implications
... Outdoor public recreation spaces can provide meeting places for adolescents, and research has shown that adolescents who report having more opportunities for recreation and meeting people in their neighbourhood feel more connected with their neighbours (21). However, little is known about the relationship between the use of outdoor public recreation spaces and adolescents' social connectedness (22,23). Among adolescents, previous studies have largely focused on the in uence of their experiences of neighbourhood destinations on their well-being (24) and physical activity (25), largely overlooking links with social connectedness (17,26). ...
Background: Outdoor public recreation spaces are important settings for leisure and physical activity. Adolescents’ use of these spaces may be related to their social connectedness; however, research on this topic is limited. This study examined associations of frequency of visitation and physical activity in outdoor public recreation spaces with social connectedness among adolescents in Melbourne, Australia.
Methods: Adolescents self-reported their frequency of visitation to parks, trails, beach/lake, and sports facilities; frequency of physical activity in a park, local street or path, and their street; and social connectedness. Separate analyses were conducted for visitation (n=349, 15.4±1.6 years, 58% female) and physical activity (n=441, 15.4±1.6 years, 59% female) using multilevel linear regression models.
Results: No significant associations were observed for frequency of visitation to a park (B = 0.86, 95% CI= -0.26, 1.99), trails (B = 0.41, 95% CI= -0.61, 1.44), beach/lake (B = -0.44, 95% CI= -1.46, 0.57), or sports facilities (B =0.64, 95% CI= -0.43, 1.70), nor for frequency of physical activity in their street (B = -0.07, 95% CI= -0.46, 0.31), local streets/paths (B = -0.05, 95% CI= -0.43, 0.33) or in parks (B = 0.23, 95% CI= -0.14, 0.60) with adolescents’ social connectedness.
Conclusions: The findings did not support the hypothesis that visiting and being active in outdoor public recreation spaces are associated with adolescents’ social connectedness. Future research should consider the duration and context of outdoor public recreation space use (e.g., sports, socialising, relaxing alone) and whether different types and/or a combination of public spaces are more/less conducive to social connectedness.
... Importantly, the essential conclusions of rapid reviews and systematic reviews do not differ substantially (Watt et al., 2008). Rapid reviews originated to support healthcare policy and practice, and have subsequently been applied in hydro-ecology (Miller et al., 2018), environmental change (Hillebrand et al., 2020) and social sciences (Wray et al., 2020). Rapid reviews offer a promising approach for addressing conservation challenges, particularly where time and financial resources are limited (McCarthy et al., 2012). ...
Peatlands support unique biodiversity and provide essential ecosystem services, such as regulating climate and providing freshwater and food. However, land-use change, resource extraction and changing climates are threatening peatlands globally. Restoring degraded peatlands requires re-establishing the key features that drive these ecosystems – the hydrological conditions, chemical properties and characteristic biota. Using the best-available evidence to identify management interventions that will effectively abate threats and restore ecological processes can help facilitate successful conservation. ‘Rapid evidence reviews’ have emerged in healthcare as a method of delivering key research findings to policymakers and decision-makers in a timely manner. Here, we used a rapid review approach to identify, appraise and synthesise scientific evidence on the effectiveness of conservation interventions intended to restore the hydrological conditions, chemical properties and/or characteristic biota of degraded boreal, montane, alpine and temperate peatlands globally. We found that there is consistent evidence that rewetting, shading or mulching, reprofiling, mowing, controlling grazers and active revegetation can improve the condition of degraded peatlands. Taking a whole-system approach was reported as essential to successful conservation because the hydrological conditions, chemical properties and biota are intrinsically linked. There is consistent evidence that restoring peatlands can enhance the ecosystem service of carbon storage. We demonstrate that applying the rapid review approach to a conservation problem: 1) proved efficient for synthesising evidence from 453 individual studies collected through 23 reviews, and 2) yielded a valuable synthesis of the common interventions to support effective, evidence-based conservation and recovery of peatlands globally. This can enable policymakers and practitioners to apply the best-available research knowledge when addressing this important challenge.
... They contribute to creating a sense of place, linking to many opportunity structures for health and wellbeing (Wilkie et al. 2019). A wide range of health behaviours and outcomes, such as physical activity, mental health, and social capital are directly supported or impeded by the level of access to, and the quality of, the public realm (Tillmann et al. 2018, Wray et al. 2020. These spaces are wellrecognized as part of the fundamental infrastructure in creating healthy, thriving, and safe communities. ...
The public realm is a well-recognized contributor to positive health and wellbeing. Public parks and recreational spaces are now some of the main outlets for people to get outdoors, however COVID-19 has created challenges in these spaces. We classify local government responses around maintaining physical distancing in the public realm using a preliminary conceptual map of theories and actions to identify variations in these approaches around the globe. This pilot classification approach provides a useful lens to examine pandemic responses, with future work building upon this map to potentially inform how cities may react to other complex planetary health issues.
The significance of outdoor games in the lives of children cannot be overstated, as outdoor play areas serve as vital laboratories for children to explore, imagine, and engage in social interactions. However, with the deepening of global urbanization, children’s freedom to play in urban environments is becoming increasingly restricted. Simultaneously, the increase of urban residential density and the proliferation of indoor activity spaces has led to a considerable reduction in outdoor play areas for children. This diminished exposure to and interaction with nature indirectly impacts the physical and mental health development of children, giving rise to a host of physical and psychological issues. Outdoor play spaces serve as dynamic environments where children can connect with nature, understand their surroundings, and cultivate curiosity. The design of these spaces must prioritize biomechanics to enhance children’s physical engagement and safety. High-quality outdoor play areas should be structured to promote movement that aligns with children’s natural motor skills, facilitating activities that encourage running, climbing, and jumping. Such designs not only stimulate physical development but also foster cognitive growth by providing opportunities for problem-solving and creativity. This review summarizes excellent design concepts and methods for outdoor play spaces for children from multiple countries and regions in recent years, including 77 papers. It delves into the design principles of children’s outdoor play spaces from a child-friendly perspective, taking into account children’s needs, safety, and sustainability. This study focuses on providing scientific support for the optimization of outdoor play spaces for children, with particular attention to aspects such as the diversity of outdoor play spaces, stimulation of intelligence, and seamless integration of natural elements. The aim of this research is to enhance the quality of outdoor play spaces for children, improve children’s outdoor play experiences, and promote children’s healthy development. By applying biomechanical principles, designers can create environments that enhance children’s interaction and exploration abilities, ultimately improving their overall quality of life. Emphasizing child-friendliness in the design of outdoor play spaces is crucial.
The practice of play, encompassing physical activity and social connectedness, exerts a positive effect on communities’ health and overall urban quality of life. Depending on design and social dynamics, public spaces in cities can be more or less welcoming for young women. Public spaces in Cairo, Egypt, lack playful elements that attract young women to partake in physical activities. This study seeks to identify and assess the current situation of physical activity and play in Cairo for young women. This shall be achieved through exploring their experiences with means of appropriation of public spaces and empowerment, according to the cultural norms, safety concerns and physical design elements. To do so, the study used digital ethnography to gain an understanding of the types of activities young women engage in public spaces and their modes of collective organisation. Observations across the city have then been conducted, and the three neighbourhoods of Al Rehab, Madinati and Zamalek have been selected to pursue more in-depth field observations and interviews. Doing so highlighted the challenges and the opportunities these young women face, shedding light on ways to strengthen their use of play-based urban forms and sports infrastructures in public spaces. The study finds that to pursue physical activity, young women tend to privilege certain safer urban spaces, such as Gated Communities and temporalities allowing for less risks of street harassment. Social media platforms have been understood as instruments for collective organisation, catalysing and multiplying female physical activity in Cairo’s public spaces. The study suggests that the use of social media platforms can be instrumentalised for young women’s empowerment in shaping diverse public spaces and placemaking processes. In the end, the research sheds light on the pathways forward to enhance young women’s engagement in the design and use of playful and active public spaces in culturally sensitive contexts.
The challenge posed by climate change has prompted researchers to investigate the mechanisms underlying ecological values and behaviors, emphasizing the pivotal role of connectedness to nature in responsible consumption. Beyond its environmental aspect, responsible consumption embraces a social dimension marked by conscientious behaviors minimizing negative societal impacts. This study pioneers a comprehensive approach by simultaneously exploring the roles of Connectedness to Nature (CN) and Connectedness to Humanity (CH) in fostering biospheric and altruistic values, which further promote eco and socio-responsible consumption. Using a structural equation modeling analysis, the mutual effects of CN and CH were controlled, thereby isolating their specific contributions. Results derived from a sample of 474 participants revealed that CN and CH significantly contributes to both facets of responsible consumption. In addition, findings confirm the biophilia hypothesis by demonstrating the substantial role of CN in shaping biospheric values and promoting eco-responsible consumption. Similarly, altruistic values mediate the association between CH and socio-responsible consumption. Post-hoc analyses highlight the positive influence of CN on altruistic values, promoting socio-responsible consumption. Surprisingly, CH shows a negative correlation with biospheric values, hindering eco-responsible consumption. Our results are discussed within the Connectedness Continuum Model and in-group/out-group dynamics, indicating that CN fosters connection with the broader natural world and the human species. Conversely, an exclusive focus on CH may result in perceiving nature as an out-group and potentially rejecting its values. Practical implications are discussed, particularly with mindfulness and contact with others and nature as avenues to enhance both connectedness and, consequently, responsible consumption.
Background
Depression is a common psychological problem in adolescents worldwide. Although the World Health Organization recommends that members of this population engage in physical activity to reduce depressive symptoms, compliance with this recommendation is often low. Furthermore, although behavioral activation (BA) is recommended as a treatment for adolescents with depression, the reported effect size is small. Compared with traditional exercises, gamified physical activity (GPA) can be particularly appealing to adolescents because it is perceived as an enjoyable experience. In this study, we integrated BA and GPA to create behavioral activation play therapy (BAPT). We designed a clinical trial to investigate the feasibility, acceptability, and effectiveness of this treatment in adolescents with depression.
Methods
This study is a randomized controlled trial (RCT) with a three-arm, assessor-blinded design, conducted to validate the effectiveness and applicability of BAPT for treating adolescent with depression. We will recruit 258 participants and randomly assign them to a BAPT group, BA group, or GPA group using a ratio of 1:1:1. Based on conventional strategies for treatment and care, the three groups will receive nine BAPT sessions, nine BA sessions, or nine GPA sessions, respectively. We will compare the outcomes of the BAPT with those of the BA and GPA interventions.
Discussion
This is the first RCT to explore the effectiveness and applicability of BAPT in adolescents with depression. This study will provide evidence that may help to decrease depressive symptoms in adolescents, and will demonstrate the treatment effectiveness in terms of increasing levels of physical activity, reducing the rate of non-suicidal self-injury behaviors, and improving sleep quality. We will also assess the presence of side effects and the treatment adherence of patients receiving BAPT.
Trial registration
Trial registration: Chinese Clinical Trial Registry, ChiCTR2300072671. Registered on 20 June 2023.
Objective
To examine the influence of economic connectedness (EC), a measure of social capital, on obstructive sleep apnea (OSA) severity and adenotonsillectomy outcomes in children.
Study Design
Retrospective study.
Setting
Single tertiary medical center.
Methods
The study population included 286 children who were referred for full‐night polysomnography for OSA and underwent adenotonsillectomy. The primary outcome was the relationship between EC and the presence of severe OSA, and secondary outcomes included postoperative emergency room visits and residual OSA after adenotonsillectomy. Linear regression, Kruskal‐Wallis test, Pearson's χ ² test, and multiple logistic regression were used for categorical and continuous data as appropriate.
Results
In this population, the median age was 9.0 (interquartile range [IQR] = 6.9‐11.7) and 144 (50.3%) were male. The majority were white (176, 62.0%), black (60, 21.1%), and/or of Hispanic ethnicity (173, 60.9%). The median EC of this population was 0.64 (IQR = 0.53‐0.86). Higher EC was associated with decreased odds of having severe OSA (odds ratio: 0.17, 95% confidence interval = 0.05‐0.61). However, EC was not associated with either postoperative emergency room visits or residual OSA.
Conclusion
EC was significantly associated with severe OSA (ie, apnea‐hypopnea index ≥ 10) but not with postoperative emergency room visits or residual OSA after adenotonsillectomy. Further research is needed to understand the effects of various social capital measures on pediatric OSA and adenotonsillectomy outcomes.
Objetivo: El estudio examinó como la soledad diaria promedio (entre personas), variabilidad intraindividual en la soledad a través de los días (dentro-de-las-personas), y la estabilidad de soledad informó sintomatología de salud física. Método: Utilizamos data diaria de una muestra nacional de 1,538 adultos de edad media (Medad = 51.02; 57.61% mujeres) que completaron ocho entrevistas de experiencias diarias vía teléfono al final del día, incluyendo síntomas de soledad y salud física (p.ej., dolor de cabeza, nausea). Mediante un modelo multinivel, examinamos soledad promedio diaria (entre personas), variabilidad intraindividual en la soledad (dentro-de-las-personas), estabilidad dentro de la soledad (iRMSSD, por sus siglas en inglés) asociado al numero y severidad promedio de síntomas de salud física diarios. Resultados: Cuando los participantes estaban menos solos en promedio, y en días cuando la soledad fue menor que el promedio por persona, tuvieron pocos síntomas de salud física y menos severos. Adicionalmente, los participantes que estaban mas estables en soledad a través de los ocho días tuvieron síntomas de salud física menos severos. Además, hubo una asociación más fuerte entre la inestabilidad en la soledad y mayores síntomas de salud física para personas que estaban en promedio mas solas. Finalmente, el incremento en la severidad de síntomas de salud física asociada con la soledad dentro-de-la-persona fue mas fuerte para participantes con soledad de variabilidad baja. Conclusión: La soledad está asociada con síntomas de salud física en una base diaria, especialmente para personas que son de variabilidad de soledad alta. Consideraciones de las múltiples fuentes de variación en la soledad diaria puede ser necesaria para afrontar adecuadamente la soledad y promover la salud. Intervenciones de salud publica que afrontan la soledad pueden ser más efectivos si apoyan conexión social que promueve niveles de soledad estables o bajos en la vida cotidiana de las personas.
Neighborhood parks are important venues to support moderate-to-vigorous (MVPA) activity. There has been a noticeable increase promoting physical activity among youth in neighborhood parks. This paper aims to assess the association between park use and MVPA among low-income youth in a large urban area. We recruited a cohort of 434 youth participants during the COVID pandemic years (2020–2022) from low-income households in Washington, D.C. We collected multiple data components: accelerometry, survey, and electronic health record data. We explored the bivariate relationship between the accelerometer-measured daily MVPA time outcome and survey-based park use measures. A mixed-effect model was fitted to adjust the effect estimate for participant-level and time-varying confounders. The overall average daily MVPA time is 16.0 min (SD = 12.7). The unadjusted bivariate relation between daily MVPA time and frequency of park visit is 1.3 min of daily MVPA time per one day with park visits (p < 0.0001). The model-adjusted estimate is 0.7 daily MVPA minutes for 1 day with park visit (p = 0.04). The duration of a typical park visit is not a significant predictor to daily MVPA time with or without adjustments. The initial COVID outbreak in 2020 resulted in a significant decline in daily MVPA time (− 4.7 min for 2020 versus 2022, p < 0.0001). Park visit frequency is a significant predictor to low-income youth’s daily MVPA time with considerable absolute effect sizes compared with other barriers and facilitators. Promoting more frequent park use may be a useful means to improve low-income youth’s MVPA outcome.
Background
Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation and other out-of-school structured physical activities, active travel to school, and outdoor play), and the number of days children met PA guidelines in a representative sample of children living in Texas.
Methods
We analyzed cross-sectional data from a statewide sample of 4th grade children in Texas (mean age = 9.4 ± 0.6 years; female = 48.7%, 51.8% Hispanic), who completed the 2019–2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. The TX SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children, and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation and other out-of-school structured physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage.
Results
Children met PA guidelines on 3.6 ± 2.3 days during the week. One in ten (11.2%) 4th grade children did not meet daily PA guidelines on any day of the week, while 72.1% met them between 1–6 days, and 16.7% met physical activity guidelines every day during the week. Participating in any structured PA (b = 0.31, 95%CI:0.20,0.42) was significantly and positively associated with the number of days children met PA guidelines. Playing outdoors 1–3 days (b = 0.26, 95%CI:0.04, 0.47) and 4–7 days in the past week (b = 0.79, 95%CI:0.59, 1.00) was significantly and positively associated with the number of days children met PA guidelines.
Conclusion
Participating in organized sports, participating in other structured PA, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.
Issue addressed:
Regular physical activity is important for children's health. Parkrun supports communities to deliver free, weekly, 5 km events in 22 countries around the world and is the largest physical activity model delivered at scale in the world. Junior parkrun aims to encourage children aged 4-14 years to be active outdoors through providing safe, cost-free and non-competitive weekly timed walk, run or jog over a 2-km distance. The aim of this study is to evaluate the junior parkrun pilot in Australia.
Methods:
A process evaluation was conducted using routinely collected data of junior parkrun participants, as well as a self-completed questionnaire.
Results:
A total of 1827 children had registered and participated in at least one junior parkrun over the course of the pilot period. Participants had, on average, attended 10% of the junior parkrun events including and subsequent to their first participation by the end of the study period. Majority of parents (61%) said that junior parkrun had increased their child's physical activity either a little or a lot, and most agreed or strongly agreed that junior parkrun was fun (90%), enjoyable (91%), energising (85%) and challenging (70%).
Conclusion:
The junior parkrun pilot appears to show promise in Australia for enabling children to engage in physical activity, in their local communities in a fun and inclusive way.
So what:
Parkrun junior can co-exist with other organised sports programs; however, it can also specifically target those not participating in any sports, given the high levels of enjoyment in a non-competitive, non-team environment.
Background
Preschool is a crucial period for developing motor skills.
Objective
This study evaluated factors associated with motor competence in preschoolers from a Brazilian urban area.
Methods
A total of 211 preschoolers (51.2% girls and 48.8% boys) were evaluated. Body mass index was calculated; the Brazilian Economic Research Criterion, the Mini-Mental Scale (MMC) and the Early Childhood Environment Rating Scale®, Revised (ECERS-R™) were applied; the Habitual Physical Activity time was recorded; the Test of Gross Motor Development (TGMD-2) was performed. Univariate analysis was performed using simple linear regression for the independent variables, considering the motor test subscales as dependent variables. Variables with p < 0.20 in the univariate analysis were considered for the multiple linear regression model and were entered into the stepwise method.
Results
The independent variables remaining in the Standard Score Locomotor model were BMI, presence of park at school, and MMC (R² = 0.16). The independent variables remaining in the Standard Object Control score were MMC and gender (R² = 0.03). The variables associated with the highest scores of Gross Motor Quotient were MMC, body mass index, and presence of a park at school, respectively (R² = 0.11).
Conclusion
Male eutrophic preschoolers who are physically active and attend schools with parks or courtyards in a Brazilian urban area have the highest scores for global cognitive function and motor competence.
Scoping reviews and rapid reviews are intentional approaches to systematically synthesize research. In sport and exercise psychology, scoping reviews can summarize information to describe what is known on a relevant topic. Rapid reviews offer accelerated knowledge synthesis through a streamlined timely and cost-effective approach that is directed and guided by stakeholders. Both scoping and rapid reviews are used to synthesize the literature, and also to describe and assess conceptual, theoretical, and methodological trends, identify gaps in research and practice, and inform future sport and exercise psychology research and practice directions. We offer evidence-based and field-specific guidelines to conduct scoping reviews and rapid reviews. These types of syntheses in sport and exercise psychology are important for advancing research and practice and highlight the value of collaborations with key stakeholders. Our guidelines will help with the uniformity and dependability of scoping and rapid reviews while also advancing the impact and value of this type of research.
The aim of this study was to evaluate an urban forest intervention program effect on physical activity, healthy eating habits, self-efficacy and life satisfaction (LS) among Israeli at-risk youth. The quasi-experimental study ran from September 2016 to June 2017; participants were randomly selected. There were 76 total study participants: 53 in the intervention and 23 in the control group. Participants ranged in age from 15 to 18 years. Questionnaires were administered to intervention and control groups before and after the intervention. Univariate and multivariable analyses evaluated the intervention effect. Repeated measures analyses of covariance were calculated to assess change in group differences. An increase was found in measures of physical activity in the intervention group (p < 0.001), while no change was noted in the control group. Healthy eating increased in both groups (p = 0.007), with no significant difference between them (p = 0.165). Unhealthy eating decreased significantly in the intervention group (p = 0.002) and increased in the control group (p = 0.007). Self-efficacy increased in the intervention group (p < 0.001), while no change was noted in the control group (p = 0.353). Likewise, LS increased in the intervention group (p < 0.001), while no change was found in the control group (p = 0.657). Findings indicate that the intervention was efficacious in increasing physical activity, healthy eating habits, self-efficacy, and LS. The effectiveness of this intervention among larger samples is warranted in future prospective studies.
Background
Early learning and childcare centers (ELCCs) can offer young children critical opportunities for quality outdoor play. There are multiple actual and perceived barriers to outdoor play at ELCCs, ranging from safety fears and lack of familiarity with supporting play outdoors to challenges around diverse perspectives on outdoor play among early childhood educators (ECEs), administrators, licensing officers, and parents.
Objective
Our study objective is to develop and evaluate a web-based intervention that influences ECEs’ and ELCC administrators’ perceptions and practices in support of children’s outdoor play at ELCCs.
Methods
The development of the fully automated, open-access, web-based intervention was guided by the intervention mapping process. We first completed a needs assessment through focus groups of ECEs, ELCC administrators, and licensing officers. We identified key issues, needs, and challenges; opportunities to influence behavior change; and intervention outcomes and objectives. This enabled us to develop design objectives and identify features of the OutsidePlay web-based intervention that are central to addressing the issues, needs, and challenges of ECEs and ELCC administrators. We used social cognitive theory and behavior change techniques to select methods, applications, and technology to deliver the intervention. We will use a two-parallel-group randomized controlled trial (RCT) design to evaluate the efficacy of the intervention. We will recruit 324 ECEs and ELCC administrators through a variety of web-based means, including Facebook advertisements and mass emails through our partner networks. The RCT study will be a purely web-based trial where outcomes will be self-assessed through questionnaires. The RCT participants will be randomized into the intervention group or the control group. The control group participants will read the Position Statement on Active Outdoor Play.
Results
The primary outcome is increased tolerance of risk in children’s play, as measured by the Teacher Tolerance of Risk in Play Scale. The secondary outcome is self-reported attainment of a self-developed behavior change goal. We will use mixed effects models to test the hypothesis that there will be a difference between the intervention and control groups with respect to tolerance of risk in children’s play. Differences in goal attainment will be tested using logistic regression analysis.
Conclusions
The OutsidePlay web-based intervention guides users through a personalized journey that is split into 3 chapters. An effective intervention that addresses the barriers to outdoor play in ELCC settings has the potential to improve children’s access to outdoor play and support high-quality early childhood education.
Trial Registration
ClinicalTrials.gov NCT04624932; https://clinicaltrials.gov/ct2/show/NCT04624932
International Registered Report Identifier (IRRID)
DERR1-10.2196/31041
Background:
There is a paucity of studies, especially among diverse populations, demonstrating the effects of policy and environmental interventions to increase regular physical activity. The Grow Healthy Together Chattanooga project provided the opportunity to assess the impact of physical activity policy and environmental interventions on the physical activity among predominately African American children living in the inner city.
Methods:
Using the System for Observing Physical Activity and Recreation in Communities (SOPARC), the authors examined the physical activity of children along urban pedestrian/bike routes/trails and recreational park areas within the boundaries of the Grow Healthy Together Chattanooga communities. SOPARC data were collected at baseline (fall 2010/spring 2011) and repeated (spring 2014) in each community.
Results:
The SOPARC assessments yielded a total of 692 child/youth observations in 2010 and 806 observations in 2014. Children/youth observed in 2014 were greater than 2 times the odds of engaging in moderate/vigorous physical activity compared with their 2010 counterparts (odds ratio = 2.75, 95% confidence interval, 1.43-5.32).
Conclusions:
The present findings support the hypothesis that policy and environmental interventions can contribute to increased physical activity levels among children/youth over ∼3-year period. These results provide evidence that improved access to "urban" pedestrian/bicycle routes/trails appears to translate into increased opportunities for physical activity among inner city children/youth.
Background
It is commonly believed that nature has positive impacts on children’s health, including physical, mental and social dimensions. This review focuses on how accessibility to, exposure to and engagement with nature affects the mental health of children and teenagers.
Methods
Ten academic databases were used to systematically search and identify primary research papers in English or French from 1990 to 1 March 2017. Papers were included for review based on their incorporation of nature, children and teenagers (0–18 years), quantitative results and focus on mental health.
Results
Of the 35 papers included in the review, the majority focused on emotional well-being and attention deficit disorder/hyperactivity disorder. Other outcome measures included overall mental health, self-esteem, stress, resilience, depression and health-related quality of life. About half of all reported findings revealed statistically significant positive relationships between nature and mental health outcomes and almost half reported no statistical significance.
Conclusions
Findings support the contention that nature positively influences mental health; however, in most cases, additional research with more rigorous study designs and objective measures of both nature and mental health outcomes are needed to confirm statistically significant relationships. Existing evidence is limited by the cross-sectional nature of most papers.
Smart and connected communities (SCC) describe the shift in urbanism towards technological solutions and the production of knowledge-based industries. Local governments are recognizing the opportunity of this paradigm shift to improve services, create more efficient policies, and increase the wellbeing of their citizens. These new tools create the possibility for local governments to respond differently to “wicked problems” facing cities, including increasing chronic disease prevalence. Using lung and skin cancers as case studies, we present smart prevention as a novel approach that uses smart city-enabled built environment monitoring to trigger local cancer-prevention policies. First, we present results of a scoping review we conducted to describe mechanisms by which features in urban built and social environments are hypothesized to contribute to lung cancer and skin cancer. We systematically searched fourteen electronic databases, yielding 47 articles that examined associations between built and social environment features and lung cancer (n = 34), and/or built and social environment features and skin cancer (n = 13). Second, we present a narrative review of smart city theory and governance. Third, we use findings from both reviews to draw conceptual links between cancer prevention and SCC – presenting a hypothetical suite of built environment and policy interventions to prevent lung and skin cancer.
Background:
This study describes and compares the percentages of Canadian children and youth who adhere to different operational definitions of the moderate-to-vigorous physical activity (MVPA) recommendation of 60 minutes per day.
Data and methods:
Data for 6- to 17-year-olds (n = 5,608) were collected from 2007 through 2015 as part of the Canadian Health Measures Survey. MVPA was measured using the Actical accelerometer. The MVPA recommendation was operationalized as accumulating 60 minutes of MVPA every day, on most days, and on average.
Results:
Data from the most recent cycle of the Canadian Health Measures Survey indicate that 7% of children and youth accumulated at least 60 minutes of MVPA on at least 6 out of 7 days, and 33% achieved a weekly average of at least 60 minutes per day. Boys accumulated more MVPA than did girls, and 6- to 11-year-olds accumulated more MVPA than did 12- to 17-year-olds. Regardless of how adherence to the recommendation is operationalized, MVPA levels among Canadian children and youth did not change over the 9-year period from 2007 to 2015.
Interpretation:
The majority of Canadian children do not meet the physical activity recommendation, regardless of the operational definition used. However, the discrepancies between results based on different interpretations of the 60-minutes-per-day recommendation highlight the importance of explicitly reporting how recommendations are operationalized to avoid misinterpreting trends and comparisons.
Background
Multi-level, longer-term obesity prevention interventions that focus on inequalities are scarce. Fun ‘n healthy in Moreland! aimed to improve child adiposity, school policies and environments, parent engagement, health behaviours and child wellbeing.
Methods
All children from primary schools in an inner urban, culturally diverse and economically disadvantaged area in Victoria, Australia were eligible for participation. The intervention, fun ‘n healthy in Moreland!, used a Health Promoting Schools Framework and provided schools with evidence, school research data and part time support from a Community Development Worker to develop health promoting strategies. Comparison schools continued as normal. Participants were not blinded to intervention status. The primary outcome was change in adiposity. Repeated cross-sectional design with nested longitudinal subsample.
Results
Students from twenty-four primary schools (clusters) were randomised (aged 5–12 years at baseline). 1426 students from 12 intervention schools and 1539 students from 10 comparison schools consented to follow up measurements. Despite increased prevalence of healthy weight across all schools, after 3.5 years of intervention there was no statistically significant difference between trial arms in BMI z score post-intervention (Mean (sd): Intervention 0.68(1.16); Comparison: 0.72(1.12); Adjusted mean difference (AMD): -0.05, CI: -0.19 to 0.08, p = 0.44). Children from intervention schools consumed more daily fruit serves (AMD: 0.19, CI:0.00 to 0.37, p = 0.10), were more likely to have water (AOR: 1.71, CI:1.05 to 2.78, p = 0.03) and vegetables (AOR: 1.23, CI: 0.99 to 1.55, p = 0.07), and less likely to have fruit juice/cordial (AOR: 0.58, CI:0.36 to 0.93, p = 0.02) in school lunch compared to children in comparison schools. More intervention schools (8/11) had healthy eating and physical activity policies compared with comparison schools (2/9). Principals and schools highly valued the approach as a catalyst for broader positive school changes. The cost of the intervention per child was $65 per year.
Conclusion
The fun n healthy in Moreland! intervention did not result in statistically significant differences in BMI z score across trial arms but did result in greater policy implementation, increased parent engagement and resources, improved child self-rated health, increased fruit, vegetable and water consumption, and reduction in sweet drinks. A longer-term follow up evaluation may be needed to demonstrate whether these changes are sustainable and impact on childhood overweight and obesity.
Clinical trial registration
ACTRN12607000385448 (Date submitted 31/05/2007; Date registered 23/07/2007; Date last updated 15/12/2009).
Purpose:
To compare the effect of 2 different playground environments on the physical activity of children with ambulatory cerebral palsy during their playground play.
Methods:
Five 7- to 8-year-old children with cerebral palsy (Gross Motor Functional Classification System [GMFCS] level II) participated. Using an alternating treatment, single-subject design, stride patterns were obtained using an activity monitor on an Americans with Disabilities Act (ADA)-compliant and noncompliant playground. Visual and statistical analysis of the stride data was used to analyze the effect of the playground environments.
Results:
Four of the 5 participants increased the number of strides on an ADA-compliant playground.
Conclusion:
Children with cerebral palsy (GMFCS II) may benefit from an ADA-compliant playground to increase their physical activity.
Beat the Street aims to get children more active by encouraging them to walk and cycle in their neighbourhood using tracking technology with a reward scheme. This pilot study evaluates the impact of Beat the Street on active travel to school in Norwich, UK. Eighty children 8-10 yrs were recruited via an intervention and control school. They wore an accelerometer for 7 days at baseline, mid-intervention and post-intervention (+20 weeks), and completed a travel diary. Physical activity overall was not higher at follow-up amongst intervention children compared to controls. However, there was a positive association between moderate-to-vigorous physical activity (MVPA) during school commute times and the number of days on which children touched a Beat the Street sensor. This equated to 3.46 mins extra daily MVPA during commute times for children who touched a sensor on 14.5 days (the mean number of days), compared to those who did not engage. We also found weekly active travel increased at the intervention school (+10.0% per child) while it decreased at the control (-7.0%), p=0.056. Further work is needed to understand how improved engagement with the intervention might impact outcomes.
England's national cycle training scheme, 'Bikeability', aims to give children in England the confidence to cycle more. There is, however, little evidence on the effectiveness of cycle training in achieving this. We therefore examined whether delivering Bikeability was associated with cycling frequency or with independent cycling.
We conducted a natural experimental study using information on children aged 10-11 years participating in the nationally-representative Millennium Cohort Study. We identified Cohort participants whose schools had offered Bikeability in 2011-2012 using operational Bikeability delivery data (children in London excluded, as delivery data not available). Our natural experimental design capitalised on the fact that Cohort participants were surveyed at different times during 2012 and were also offered Bikeability at different times during 2012. This allowed us to compare cycling levels between children whose schools delivered Bikeability before their survey interview ('intervention group', N = 2563) and an otherwise comparable group of children whose schools delivered Bikeability later in the year ('control group', N = 773). Parents reported whether their child had completed formal cycle training; their child's cycling frequency; whether their child ever made local cycling trips without an adult; and other child and family factors. We used Poisson regression with robust standard errors to examine whether cycling behaviour differed between the intervention and control groups.
Children whose school had offered Bikeability were much more likely to have completed cycle training than the control group (68 % vs. 28 %, p < 0.001). There was, however, no evidence that delivering Bikeability in school was associated with cycling more often (49.0 % cycling at least once per week in the intervention group vs. 49.6 % in the control group; adjusted risk ratio 0.99, 95 % CI 0.89, 1.10). There was likewise no evidence of an association with cycling independently (51.5 % in the intervention group vs. 50.1 % in the control group; adjusted risk ratio 0.97, 95 % CI 0.89, 1.06).
Offering high-quality cycle training free at the point of delivery in English schools encourages children to do cycle training, but we found no evidence of short-term effects on cycling frequency or independent cycling. Future evaluation should investigate longer-term effects on these and other stated Bikeability objectives such as increasing cycling safety.
To assess the effect of a school playground intervention on the physical activity levels of primary/elementary aged children.
Two-arm parallel group randomized controlled trial.
In 2011, children aged 4-13 years from thirteen primary/elementary schools (in Illawarra, New South Wales, Australia) were invited to participate in the study. School recruitment was based on existing policies, equipment and willingness to participate. Participating schools were randomly allocated to the intervention or control using the 'hat and draw' method. The intervention was delivered over four months. Intervention schools introduced policy changes and portable equipment to break-time after baseline measures were collected. The primary outcome was the proportion of break-time spent in Moderate to Vigorous Physical Activity (MVPA) assessed by the System for Observing Playground Activity in Youth (SOPLAY). The analysis involved linear mixed models adjusting for the clustering effect of schools. The study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614001128684).
Four schools (two intervention and two control) met the inclusion criteria (1582 children: 790 males; 267 controls, total of 792 females; 248 controls). Students from the intervention schools had a greater increase at follow-up in the proportion of break-time in MVPA; (adjusted difference=12.5 percentage points, 95% CI [-13.0%, 38.0%]; P=0.17; r=0.6) compared to the controls. MVPA at recess significantly increased (adjusted difference=18.0 percentage points, 95% CI [6.9%, 29.1%]; P=0.02; effect size=0.7). There were no significant increases in MVPA when examining overall break times. Results were greater for girls compared to boys.
Making environmental and policy changes are promising strategies for promoting health-enhancing physical activity during school break-time.
Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed.
Physical activity in children and adolescents is on a decline trend. To this end, we conducted a matched-pair randomized controlled trial to examine the effects of a 4-week STAR (School-based; Train-the-trainer; Accessibility of resources; Recreational) skipping programme. 1,386 schoolchildren from 20 primary and secondary schools were recruited. Schools were randomized into the experimental or wait-list control group. Participants self-reported their health-related quality of life using the KIDSCREEN-27. Accelerometers were used to measure the time a subgroup of participants (n = 480) spent in moderate-to-vigorous physical activity during school hours on five consecutive days. Measures were taken at pre- and post-test. At post-test, students in the experimental group, compared to those in the control group, engaged in less moderate-to-vigorous physical activity during school hours. Health-related quality of life from two groups of students was similar, but the experimental group reported higher levels of autonomy and parent relationships. Results suggested that although the intervention did not increase students' physical activity levels, it slightly improved their health-related quality of life. Future studies should explore personal factors that might mediate the effect of the intervention.
Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment-a community intervention designed to promote active living and decrease obesity within a small southern town.
In 2011, community leaders implemented the Mebane on the Move intervention-a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention change in minutes of PA and BMI z-score, adjusting for confounders.
At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m(2); 95% CI: -0.9, -0.02; p=0.045), compared to children in the comparison community.
We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful.
A Play Street is a street that is reserved for children’s safe play for a specific period during school vacations. It was hypothesized that a Play Street near children’s home can increase their moderate- to vigorous-intensity physical activity (MVPA) and decrease their sedentary time. Therefore, the aim of this study was to investigate the effect of Play Streets on children’s MVPA and sedentary time.
A nonequivalent control group pretest-posttest design was used to determine the effects of Play Streets on children’s MVPA and sedentary time. Data were collected in Ghent during July and August 2013. The study sample consisted of 126 children (54 from Play streets, 72 from control streets). Children wore an accelerometer for 8 consecutive days and their parents fill out a questionnaire before and after the measurement period. During the intervention, streets were enclosed and reserved for children’s play. Four-level (neighborhood – household – child – time of measurement (no intervention or during intervention)) linear regression models were conducted in MLwiN to determine intervention effects.
Positive intervention effects were found for sedentary time (β = -0.76 ± 0.39; χ2 = 3.9; p = 0.05) and MVPA (β = 0.82 ± 0.43; χ2 = 3.6; p = 0.06). Between 14h00 and 19h00, MVPA from children living in Play Streets increased from 27 minutes during normal conditions to 36 minutes during the Play Street intervention, whereas control children’s MVPA decreased from 27 to 24 minutes. Sedentary time from children living in the Play Street decreased from 146 minutes during normal conditions to 138 minutes during the Play Street intervention, whereas control children’s sedentary time increased from 156 minutes to 165 minutes. The intervention effects on MVPA (β = -0.62 ± 0.25; χ2 = 6.3; p = 0.01) and sedentary time (β = 0.85 ± 0.0.33; χ2 = 6.6; p = 0.01) remained significant when the effects were investigated during the entire day, indicating that children did not compensate for their increased MVPA and decreased sedentary time, during the rest of the day.
Creating a safe play space near urban children’s home by the Play Street intervention is effective in increasing children’s MVPA and decreasing their sedentary time.
Background
Active travel to school can be an important contributor to the total physical activity of children but levels have declined and more novel approaches are required to stimulate this as an habitual behaviour. The aim of this mixed methods study was to investigate the feasibility of an international walk to school competition supported by novel swipecard technology to increase children¿s walking to/from school.Methods
Children aged 9¿13 years old participated in an international walk to school competition to win points for themselves, their school and their country over a 4-week period. Walks to and from school were recorded using swipecard technology and a bespoke website. For each point earned by participants, 1 pence (£0.01) was donated to the charity of the school¿s choice. The primary outcome was number of walks to/from school objectively recorded using the swipecard tracking system over the intervention period. Other measures included attitudes towards walking collected at baseline and week 4 (post-intervention). A qualitative sub-study involving focus groups with children, parents and teachers provided further insight.ResultsA total of 3817 children (mean age 11.5¿±¿SD 0.7) from 12 schools in three cities (London and Reading, England and Vancouver, Canada) took part in the intervention, representing a 95% intervention participation rate. Results show a gradual decline in the average number of children walking to and from school over the 4-week period (week 1 mean 29%¿±¿SD2.5; week 2 mean 18%¿±¿SD3.6; week 3 mean 14%¿±¿SD4.0; week 4 mean 12%¿±¿SD1.1). Post intervention, 97% of children felt that walking to school helped them stay healthy, feel happy (81%) and stay alert in class (76%). These results are supported by qualitative findings from children, parents and teachers. Key areas for improvement include the need to incorporate strategies for maintenance of behaviour change into the intervention and also to adopt novel methods of data collection to increase follow-up rates.Conclusions
This mixed methods study suggests that an international walk to school competition using innovative technology can be feasibly implemented and offers a novel way of engaging schools and motivating children to walk to school.
Background
Drop-off spots are locations in the proximity of primary schools where parents can drop off or pick up their child. From these drop-off spots children can walk to and from school. This pilot study aimed to investigate the feasibility and effectiveness of drop-off spots and to evaluate how drop-off spots are perceived by school principals, teachers and parents of 6-to-12-year old children.Methods
First, a feasibility questionnaire was completed (n¿=¿216) to obtain parental opinions towards the implementation of drop-off spots. A drop-off spot was organized (500¿800 m distance from school) in two primary schools. A within-subject design was used to compare children¿s (n¿=¿58) step counts and number of walking trips during usual conditions (baseline) and during implementation of a drop-off spot (intervention). Three-level (class-participant-condition) linear regression models were used to determine intervention effects. After the intervention, 2 school principals, 7 teachers and 44 parents filled out a process evaluation questionnaire.ResultsPrior to the intervention, 96% expressed the need for adult supervision during the route to school. Positive significant intervention effects were found for step counts before/after school hours (+732 step counts/day; X2¿=¿12.2; p¿<¿0.001) and number of walking trips to/from school (+2 trips/week; X2¿=¿52.9; p¿<¿0.001). No intervention effect was found for total step counts/day (X2¿=¿2.0; p¿=¿0.16). The intervention was positively perceived by the school principals and parents, but teachers expressed doubts regarding future implementation.Conclusion
This pilot study showed that implementing drop-off spots might be an effective intervention to promote children¿s walking to school. Implementing drop-off spots does not require major efforts from the schools and schools can choose how and when they organize drop-off spots. However, motivating teachers and involving other volunteers (e.g. parents, grandparents) may be needed. Future studies should investigate the feasibility and effectiveness of drop-off spots in a larger sample of schools.
Background:
Green spaces have been associated with improved mental health in children; however, available epidemiological evidence on their impact on child behavioral development is scarce.
Objectives:
We investigated the impact of contact with green spaces and blue spaces (beaches) on indicators of behavioral development and symptoms of attention deficit/hyperactivity disorder (ADHD) in schoolchildren.
Methods:
This study was based on a sample of 2,111 schoolchildren (7-10 years of age) from 36 schools in Barcelona in 2012. We obtained data on time spent in green spaces and beaches and Strengths and Difficulties Questionnaires (SDQ) from parents, and ADHD/DSM-IV questionnaires from teachers. Surrounding greenness was abstracted as the average Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, and 500 m around each home address. Proximity to green spaces was defined as living within 300 m of a major green space (≥ 0.05 km2). We applied quasi-Poisson mixed-effects models (with school random effect) to separately estimate associations between indicators of contact with green spaces and SDQ and ADHD total and subscale scores.
Results:
We generally estimated beneficial associations between behavioral indicators and longer time spent in green spaces and beaches, and with residential surrounding greenness. Specifically, we found statistically significant inverse associations between green space playing time and SDQ total difficulties, emotional symptoms, and peer relationship problems; between residential surrounding greenness and SDQ total difficulties and hyperactivity/inattention and ADHD/DSM-IV total and inattention scores; and between annual beach attendance and SDQ total difficulties, peer relationship problems, and prosocial behavior. For proximity to major green spaces, the results were not conclusive.
Conclusion:
Our findings support beneficial impacts of contact with green and blue spaces on behavioral development in schoolchildren.
1984b. Effects of rootstocks and K and n fertilizers on seasonal apple fruit mineral composition in a high-density orchard.. 1992. The influence of nitrogen fertilization, season of application, and orchard floor manage-ment on fruit quality and leaf mineral content of 'Golden Delicious' apple trees. Fruit Var. ADDITIONAL INDEX WORDS. gardening, environmental education, children's horticulture, horticultural therapy, elementary education, outdoor education SUMMARY. Children's gardens are receiving increased attention from communities and schools. Educators recognize that gardens provide beauty, produce and education, and serve as an outlet in which gardeners may gain personal benefits. The objectives of this research study were to evaluate whether children partici-pating in garden activities benefited by an improvement in interpersonal relationships and attitudes toward school. No significant differences were found between pre-and posttests and the control and experimental group comparisons. However, demographic comparisons offered interesting insight into trends in the data. Female students had significantly more positive attitudes towards school at the conclusion of the garden program compared to males. The results also showed that there were differences in interpersonal relationships between children depending on grade level in school. In addition, childrens' attitudes toward school were more positive in schools that offered more intensive individualized gardening.
Background:
Multicomponent school-based interventions have the potential to reduce the age-related decline in adolescents' physical activity (PA), yet there is not consistent evidence to guide non-curricular and school environment interventions. The aim of this study was to assess the effectiveness of a multicomponent environmental school-based intervention, designed to reduce the age-related decline in PA among adolescents.
Methods:
A cluster randomized controlled trial was conducted with 7 intervention and 7 control schools. Baseline measurements were carried out in spring 2010 with 2 years of follow-up. A total of 1,348 students (11-13 years, in grade 5 and 6) enrolled in the study at baseline. The 14 schools included in the study were located in the Region of Southern Denmark. The intervention consisted of organizational and physical changes in the school environment with a total of 11 intervention components. The primary outcome measure was overall PA (cpm, counts per minute) and was supported by analyses of time spent in MVPA, and time spent sedentary. Furthermore, a secondary outcome measure was PA in school time and during recess. PA was measured using accelerometer (Actigraph GT3X).
Results:
A total of 797 students completed the trial and had valid accelerometer data. No significant difference was found for overall PA with an adjusted difference of -19.1 cpm (95% CI: -93, 53) or for school time activity with an adjusted difference of 6 cpm (95% CI: -73, 85). A sensitivity analysis revealed a positive significant intervention effect of PA in recess with an adjusted difference of 95 cpm.
Conclusions:
No evidence was found of the overall effect of a non-curricular multicomponent school-based intervention on PA among Danish adolescents. The intervention was positively associated with PA during school time and recess, however, with small estimates. Lack of effect on overall PA could be due to both program theory and different degrees of implementation.
Trial registration:
www.Controlled-Trials.com ISRCTN79122411.
Purpose
To evaluate the effectiveness of Preventing Obesity by Design (POD), a childcare center outdoor renovation intervention.
Design
Pre-post intervention evaluation.
Setting
North Carolina licensed childcare centers (N = 27).
Subjects
Preschool children.
Intervention
Outdoor renovation, teacher training.
Measures
Behavior mapping, Preschool Outdoor Environment Measurement Scale (POEMS), center director interview.
Analysis
Descriptive statistics, ordinary least squares and logistic regressions calculated to assess levels of association between environmental change, children's physical activity (PA), social behaviors, and environmental quality. Qualitative interview data analyzed to help understand intervention impact.
Results
Behavior mapping showed that site layout attributes, such as the form (i.e., “single loop” and “double loop”) of pathways (functioning as circulation routes and wheeled toy settings), are associated with higher levels of PA. Teacher interaction was associated with decreased children's PA. Absence of teacher or lack of child/child interaction was associated with increased PA. POEMS assessment of environmental quality was higher after renovation. POEMS domains (Physical Space and Teacher/Caregiver Roles) were positively associated with PA. After renovation, 68% of center directors reported positive changes in children's behavior and 40% mentioned edible plant installations as greatest success.
Conclusion
Built environment renovation of childcare center outdoors, including looped pathways installation, coupled with teacher training, may support increased PA. Renovation, including food gardens, may be a key to success for preschool health promotion and support change in childcare policy.
The purpose of the study was to investigate the relative importance of child and adolescent social and academic pathways to well-being in adulthood (32-years) indicated by a sense of meaning, social engagement, positive coping and prosocial values. Data were drawn from a 15 wave (32-year) longitudinal study of the health and development of around 1000 New Zealanders (Dunedin Multidisciplinary Health and Development Study, New Zealand). Moderate continuity in social connectedness (0.38) and high continuity in academic ability (0.90) was observed across childhood and adolescence. Adolescent social connectedness was a better predictor of adult well-being than academic achievement (0.62 vs. 0.12). There was evidence of an indirect pathway from adolescent academic achievement to adult well-being through social connectedness (0.29). Indicators of well-being in adulthood appear to be better explained by social connection rather than academic competencies pathways. Implications for promoting longer term well-being during the school years are discussed.
Background
Incorporating cycling into daily life is one way to increase physical activity.
Purpose
This study examined the impact of building new bike lanes in New Orleans to determine whether more people were cycling on the street and with the flow of traffic after bike lanes were built.
Methods
Through direct observation of one intervention and two adjacent streets, observers counted cyclists riding on the street and sidewalk, with and against traffic, before and after installation of the lanes. Data were tallied separately for adults, children, males, females, and by race for each location.
Results
There was an increase in cyclists on all three streets after the installation of the bike lanes, with the largest increase on the street with the new lane. Additionally, the proportion of riders cycling with traffic increased after the lanes were striped.
Conclusions
Bike lanes can have a positive impact in creating a healthy neighborhood.
Background:
Schools can be effective settings for improving eating habits and physical activity, whereas it is more difficult to prevent obesity. A key challenge is the "implementation gap". Trade-off must be made between expert-driven programmes on the one hand and contextual relevance, flexibility, participation and capacity building on the other. The aim of the Stockholm County Implementation Programme was to improve eating habits, physical activity, self-esteem, and promote a healthy body weight in children aged 6-16 years. We describe the programme, intervention fidelity, impacts and outcomes after two years of intervention.
Methods:
Nine out of 18 schools in a middle-class municipality in Sweden agreed to participate whereas the other nine schools served as the comparison group (quasi-experimental study). Tailored action plans were developed by school health teams on the basis of a self-assessment questionnaire called KEY assessing strengths and weaknesses of each school's health practices and environments. Process evaluation was carried out by the research staff. Impacts at school level were assessed yearly by the KEY. Outcome measures at student level were anthropometry (measured), and health behaviours assessed by a questionnaire, at baseline and after 2 years. All children in grade 2, 4 and 7 were invited to participate (n=1359) of which 59.8% consented. The effect of the intervention on health behaviours, self-esteem, weight status and BMIsds was evaluated by unilevel and multilevel regression analysis adjusted for gender and baseline values.
Results:
Programme fidelity was high demonstrating feasibility, but fidelity to school action plans was only 48% after two years. Positive and significant (p<.05) impacts were noted in school health practices and environments after 2 years. At student level no significant intervention effects were seen for the main outcomes.
Conclusions:
School staff has the capacity to create their own solutions and make changes at school level on the basis of self-assessment and facilitation by external agents. However these changes were challenging to sustain over time and had little impact on student behaviours or weight status. Better student outcomes could probably be attained by a more focused and evidence-based approach with stepwise implementation of action plans.
Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children's outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim of informing child injury prevention. Generational trends indicate children's diminishing engagement in outdoor play is influenced by parental and societal concerns. We outline the importance of play as a necessary ingredient for healthy child development and review the evidence for arguments supporting the need for outdoor risky play, including: (1) children have a natural propensity towards risky play; and, (2) keeping children safe involves letting them take and manage risks. Literature from many disciplines supports the notion that safety efforts should be balanced with opportunities for child development through outdoor risky play. New avenues for investigation and action are emerging seeking optimal strategies for keeping children "as safe as necessary," not "as safe as possible." This paradigm shift represents a potential for epistemological growth as well as cross-disciplinary collaboration to foster optimal child development while preserving children's safety.
This study investigated the impact of renovation and redesign of a university preschool's outdoor space on children's sedentary behavior, light activity, and moderate-to-vigorous-physical-activity (MVPA) during unstructured recess. Physical activity was measured by accelerometry and direct observation in two independent samples of 50 (baseline) and 57 (postintervention) children (Mage = 4.4 yrs ± 0.5). Controlling for gender, age, BMI and recess length, observational data, but not accelerometry, revealed a significant decrease in intervals spent sedentary (-26.5%) and increases in light physical activity (+11.6%) and MVPA (+14.9%). Higher levels of MVPA were associated with specific environmental changes (new looping cycle path, OR = 2.18; increased playground open space, OR = 7.62; and new grass hill, OR = 3.27). Decreased sedentary behavior and increased light activity and MVPA may be realized with environmental changes that promote continuous and novel movement experiences in more expansive spaces.
This study examined environmental influences on a child's mode of travel between home and school. Grade 7 and 8 students (n = 614) from twenty-one schools throughout London, Ontario, participated in a school-based travel mode survey. Geographic information systems (GIS) were employed to examine environmental characteristics of the child's mode of travel between home and school measured at the scale of the likely travel route. Logistic regression was used to assess what factors influence both the to- and from-school trip. Over 62 percent of students living within 1.6 kilometers (1 mile) of school walked or biked to school and 72 percent walked or biked home from school. Actively commuting to school was positively associated with shorter trips, with distance being the most important correlate. Boys were significantly more likely to use active travel modes than girls. Higher traffic volume along the route was negatively related to rates of active travel and children from higher income neighborhoods were less likely to actively travel than children from lower income neighborhoods. In terms of environmental characteristics, the presence of street trees was positively associated and higher residential densities and mixed land uses were negatively associated with active travel to school. For the journey home, crossing major streets and increased intersection density were negatively associated with active travel. The findings of this research give evidence that active travel is associated with the environmental characteristics of walking routes. This information should be considered for urban planning and school planning purposes to improve children's walking environments.
Two teachers from a school in Copenhagen were allowed to move their third grade teaching into a forest every Thursday for three years. Thus 20% of the class's regular teaching took place in an outdoor environment. The purpose of the present study was to ask the children how they experienced lessons in the classroom and the forest settings. Therefore, two almost identical questionnaires including a total of 26 statements adjusted to each context were completed by the children four times from 2000 to 2003. Further, in the forest questionnaire three specific statements were added about the outdoor environment plus one question about their choice of playmates during breaks at school and breaks in the forest. Ten statements were categorized as ‘social relations’, 14 statements as ‘teaching’ and finally two related to ‘self-perceived physical activity’. A significant difference (p < 0.001) was found between the school/classroom and the outdoor environment when scores from all four questionnaires (2000–2003) were summed. The categories ‘social relations’ (p < 0.001), ‘teaching’ (p < 0.001) and ‘self-perceived physical activity’ (p < 0.001) all showed significant differences. It is concluded from the present case study that the combination of classroom and outdoor teaching, over a three-year period had a positive effect on the children's social relations, experience with teaching and self-perceived physical activity level.
Physical activity levels were measured with an accelerometer in a case study including 19 children, from nine to ten years of age, in a Danish primary school. The teachers conducted their teaching in a forest every Thursday from 2000 to 2003. The purpose of this study was to measure the students' activity levels during outdoor learning days in the forest and compare them with a traditional school day on the one hand, and a traditional school day including two physical education lessons, on the other. The mean activity levels were more than twice as high on the forest days measured on two occasions. Expressed in percentages, winter (2000) measurements were 106% (range 14–194%), and summer (2001) measurements were 113% (range 41–224%) higher compared to traditional school days. Furthermore, in 2002 the mean activity level measured on a day including two physical education lessons was equal to a day in an outdoor environment. In conclusion, this case study demonstrates a significantly higher level of physical activity when indoor and outdoor learning contexts are combined. From a physical health perspective outdoor learning is recommended in the folkeskole.
The physical and social participatory properties of landscapes have been explored using affordance theory but, as yet, the affective dimension of affordances is ill-defined. This paper sets out a framework for integrating affect within the affordance perceptual model. In doing so, it draws on two established models of emotion that identify ‘valence’ (pleasure-displeasure) and ‘arousal’ (inactive-active) as basic dimensions underlying an emotional response. Ethnographic methods were employed over a six-month period to observe the emotional responses to a forest setting in boys (aged 10–12) with extreme behaviour problems and confined to a specialist residential school in central Scotland. Over time, changes in affective responses to the setting were mapped and located both within the physical setting and within the circumplex emotion model. Results show an increase in positive affective responses to the forest setting over time, accompanied by increased trust, exploratory activity and social cohesion, dimensions linked in the literature with well-being. The significance of this paper is two-fold: first, it extends research in restorative health by showing how forest settings can, in a rehabilitation context over time, offer opportunities for long-term ‘instoration’ in boys suffering from extreme mental trauma. Second, it is a first attempt at integrating affect within the affordance perception framework providing a conceptual model which can be expanded upon by future researchers.
Background:
As populations become increasingly urbanised, the preservation of urban green space (UGS) becomes paramount. UGS is not just dedicated recreational space such as public parks, but other types of informal green space are important, for example, street trees and roof gardens. Despite the potential from cross-sectional evidence, we know little about how to design new, or improve or promote existing UGS for health, wellbeing, social and environmental benefits, or known influencing factors such as physical activity.
Objectives:
To perform a meta-narrative review of the evidence regarding the health, wellbeing, social, environmental and equity effects, or known influencing factors of these outcomes, of UGS interventions.
Data sources:
Eight electronic databases were searched ((Medline, PsycINFO, Web of Science (Science and Social Science Citation Indices), PADDI (Planning Architecture Design Database Ireland), Zetoc, Scopus, Greenfiles, SIGLE (System for Information on Grey Literature in Europe)), and reference lists of included studies and relevant reviews were hand searched for further relevant studies.
Study eligibility criteria, participants, and interventions:
Eligibility criteria included: (i) evaluation of an UGS intervention; and (ii) health, wellbeing, social or environmental outcome(s), or known influencing factors of these outcomes, measured. Interventions involving any age group were included. Interventions must have involved: (a) physical change to green space in an urban-context including improvements to existing UGS or development of new UGS, or (b) combination of physical change to UGS supplemented by a specific UGS awareness, marketing or promotion programme to encourage use of UGS.
Study appraisal and synthesis methods:
Following a meta-narrative approach, evidence was synthesised by main intervention approach, including: (i) park-based; (ii) greenways/trails; (iii) urban greening; (iv) large green built projects for environmental purposes. Outcomes such as economic (e.g. cost effectiveness and cost-benefit analyses), adverse effects and unintended consequences were also extracted. Evidence was synthesised following the RAMESES guidelines and publication standards, the PROGRESS-plus tool was used to explore equity impact, and risk of bias/study quality was assessed. The findings from the evidence review were presented at an expert panel representing various disciplines in a workshop and these discussions framed the findings of the review and provide recommendations that are relevant to policy, practice and research.
Results:
Of the 6997 studies identified, 38 were included. There was strong evidence to support park-based (7/7 studies) and greenway/trail (3/3 studies) interventions employing a dual-approach (i.e. a physical change to the UGS and promotion/marketing programmes) particularly for park use and physical activity; strong evidence for the greening of vacant lots (4/4 studies) for health, wellbeing (e.g. reduction in stress) and social (e.g. reduction in crime, increased perceptions of safety) outcomes; strong evidence for the provision of urban street trees (3/4 studies) and green built interventions for storm water management (6/7 studies) for environmental outcomes (e.g. increased biodiversity, reduction in illegal dumping). Park-based or greenway/trail interventions that did not employ a dual-approach were largely ineffective (7/12 studies showed no significant intervention effect). Overall, the included studies have inherent biases owing to the largely non-randomized study designs employed. There was too little evidence to draw firm conclusions regarding the impact of UGS interventions on a range of equity indicators. LIMITATIONS; CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: UGS has an important role to play in creating a culture of health and wellbeing. Results from this study provide supportive evidence regarding the use of certain UGS interventions for health, social and environmental benefits. These findings should be interpreted in light of the heterogeneous nature of the evidence base, including diverging methods, target populations, settings and outcomes. We could draw little conclusions regarding the equity impact of UGS interventions. However, the true potential of UGS has not been realised as studies have typically under-evaluated UGS interventions by not taking account of the multifunctional nature of UGS. The findings have implications for policymakers, practitioners and researchers. For example, for policymakers the trajectory of evidence is generally towards a positive association between UGS and health, wellbeing, social and environmental outcomes, but any intervention must ensure that negative consequences of gentrification and unequal access are minimised.
Physical activity in Canada mirrors the gender gap observed globally, with boys more likely than girls to meet recommended guidelines. While a growing body of research has examined the relationships between environmental factors and children’s physical activity levels, much less is known about how environments play a role in gendering physical activity. In this paper, using a material feminist approach to environmental affordances, we explore girls’ perspectives on the features of their everyday environments that support or inhibit their uptake of physical activities in Southwestern Ontario, Canada. As part of the larger multi-method Spatial Temporal Environment and Activity Monitoring (STEAM) project, we held six focus groups with girls ages 10–12 years from rural, suburban, and urban schools. Through inductive thematic analysis, we identified two themes: (1) Outdoor matter matters for physical activity, and (2) Social levers and liabilities shape physical activity affordances. Our results indicate that some girls may be better afforded physical activity opportunities by providing proximate outdoor play in spaces with natural elements and diverse infrastructure, coupled with efforts to alleviate social liabilities (e.g., care responsibilities) and leverage social supports (e.g., peers). Based on our findings, we put forward naturalised schoolyards as a potentially gender-sensitive physical activity intervention. This study contributes to identifying the gendered ways in which environments may differentially ‘afford’ children opportunities for physical activity, thereby opening the way for developing more gender-equitable interventions.
In this article we have provided a perspective on the importance and value of youth mental health services for society and argued that advancing youth mental health services should be the number one priority of health services in Canada. Using the age period of 12-25 years for defining youth, we have provided justification for our position based on scientific evidence derived from clinical, epidemiological and neurodevelopmental studies. We have highlighted the early onset of most mental disorders and substance abuse as well as their persistence into later adulthood, the long delays experienced by most help seekers and the consequence of such delays for young people and for society in general. We have also provided a brief review of the current gross inadequacies in access and quality of care available in Canada. We have argued for the need for a different conceptual framework of youth mental disorders as well as for a transformation of the way services are provided in order not only to reduce the unmet needs but also to allow a more meaningful exploration of the nature of such problems presenting in youth and the best way to treat them. We have offered some ideas based on previous work completed in this field as well as current initiatives in Canada and elsewhere. Any transformation of youth mental health services in Canada must take into consideration the significant geographic, cultural and political diversity across the provinces, territories and indigenous peoples across this country.
Background: Urban greenspace can benefit mental health through multiple mechanisms. They may work together, but previous studies have treated them as independent.
Objectives: We aimed to compare single and parallel mediation models, which estimate the independent contributions of different paths, to several models that posit serial mediation components in the pathway from greenspace to mental health.
Methods: We collected cross-sectional survey data from 399 participants (15 – 25 years of age) in the city of Plovdiv, Bulgaria. Objective “exposure” to urban residential greenspace was defined by the Normalized Difference Vegetation Index (NDVI), Soil Adjusted Vegetation Index, Tree cover density within the 500-m buffer, and Euclidean distance to the nearest urban greenspace. Self-reported measures of availability, access, quality, and usage of greenspace were also used. Mental health was measured with the General Health Questionnaire. The following potential mediators were considered in single and parallel mediation models: restorative quality of the neighborhood, neighborhood social cohesion, commuting and leisure time physical activity, road traffic noise annoyance, and perceived air pollution. Four models were tested with the following serial mediation components: (1) restorative quality social cohesion; (2) restorative quality physical activity; (3) perceived traffic pollution restorative quality; (4) and noise annoyance physical activity.
Results: There was no direct association between objectively-measured greenspace and mental health. For the 500-m buffer, the tests of the single mediator models suggested that restorative quality mediated the relationship between NDVI and mental health. Tests of parallel mediation models did not find any significant indirect effects. In line with theory, tests of the serial mediation models showed that higher restorative quality was associated with more physical activity and more social cohesion, and in turn with better mental health. As for self-reported greenspace measures, single mediation through restorative quality was significant only for time in greenspace, and there was no mediation though restorative quality in the parallel mediation models; however, serial mediation through restorative quality and social cohesion/physical activity was indicated for all self-reported measures except for greenspace quality.
Conclusions: Statistical models should adequately address the theoretically indicated interdependencies between mechanisms underlying association between greenspace and mental health. If such causal relationships hold, testing mediators alone or in parallel may lead to incorrect inferences about the relative contribution of specific paths, and thus to inappropriate intervention strategies.
This study explored youths' experiences and perceptions about community engagement as a result of participating in a community-based data collection project using paper and mobile technology park environmental audit tools. In July 2014, youth (ages 11-18, n=50) were recruited to participate in nine focus groups after auditing two parks each using paper, electronic, or both versions of the Community Park Audit Tool in Greenville County, SC. The focus groups explored the youths' experiences participating in the project, changes as a result of participation, suggested uses of park audit data collected, and who should use the tools. Four themes emerged related to youths' project participation experiences: two positive (fun and new experiences) and two negative (uncomfortable/unsafe and travel issues). Changes described as a result of participating in the project fell into four themes: increased awareness, motivation for further action, physical activity benefits, and no change. Additionally, youth had numerous suggestions for utilizing the data collected that were coded into six themes: maintenance & aesthetics, feature/amenity addition, online park information, park rating/review system, fundraising, and organizing community projects. Finally, six themes emerged regarding who the youth felt could use the tools: frequent park visitors, community groups/organizations, parks and recreation professionals, adults, youth, and everyone. This study revealed a wealth of information about youth experiences conducting park audits for community health promotion. Understanding youth attitudes and preferences can help advance youth empowerment and civic engagement efforts to promote individual and community health.
Introduction:
The current study utilised objective techniques to investigate the relationship between children's time spent in greenspace (open land covered in grass or other vegetation) with various physical and psychological variables. Potential relationships between physical activity and greenspace with body composition, emotional wellbeing, sensation seeking tendencies, ability to appraise risk, and cognitive development are investigated.
Methods:
108 participants aged 11-14 years from three intermediate schools in Auckland, New Zealand, were assessed. Moderate-to-vigorous physical activity (MVPA) and geolocational data were recorded using accelerometers and portable global positioning system (GPS) receivers (respectively) over a 7-day period in September-December 2014. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated from height, weight, and waist circumference. Participants also completed online cognitive testing, a computerised risk appraisal tool, and a questionnaire for assessing emotional wellbeing and sensation seeking characteristics. Data analysis took place during February to May 2015. Generalised linear mixed models were used to quantify the associations between MVPA, greenspace exposure, and secondary outcome variables.
Results:
Findings confirmed that greenspace exposure is positively associated with MVPA in children (B=0.94; p<0.05). Furthermore, both greenspace exposure and MVPA were related to greater emotional wellbeing, with the former exhibiting a stronger relationship than the latter. Risk-taking and sensation seeking scores were positively associated with MVPA, but not with greenspace exposure. No associations were detected between BMI, WHtR, cognitive domains, and either MVPA or greenspace exposure.
Conclusions:
Findings support the theory that for children, greenspaces are an important environmental influence on physical activity and emotional wellbeing.
Thesis (Ph. D.)--University of Minnesota, 2002. Includes bibliographical references (leaves 170-181).
This study investigates the association between perceived restorativeness of high school greenness and students’ perceived restoration and health. A total of 223 high school students’ aged 12–20 participated in the study. Measures included Attention Restoration Theory components (i.e. being away, fascination, coherence, and compatibility), naturalness of school greenness, and health indicators (i.e. stress, mental health, physical health, and quality of life). Bivariate correlations and multivariate regression analysis controlling for sex, age, accommodation, and income showed that perceived restorativeness (i.e. being away (b = .29, p ≤ .001), fascination (b = .35, p ≤ .001), coherence (b = .09, p ≤ .041), and compatibility (b = .35, p ≤ .001)) is predicted by the green space present in the high school campus. For health, none of the health indicators was correlated with high school greenness. Stratified analyses showed that boys reported better perceived restorativeness (i.e. being away, fascination, and compatibility) and less stress (b = .19, p ≤ .037) compared to girls. Younger students reported better health (i.e. physical health (b = .27, p ≤ .034) and quality of life (b = .45, p ≤ .027)), whereas older students reported stronger perceived restorativeness than younger students. Commuter students reported positive perceived restorativeness (i.e. being away, fascination, and compatibility), while boarder students reported negative perceived restorativeness. Findings indicate that high school greenness could be an effective resource in contributing to students’ perceived restoration. However, for health benefits students’ perception and preferences for certain qualities and features of green space in schools should be provided.
Few controlled evaluations of Safe Routes to School (SRTS) initiatives have been conducted. The Texas Childhood Obesity Prevention Policy Evaluation (T-COPPE) study included three conditions: schools awarded infrastructure (I) projects (n = 23), schools awarded noninfrastructure (NI) projects (n = 21), and matched comparison (C) schools (n = 34). Fourth-grade children completed tallies to determine transport to/from schools. Serial cross-sectional surveys were collected from students and parents at baseline (2009) and follow-up (2012). Data were analyzed using mixed linear regression and growth curve models. Morning percent active commuting to school (ACS) in I and NI schools were higher than C schools (p = .024, p = .013, respectively). Afternoon percent ACS in NI schools decreased more over time compared with C schools (p = .009). I and NI school students had higher ACS self-efficacy; similar results were noted for parents in I schools. Policies that provide cost-reimbursement funding for SRTS achieve modest short-term ACS outcomes, with few differences between types of funding allocations.
The purpose of this study was to determine differences in sedentary behaviors and moderate-to-vigorous physical activity (MVPA) levels and playground utilization of young children before and after renovating a traditional playground to incorporate more natural elements. After initial assessments, the traditional playground was converted to a natural playground. Both playgrounds consisted of a covered porch and a play area. A significantly greater proportion of children engaged in MVPA on the playground after the renovation. The average number of children using the covered porch decreased and increased for the play area. These results suggest that the use of natural playgrounds may be a way to increase MVPA in children.
Almost 20% of American children aged 6 to 11 years are obese. A decrease in physical activity has been associated with an increase in obesity. The school environment is one place where many children can be reached. This cross-sectional study determined which types of playground areas attract children and promote moderate to vigorous physical activity (MVPA) or sedentarism.
Children on two urban elementary school playgrounds (one of which offered a jogging program called Jog and Walk Stars [JAWS]) were observed before school with use of the System for Observing Play and Leisure Activity in Youth and System for Observing Play and Recreation in Communities observational tools. Descriptive statistics, paired-samples t tests, and independent-samples t tests were used to analyze the data.
The highest populated areas for schools K and B on non-JAWS days were the general blacktop areas; however, approximately 50% of the children in these areas were sedentary. At school B on days when the JAWS program was offered, the highest populated area was the JAWS track, and 99% of those children participated in MVPA. There was a significant difference in counts for average total sedentary children per square foot between school K (M = 216.70) and school B on JAWS days: M = 80.38, t (22.02) = 2.24, p < .5, two-tailed.
A playground environment assessment to identify areas that promote MVPA, such as offering a JAWS program, may be one avenue to address the need for increasing MVPA levels in children in general, in addition to physical education class, and help them obtain the recommended 60 minutes of daily MVPA.
Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Objective
This study examines effects of a school garden intervention on elementary school children’s physical activity (PA).
Method
Twelve schools in New York were randomly assigned to receive the school garden intervention (n = 6) or to the waitlist control group that later received gardens (n = 6). PA was measured by self-report survey (Girls health enrichment multi-site study Activity Questionnaire) (N = 227) and accelerometry (N = 124, 8 schools) at baseline (Fall 2011) and follow-up (Spring 2012, Fall 2012, Spring 2013). Direct observation (N = 117, 4 schools) was employed to compare indoor (classroom) and outdoor (garden) PA. Analysis was by general linear mixed models.
Results
Survey data indicate garden intervention children’s reports of usual sedentary activity decreased from pre-garden baseline to post-garden more than control group children’s (Δ = -.19, p = .001). Accelerometry data reveal that during the school day, children in the garden intervention showed a greater increase in percent of time spent in moderate and moderate-to-vigorous PA from baseline to follow-up than control group children (Δ = + .58, p = .010; Δ = + 1.0, p = .044). Direct observation within-group comparison of children at schools with gardens revealed that children move more and sit less during an outdoor garden-based lesson than during an indoor, classroom-based lesson.
Conclusion
School gardens show some promise to promote children’s PA.
Clinical Trials Registration: clinicaltrials.gov #NCT02148315
In this study, we investigated the relationship between school ground design and children's physical activity levels. In particular, we were interested in understanding the contribution of 'green' school ground design to physical activity levels. Data for this study were collected at an elementary school in Australia and in Canada. At each school, scans of Target Areas were completed to record the students' location and intensity of physical activity, based on the System for Observing Play and Leisure Activity in Youth (SOPLAY) (Australia: 23 scans, 6 Target Areas; Canada: 18 scans, 7 Target Areas). At both schools, the highest percentage of children present was engaged in vigorous physical activity on the manufactured equipment (42% of children/scan). Similarly, at both schools, the green area encouraged the highest percentage of children present to be engaged in moderate physical activity (47% of Australian children/scan, 51% of Canadian children/scan). The patterns of sedentary behavior differed slightly between countries. At the Australian school, the paved sporting courts (57%) and the paved canteen courtyard (50.5%) promoted the highest degree of sedentary play. At the Canadian school, the treed grassy berm (42%) and the treed concrete steps (43%) encouraged the highest percentage of sedentary behavior, followed by the open asphalt (34%). These results are also discussed in light of gender distribution. We conclude with a discussion of the design and cultural factors that influence children's physical activity on school grounds. We argue that if school grounds are to realize their potential to promote physical activity, they should include a greater diversity of design features and 'green' elements that engage children of varying interests and abilities in active play.
To evaluate the impact of a multi-level intervention on the physical activity levels of 3-5year old children attending center-based childcare services.
The trial was conducted in New South Wales Australia in 2010 in 20 centers with 459 children. The intervention, included: fundamental movement skill sessions; structured activities; staff role modelling; limiting small screen recreation and sedentary time; and anactivity promoting physical environment. Control services continued with usual routines. Physical activity during care was assessed using pedometers at baseline and at six months after baseline. Intervention implementation was assessed via observation of staff physical activity practices and audits of service environment and policy.
Mean step counts at baseline and follow-up were 17.20 (CI 15.94-18.46) and 16.12 (CI 14.86-17.30) in the intervention group and 13.78 (CI 12.76-14.80) and 13.87 (CI 12.57-15.17) in the control group (p=0.12). Intervention services showed significantly greater increases in the total minutes that teachers led structured activities, relative to control group services (p=0.02).
The intervention showed no significant effect on child step counts per minute despite increasing time that staff delivered structured activity which is likely to be attributable to difficulties experienced by service staff in delivering a number of intervention components.
The importance of play for children’s development and wellbeing has been well established. However, disabled children and their families frequently find accessing play sites challenging due to a range of physical and social barriers and are therefore unable to experience many of the benefits play in this setting provides. Increasingly, United Kingdom policy has recognised this with the 2008 Play Strategy making an explicit commitment supported by funding to ensure that more inclusive public play facilities are developed. Using a case study example of a newly developed ‘inclusive’ play facility, this paper examines the views of young disabled people and their families regarding what makes a play facility inclusive. Using a socio-spatial analysis the paper identifies the importance of not only addressing physical constraints but also creating a space where disability is viewed positively and able-bodied discourses are not privileged at the expense of others. The importance of consulting with families, location of facilities and the role of play workers are all analysed. The paper concludes by critically examining the implications of the findings for the delivery of the Play Strategy particularly within the context of public spending cuts imposed by the new Coalition Government, and considers whether inclusive play spaces can become a standard and embedded part of community facilities.
This study examined the effects of different recess timing regimens on preschoolers’ classroom attention. Using cognitive immaturity theory, we predicted that attention to a classroom task would be greater after a recess break. We also examined the extent to which different recess timing regimens related to post‐recess attention. Participants were 27 European American children (18 girls and nine boys; mean = 55.56 months, standard deviation = 4.01) from a northeastern US preschool. Observations were made in the classroom before and after recess and outdoors on the playground during recess. Findings revealed that post‐recess attention was greater following sustained outdoor play periods. Gender differences emerged. Girls were more attentive to classroom tasks than boys were. Our findings support and parallel empirical findings with primary school children on the role of recess in children’s cognitive performance. It seems reasonable that outdoor recess breaks rejuvenate young children and help them attend to classroom tasks.
Objective:
To explore the effects of an innovative school-based intervention for increasing physical activity.
Methods:
226 children (5-7 years old) randomly selected from 12 Australian primary schools were recruited to a cluster randomised trial with schools randomly allocated to intervention or control conditions. The 13-week intervention comprised: (1) altering the school playground by introducing loose materials and (2) a teacher-parent intervention exploring perceptions of risk associated with children's free play. The primary outcomes were total accelerometer counts and moderate-vigorous physical activity during break times. Testing took place in Sydney, 2009-2010.
Results:
221 participants were tested at baseline. Mixed-effect multilevel regression revealed a small but significant increase from the intervention on total counts (9400 counts, 95% CI 3.5-15.2, p=0.002) and minutes of MVPA (1.8 min, 95% CI 0.5-3.1, p=0.006); and a decrease in sedentary activity (2.1 min, 95% CI 0.5-3.8, p=0.01) during break times. We retested children in one intervention school after 2 years; they maintained the gains.
Conclusions:
Capturing children's intrinsic motivations to play while simultaneously helping adults reconsider views of free play as risky provided increases in physical activity during break times. Using accelerometry as the sole measure of physical activity may underestimate the effect.
Trial registration:
ACTRN12611000089932.
Abstract The purpose of this study was to establish whether an accumulated brisk walking programme, performed during the school day, is effective in changing body composition in primary school children aged 5-11 years. Altogether, 152 participants (79 boys and 73 girls) took part in this repeated-measures intervention study, divided into groups of walkers and controls. The walkers took part in the intervention during school time, which involved brisk walking around the school grounds for 15 min in the morning and afternoon, at least three times a week for 15 weeks. This represented an additional 90 min of moderate physical activity per week. The controls undertook their usual school day activities. Pre- and post-intervention anthropometric and body composition measures were taken. Body fat (-1.95 ± 2.6%) and fat mass (-0.49 ± 1.0 kg) were significantly reduced in the walkers after the intervention, whereas the controls showed no significant changes in these measures. Our results show that regular accumulated bouts of brisk walking during the school day can positively affect body composition in primary school children.