CONTEXT

Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health.

OBJECTIVE

We systematically evaluated evidence regarding the relationship between nature contact and children’s health.

DATA SOURCES

The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021.

STUDY SELECTION

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms.

DATA EXTRACTION

Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed.

RESULTS

The strongest evidence for type of nature exposure was residential green space studies (n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity (n = 108, 32%) and cognitive, behavioral, or mental health (n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design.

LIMITATIONS

Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional (n = 204, 69%), limiting our ability to assess causality.

CONCLUSIONS

Current literature supports a positive relationship between nature contact and children’s health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn.

The American Academy of Pediatrics has long recognized the importance of play and has encouraged outdoor play to promote children’s health and social-emotional development.13  Outdoor play environments vary widely, from urban parking lots to grass sports fields to wilderness. There is increasing evidence that outdoor play environments containing natural elements may offer health benefits that come specifically from engaging in the natural world. Recent studies have demonstrated that a broad range of outcomes are related to access to, and contact with nature, including increased physical activity, reduced obesity, decreased stress, and improved mental health.46 

However, nature contact is not regularly experienced by all children because of urbanization, sedentary indoor lifestyles, and disparities in access to green space.79  Neighborhoods with more socioeconomically disadvantaged residents and families of color tend to have fewer nearby residential parks, and financial and transportation limitations that prevent access to parks and wilderness outside of city limits.1013  This inequity extends to school grounds in low-income neighborhoods, which are less likely to have school gardens compared with schools in high-income neighborhoods.11  Furthermore, there is evidence that contact with nature and green space may disproportionately benefit disadvantaged populations by attenuating the toxic effects of poverty: the so-called “equigenic” effect.1417  For these reasons, promoting nature contact and ensuring equitable access to green spaces could play a role in improving health outcomes and behaviors, and reducing health disparities.18 

Pediatricians are uniquely positioned to offer guidance about evidence-informed interventions to promote child health during clinical interactions, and through community advocacy. Our goal was to conduct a systematic review to aggregate and evaluate the evidence regarding the effects of nature contact on children’s health, and to make it available to pediatric health care providers. Therefore, we explore the full breadth of quantitative evidence with a systematic literature search and consensus-based review process to make the evidence accessible on which to base clinical recommendations, health-promoting programs, and policies and to guide future research.

This review followed Preferred Reporting Items for Systematic Reviews procedures and guidelines19  and was registered in the International Prospective Register of Systematic Reviews systemic review database (Registration number: CRD42018087552).20 

We developed a comprehensive search strategy of relevant databases in consultation with a University of Washington librarian. The electronic database search was initiated in PubMed by using the first iteration of the search terms; subsequent searches were conducted in Cumulative Index to Nursing and Allied Health Literature, PsycInfo, ERIC, Scopus, and Web of Science databases. In all searches (Supplemental Information 1), the first element included nature terms (eg, green space) and the second element included child health outcome terms (eg, physical activity). Broad search terms were selected, and truncated terms and several variations of the same term were included to capture all relevant articles. Because different databases use different search methods, a revision of the initial search string was often required to fit each database’s search method to maximize results. We excluded articles that (1) included only participants 19 years of age or older, (2) involved nonhuman subjects, (3) were written in languages other than English, (4) were systematic literature reviews, (5) lacked text describing natural environments, (6) had exposures that combined nature contact and a nonnature environmental factors, (7) examined outcomes not related to child health, or (8) the exposure was measured prenatally (Supplemental Information 2). The database search was completed on February 23, 2021.

Title and Abstract Screening

Initial study screening and selection was performed by using Covidence, a Web-based platform for managing systematic literature reviews that facilitates removing duplicates, screening citations for relevance, abstract and full text review, study extraction, and risk of bias assessment.21  We established criteria for study inclusion and exclusion by consensus. Criteria are specified in Supplemental Information 2. All titles and abstracts of selected studies were screened by 2 authors to determine whether to include or exclude for full text review. If a study received conflicting votes or if the reason for exclusion differed between the 2 reviewers, consensus was reached through discussion with a third author.

Full Text Review

All studies retained after the title and abstract screening phase then underwent full text review by 2 authors. The full text review was the final step for determining if a study would be included or excluded from the final literature review. If the reviewers disagreed or if the reason for exclusion differed between the 2 reviewers, consensus was reached through discussion with a third author.

Data Extraction and Quality Assessment

All studies selected for inclusion in the full text review were independently evaluated for quality by 2 authors using the Mixed Methods Appraisal Tool (MMAT), a reliable and valid quality assessment tool for multiple study designs including quantitative randomized controlled trials (RCTs) and quantitative nonrandomized trials (eg, experimental, observational, etc).22  The MMAT includes 5 items, with different questions for RCTs and quantitative nonrandomized study designs. We did not generate an overall MMAT score to define high- or low-quality studies because we deemed an overall score alone is insufficient to identify methodologic strengths and weaknesses. Instead, in accordance with recommendations from the MMAT developers, we examined which MMAT questions met criteria to receive a “yes,” “can’t tell,” or “no.” MMAT questions were stratified by study design and “yes” answers indicated a more rigorous methodologic approach. Consensus for quality assessment was reached between 2 reviewers.

In reviewing the Cochrane tools for bias assessment, Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) for nonrandomized designs and Risk of Bias 2 (RoB 2) for RCTs,23,24  we determined these tools were excellent but not feasible given their extensive criteria for the large number of articles included in our review (n = 296). Thus, we examined other tools that rigorously identified common and relevant sources of bias and had established reliability and validity. We had originally intended the MMAT to be used only to assess study quality.22  On review, we recognized that many of the MMAT questions assessed relevant areas of bias. For example, appraising whether participants were representative of the target population assesses selection bias, and evaluating whether outcome data are complete assesses attrition bias (see Supplemental Table 6 for detailed description). This approach has been used in other recent systematic reviews.25,26  All studies were reviewed for bias by 2 reviewers using the MMAT.22  Risk of bias was scored as low (“yes” on MMAT, indicating higher quality), unclear (“can’t tell” on MMAT, indicated uncertainty in quality), or high (“no” on MMAT, indicated lower quality). Consensus was reached by at least 2 reviewers for all articles.

We used a previously published framework to categorize nature exposures27 : gardening, green space activity (eg green space not near residence or school), residential green space, school green space, greening intervention, wilderness experience, nature walk, and “other.” Studies in which researchers evaluated mixed spaces were categorized as other. Measures of nature exposure included self or proxy-report measures, intervention-associated exposures, and objective measures such as land-use data and Normalized Difference Vegetation Index, an approach used to estimate the density of green on an area of land.28  Studies with multiple nature exposures were included; each exposure was included independently.

We grouped health outcomes and behaviors into 7 categories: (1) physical activity; (2) cognitive, behavioral, and mental health; (3) BMI; (4) cardiovascular and metabolic measures; (5) asthma and allergy; (6) academic and learning; and (7) other. For mental health outcomes, we included a range of outcomes from psychological well-being to mental health diagnoses.29  We limited our academic and learning outcomes category to those most related to classroom performance. Studies with multiple outcomes were included; each outcome was included as an independent outcome.

We used standard definitions of study designs, to maintain consistency across reviewers.30  Because there is no accepted standardized metric that formally summarizes strength of evidence for systematic literature reviews, we relied on the clinical and methodologic expertise of our authorship team to determine the variables critical to assessing methodologic strength of evidence. The a priori variables included (1) number of “yes” responses on the MMAT, (2) number of studies within each nature exposure or health outcome category, (3) sample size (n) within each study, (4) strength of association, (5) consistency in results, (6) variability in outcomes, and (7) study design. Strength of evidence was determined by consensus by the full authorship group and ranked on an eight-point scale: low (−), low, low (+), moderate (−), moderate, moderate (+), high (−), or high. Final strength of evidence classification indicates the strength of a positive association between nature and health in childhood (ie, health promoting).

Study Design, Nature Exposures, and Health Outcomes and Behaviors

Our search yielded 10 940 studies for title and abstract screening; 296 were selected for inclusion (Fig 1). Among included studies, the majority were observational (n = 225, 76%), and of these, 204 (69%) were cross-sectional. Only 13 (4%) were RCTs. Half of the studies examined the presence of residential green space (n = 147, 50%) as the nature exposure. The most common health outcomes and behaviors were physical activity (n =108, 32%); cognitive, behavioral, or mental health (n = 85, 25%); and BMI (n = 45, 13%) (Fig 2). No strength of evidence summary is reported for studies in the “other” nature exposures3151  or health outcomes and behaviors33,40,5282  categories because of high variability in exposures and outcomes evaluated.

Risk of Bias

Overall, observational studies (n = 225) had the lowest risk for bias (Fig 3). Although 44% were at high risk of selection bias because of participants not being representative of the target population, there was low risk of bias in all other bias categories evaluated. For experimental studies (n = 58), 95% of studies were at high risk of selection bias because of participants not being representative of the target population and 55% of studies were at high risk of confounding bias. For RCTs (n = 13), 46% had a high risk of selection bias because of groups not being comparable at baseline; 62% had a high risk of detection bias because of outcome assessors not being blinded to intervention assignment.

Quality Assessment

To assess methodologic limitations and opportunities to strengthen evidence in future studies, we summarized the results of studies meeting criteria for a “yes” (more rigorous) categorization for each MMAT question and stratified results by study design (Tables 1 and 2). For the RCTs (n = 13), no studies had outcome assessors that were blinded to group allocation, and 31% (n = 4) of studies had groups that were comparable at baseline. For experimental studies (n = 58), 2% (n = 1) included participants representative of the target population and 33% (n = 19) adequately accounted for confounding. Observational studies (n = 225) had similar challenges. Only 48% (n = 108) enrolled participants representative of the target population and 79% (n = 178) appropriately measured the of outcome of interest. In most studies, regardless of design, the intervention (or exposure in observational studies) was administered as intended.

High (−): Residential Green Space (n = 147)

Studies of residential green space were largely observational (97%, n = 143), and approximately half used geographic information system mapping as an objective assessment of nature exposure (Table 3).* Overall, n = 86 (59%) reported positive associations between nature exposure and improved health, n = 50 (34%) reported mixed or null results, and n = 11 (7%) found negative associations. Most of the negative associations were reported for asthma and allergy-related conditions (n = 8, 5%), which had considerable diagnostic heterogeneity (eg, conjunctivitis, asthma, allergy, etc) and type of allergen (eg, grass, trees, etc). Physical health outcomes and behaviors were most common (n = 110, 75%), followed by mental health (n = 30, 20%) and academic or learning outcomes (n = 7, 5%). Researchers in the single RCT found that increased residential park density was associated with a decrease in BMI z scores in overweight rural youth (8–14 years).93 

Moderate (±): School Green Space (n = 40)

Studies evaluating school green space were 90% observational and 10% experimental (no RCTs) (Table 3). Researchers of 1 large longitudinal cohort study (n =94 997) reported that children attending schools in neighborhoods with greater green space density (eg, parks) had improved fitness during the school year.224  Overall, associations between school green space and child health were mostly positive (n = 33, 83%); n = 4 (10%) had null or mixed findings and n = 3 (7%) reported negative associations. The most common outcomes were physical health (n =22, 55%), academic or learning outcomes (n = 12, 30%), and last, mental health (n = 4, 10%).

General Green Space Activity (n = 35)

For general green space activity, 80% of the studies were observational (Table 3).73,250283  Most associations were positive (n = 19, 54%), n = 16 (46%) found null or mixed results, and no negative associations were reported. The most common outcomes were physical health (n =27, 77%), then mental health (n = 6, 17%), and last, academic or learning outcomes (n = 2, 6%). The single RCT reported that preschool-aged children attending a 10-week nature program reported lower stress and changes in fecal serotonin and gut microbiome diversity.73 

Moderate (−)

Wilderness experience (n =  11)58,59,284291  and gardening (n = 12)5256,72,77,79,292295  were both categorized as moderate (−) (Table 3). Although there was strong and consistent evidence supporting a positive impact of nature exposure on health outcomes and behaviors in these categories, both contained a limited number of studies with additional noteworthy methodologic weaknesses. All studies evaluating wilderness experience were experimental but generally had small sample sizes (median n = 58), and only 27% accounted for confounders. Gardening studies had wide variation in the types of outcomes, making it difficult to assess consistency in results; 84% were experimental or RCTs and 42% reported null or mixed results. Two RCTs randomized schools to gardening interventions; positive associations were found for school gardens increasing moderate-to-vigorous physical activity (accelerometry)295  and science knowledge.293 

Low (±) or Low

Classroom interventions (n = 17)233,296311  were categorized as low (+) strength of evidence (Table 3). Greening interventions (n = 9)57,68,312318  and nature walks (n = 4)319322  were both categorized as low strength of evidence primarily because of the small number of studies within each category. Most (77%) of the greening intervention studies were experimental or RCTs; 56% reported null or mixed results. All 4 nature walk studies were experimental and reported positive associations, but median sample size was small (n = 42) and none adjusted for appropriate confounders. The single RCT in the greening intervention category reported decreases in depressed affect, antisocial behavior, and moderate-to-vigorous physical activity (accelerometry) after renovating outdoor preschool spaces to include more natural elements.313  Although the authors noted that lower moderate-to-vigorous physical activity was unexpected, activity was measured only during the scheduled outdoor period (20-minute interval), and the reduction was small (1.32 minutes, SE = 0.37, P < .001).313  In 1 RCT in the “other” category, researchers found that psychological well-being was improved for adolescents in an outdoor versus indoor space after completing stressor tasks37 ; researchers in another reported that views of green landscapes versus rooms without windows improved attention performance and stress recovery in high school students.40 

When evaluating the strength of evidence stratified by health outcome (Table 4), we incorporated all outcomes including when multiple health outcomes and behaviors were reported within individual studies. Thus, our final sample size (n = 343) is larger than the total study number (n = 296).

High (−): Physical Activity (n = 108)

Researchers in most studies evaluating physical activity were observational (n = 88, 81%), used objective measures such as accelerometry (n = 59, 55%), and reported positive associations (n = 71, 66%). Null or mixed results for physical activity were found in n = 33 studies (31%), and n = 3 studies (3%) reported negative associations. The most common nature exposures for physical activity were residential green space (n = 45, 42%) and general green space activity (n = 25, 23%). The one RCT in this category found that low-income elementary schools randomly assigned to gardening interventions reported children had increased moderate-to-vigorous physical activity (accelerometry) compared with control schools.295 

Cognitive, Behavioral, and Mental Health (n = 85)

Of the studies evaluating cognitive, behavioral, and mental health, 58% were observational (n = 49), but 37% (n = 31) were experimental and 6% (n = 5) were RCTs.§ Positive associations were found in 71 studies (83%), and 12 studies (15%) reported mixed or null results; 2 studies (2%) reported negative associations. Within this broad category, attention and depression were the most common outcomes. Studies revealing positive associations between nature contact and mental health most commonly used the reliable and valid Strengths and Difficulties Questionnaire.325  The primary nature exposure used to assess cognitive, behavioral, and mental health outcomes was residential green space (n = 34, 42%). Most wilderness exposure studies also evaluated behavioral and mental health (n = 8, 10%). All 5 RCTs reported positive associations with well-being,57  mental fatigue recovery,40  cognitive tasks and emotional status,49  performance tasks and perceived restorativeness,322  and perceived stress.73 

Moderate (−) Overweight and Obesity (BMI) (n = 45)

Studies evaluating childhood weight status were categorized as having only moderate (−) strength of evidence because most were observational (n = 41, 91%).ǁ Roughly one-third (n = 16, 36%) reported positive associations, but more than half (n = 27, 60%) reported mixed or null results and n = 19 (42%) were null. Two negative associations were reported (4%). Residential green space was the most common nature exposure evaluated (n = 34, 76%). Of the 2 RCTs, researchers in 1 found that increased residential park density, as part of a larger behavioral weight management intervention that included dietary education, was associated with a decrease in BMI z scores in overweight rural youth (8–14 years).93  In the other, researchers reported null results for the effect of a school-based gardening intervention on BMI.294 

Low (±) or Low

Academic and learning outcomes (n = 27), asthma and allergy outcomes (n = 26),# and cardiovascular and metabolic outcomes (n = 16),** were all categorized as low (+) principally because of the small number of studies within each category. Academic and learning outcomes varied widely with the most common outcome being grades and test scores (n = 14, 52%). Many of these studies reported positive associations (n = 22, 81%), n = 5 (19%) reported mixed or null results, and one study reported that green space was negatively correlated with academic achievement.217  Researchers in both RCTs found no difference in achievement for children in outdoor compared with indoor settings.293,301  Studies in the asthma and allergy category were all observational. Positive associations were reported for n = 13 studies (50%); negative associations were found in n = 8 (31%) studies, indicating that green space may exacerbate allergies or asthma in certain scenarios in childhood. For cardiovascular and metabolic outcomes, n = 7 (44%) of studies reported positive associations and n = 9 (56%) reported null or mixed results. Most were observational (n = 9, 56%) and focused on blood pressure (n = 8, 50%). The remaining studies reported heterogenous outcomes. All 3 RCTs reported null results for the associations between dish gardens in hospitalized patients and blood pressure,49  school-based gardening intervention and blood pressure,294  and time in outdoor and indoor environments for heart rate and heart rate variability.37 

Negative Associations

Authors in 15 studies reported negative associations between nature exposures and health outcomes or behaviors, primarily in residential green space (n = 11, 73%) (Table 3). Most negative associations were reported for asthma and allergy-related conditions (n = 8, 53%), which had considerable heterogeneity both for diagnosis (eg, conjunctivitis, asthma, allergy, etc) and for the type of allergen (eg, grass, trees, etc) (Table 4).†† Three studies (3%) evaluating physical activity reported negative associations: living in an urban green neighborhood reduced walking or bicycling,145  renovation of an outdoor space at a preschool decreased moderate or vigorous physical activity,313  and living in greener neighborhoods was associated with higher inactivity.225  Researchers in 2 studies (2%) examining cognitive, behavioral, or mental health reported negative associations. In one, more green space play time was associated with increased behavioral difficulties,214  and increased neighborhood parks or playgrounds was associated with more depressed feelings and mood.174 

Our systematic review included a substantial body of literature, covering a wide range of nature exposures and outcomes, and most often found positive associations between nature exposure and children’s health. The evidence for an association between nature and health is currently most compelling for outcomes related to physical activity and cognitive, behavioral, and mental health. For nature exposures, the evidence was strongest for presence of green space near the child’s home, school, and for activity done in green spaces, highlighting the importance of ready access to nature. We believe our review warrants pediatricians, public health practitioners, and policy makers claiming a solid and growing body of evidence for policies and practices that promote environmental justice and equitable nature contact for children where they live, play, and learn.

Although outdoor time is associated with health benefits and daily outdoor play is recommended for children,2  we excluded studies that only reported outdoor time and did not specifically describe nature contact. Although focusing only on outdoor time is simple, all outdoor spaces are not comparable: a parking lot is not a park, an urban playground without natural elements is not a garden. The purpose of this review was to assess the literature specifically focused on contact with the natural world for children’s health. We evaluated the full breadth of quantitative evidence with a systematic search and consensus-based review process.

Although many types of nature exposures were studied, most researchers examined nature or green space contact close to children’s homes or schools, with moderate (+) to high (−) strength of evidence for these nature exposures. Most studies focusing on residential green space used land-use data or Normalized Difference Vegetation Index and found positive associations with many physical and mental health outcomes for children. Although there were fewer studies focused on school green space, the strength of evidence was relatively strong because of consistently positive associations for outcomes such as physical activity, weight status, and test scores. These findings are supportive of greening schoolyards to increase access to daily opportunities for children to move and play in nature-rich settings located in their neighborhoods.328  The strength of evidence was low to moderate for other nature exposure categories primarily because of the low number of studies and small sample sizes.

A consistent limitation related to nature exposure was that researchers did not measure access to, quality of, or actual use of these parks or green spaces. Researchers in previous studies have found that park proximity alone is insufficient to predict use, and characteristics such as amenities and programming also need to be considered.329,330  Future research on park proximity and green space access would be of greater value if investigators incorporated measures of actual use of the space. In addition, many studies did not describe the natural features of the exposure. If future studies differentiated between natural characteristics such as green space versus “blue space” (eg, water features) or exposure to tree canopy versus smaller plants or grass, it might help delineate which types of nature contact, and how much, are most impactful.331 

Of the specific health outcomes and behaviors, compelling evidence was found for most studies focused on the relationship between nature contact and physical activity, a health behavior with numerous known benefits for children including healthy weight and cardiorespiratory fitness.332  Although outdoor time has been found to be a consistent correlate of children’s physical activity, existing literature does not typically focus on the independent contribution of nature-rich outdoor spaces. Studies in adult populations support the concept of “green exercise;” physical activity in natural environments is associated with health benefits beyond physical activity, particularly mental health.333335  Although there were several studies of childhood overweight and obesity that reported positive associations with nature contact, most reported null findings. Given the global challenges related to physical inactivity,336  obesity,337  and poor mental health, our review lends support to increasing equitable access and use of parks and green spaces.

We also found a strong evidence base for the relationship between nature contact and children’s cognitive, behavioral, and mental health. Most studies found a positive association for a range of outcomes, including attention and mood, and a few researchers examined longitudinal outcomes for >6 months. Studies included participants from preschool-aged to adolescents, and nature exposures close to home and in the wilderness. This not only highlights the diversity of the current literature but also suggests a range of potential mental health benefits from nature contact. Our findings are consistent with those of another recent review that was focused only on mental health outcomes in adolescents and found beneficial associations between green space exposure and numerous mental health outcomes.338 

There are a number of methodologic limitations inherent to our review. First, there was wide variability across studies in participant samples, nature exposures, and outcome measures, which made it difficult to aggregate and draw meaningful conclusions on the state of the evidence for certain categories. Second, risk of selection bias was moderate for observational studies and RCTs but high for experimental studies; experimental studies had moderately high risk for confounding bias. Third, most of the literature were observational. Although causality cannot be rigorously assessed, we found a low risk of confounding bias for observational studies. Fourth, because the nature exposures and health outcomes and behaviors studied were evaluated by using many different methodologies and instruments, we attempted to construct a measure of overall strength of evidence for each category of nature exposure and health outcome. Although we used a priori criteria and consensus from the entire authorship group, we acknowledge that this type of collective judgment is not wholly objective. Fifth, we used a reliable and validated tool, the MMAT, to assess study quality and bias. Although the MMAT is suited for quantitative study designs, we acknowledge that this approach also requires some subjective decision-making. Sixth, the literature search included articles published in English; thus, it is possible that relevant articles have been missed.

The coronavirus disease 2019 pandemic and attention to the health consequences of systemic racism have highlighted the importance of equitable access to safe, outdoor places.339341  Pandemic-related school closures and social distancing recommendations restricted opportunities and spaces for children to play. Although some communities had access to green spaces, others have not, largely because of historical environmental injustices that resulted in disparities in access to nature. Families of color and those living in poverty have less access to nearby parks and green space compared with those more privileged342,343 ; a recent study found that park access increased the odds of outdoor activities in children.344,345  A notable limitation of extant literature in our review is that few studies examined the impact of nature exposure on marginalized communities most at risk for inequitable access to green space and health disparities. This limitation is particularly important because of “equigenic effects”: the idea that an environmental factor (eg, nature contact) could not only disrupt the existing relationship between socioeconomic disadvantage and health but could have a greater effect on those most disadvantaged.15,16 

The available evidence reveals a positive relationship between nature contact and children’s health. Although there is a need for higher quality evidence, the total weight of the current evidence supports advocacy for practices and policies that address issues of equitable access to nature. Pediatric health care providers, legislators, and the public need to recognize that nature contact, especially access close to children’s homes, is a potent environmental and social determinant of health with the potential to prevent disease and promote health equity in children. Along with access to safe and high-quality education, health care, housing, neighborhoods, water, and food, the opportunity for children to access nature-rich environments must now be designated a public health priority.

We thank Kelley Scholz for her contributions to this literature review.

*

Refs 6167, 6971, 74, 76, and 82216.

Refs 60, 75, 78, 80, 81, 141, 211, and 217249.

Refs 3436, 38, 4244, 47, 50, 51, 54, 56, 7477, 8385, 97, 98, 102106, 110, 111, 121, 125, 130132, 134, 136, 139141, 145, 184, 194203, 205208, 210213, 219, 220, 224, 225, 227, 243265, 267269, 273, 274, 280283, 295, 296, 298, 300, 307309, 313315, 317, 318, and 323.

§

Refs 32, 38, 40, 41, 4547, 49, 54, 57, 62, 73, 86, 90, 94, 96, 113, 115, 116, 119, 123, 129, 142, 143, 147, 148, 150, 169184, 209, 214, 218, 229, 238240, 243, 247, 249, 266, 270272, 277279, 284287, 289291, 297, 299, 302307, 310313, 318322, and 324.

ǁ

Refs 31, 44, 54, 56, 8789, 92, 93, 99101, 107109, 114, 118, 122, 126, 131, 135, 138, 144, 185193, 200, 202, 204, 206, 208, 211, 222, 241, 242, 273, 280, 282, and 294.

Refs 48, 86, 88, 146, 148, 149, 217, 221, 223, 226, 228235, 275, 288, 293, 301303, 316, 326, and 327.

#

Refs 91, 95, 112, 117, 118, 120, 128, 137, 151165, 215, 216, and 236.

**

Refs 37, 39, 49, 59, 123, 124, 127, 166168, 185, 237, 276, 292, 294, and 297.

††

Refs 112, 118, 128, 154, 156, 158, 159, and 165.

FUNDING: Funding by BestStart Washington. BestStart Washington has no role in the design and conduct of the study.

Dr Fyfe-Johnson contributed methodologic design additions, participated in full text review, data extraction, quality assessment, categorical exposure, and outcome summaries, moderated the consensus process, drafted the initial manuscript, and reviewed and revised the manuscript; Ms Hazlehurst and Ms Perrins participated in screening, full text review, data extraction, quality assessment, categorical exposure, and outcome summaries, performed all analyses, and reviewed and revised the manuscript; Dr Bratman participated in screening, full text review, data extraction, quality assessment, categorical exposure, and outcome summaries and reviewed and revised the manuscript; Mr Thomas participated in screening, full text review, data extraction, and quality assessment, and reviewed and revised the manuscript; Ms Garrett participated in screening, full text review, data extraction, quality assessment, and categorical exposure and outcome summaries and reviewed and revised the manuscript; Ms Hafferty and Ms Cullaz participated in screening, full text review, data extraction, and reference management and reviewed and revised the manuscript; D. Marcuse conceptualized and designed the study, participated in screening, full text review, data extraction, and quality assessment and critically reviewed and revised the manuscript; Dr Tandon conceptualized and designed the study, participated in screening, full text review, data extraction, quality assessment, categorical exposure, and outcome summaries, drafted the initial manuscript, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

MMAT

Mixed Methods Appraisal Tool

RCT

randomized controlled trial

RoB 2

Risk of Bias 2

ROBINS-I

Risk Of Bias In Non-randomized Studies of Interventions

1
Ginsburg
KR
;
American Academy of Pediatrics Committee on Communications; American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health
.
The importance of play in promoting healthy child development and maintaining strong parent-child bonds
.
Pediatrics
.
2007
;
119
(
1
):
182
191
2
Yogman
M
,
Garner
A
,
Hutchinson
J
,
Hirsh-Pasek
K
,
Golinkoff
RM
;
Committee on Psychosocial Aspects of Child and Family Health; Council on Communications and Media
.
The power of play: a pediatric role in enhancing development in young children
.
Pediatrics
.
2018
;
142
(
3
):
e20182058
3
Tremblay
MS
,
Gray
C
,
Babcock
S
, et al
.
Position statement on active outdoor play
.
Int J Environ Res Public Health
.
2015
;
12
(
6
):
6475
6505
4
Frumkin
H
,
Bratman
GN
,
Breslow
SJ
, et al
.
Nature contact and human health: a research agenda
.
Environ Health Perspect
.
2017
;
125
(
7
):
075001
5
Gray
C
,
Gibbons
R
,
Larouche
R
, et al
.
What is the relationship between outdoor time and physical activity, sedentary behaviour, and physical fitness in children? A systematic review
.
Int J Environ Res Public Health
.
2015
;
12
(
6
):
6455
6474
6
Lubans
DR
,
Morgan
PJ
,
Cliff
DP
,
Barnett
LM
,
Okely
AD
.
Fundamental movement skills in children and adolescents: review of associated health benefits
.
Sports Med
.
2010
;
40
(
12
):
1019
1035
7
Casey
JA
,
James
P
,
Cushing
L
,
Jesdale
BM
,
Morello-Frosch
R
.
Race, ethnicity, income concentration and 10-year change in urban greenness in the United States
.
Int J Environ Res Public Health
.
2017
;
14
(
12
):
1546
8
Dai
D
.
Racial/ethnic and socioeconomic disparities in urban green space accessibility: where to intervene?
Landsc Urban Plan
.
2011
;
102
(
4
):
234
244
9
Locke
DH
,
Hall
B
,
Grove
JM
, et al
.
Residential housing segregation and urban tree canopy in 37 US cities
.
npj Urban Sustainability
.
2021
;
1
:
15
10
Byrne
J
.
When green is white: the cultural politics of race, nature and social exclusion in a Los Angeles urban national park
.
Geoforum
.
2012
;
43
(
3
):
595
611
11
Stewart
IT
,
Purner
EK
,
Guzmán
PD
.
Socioeconomic disparities in the provision of school gardens in Santa Clara County, California
.
Child Youth Environ
.
2013
;
23
(
2
):
127
153
12
Wolch
JR
,
Byrne
J
,
Newell
JP
.
Urban green space, public health, and environmental justice: the challenge of making cities ‘just green enough.’
Landsc Urban Plan
.
2014
;
125
:
234
244
13
Cousins
JJ
.
Justice in nature-based solutions: research and pathways
.
Ecol Econ
.
2021
;
180
:
106874
14
Hartig
T
.
Green space, psychological restoration, and health inequality
.
Lancet
.
2008
;
372
(
9650
):
1614
1615
15
Mitchell
R
,
Popham
F
.
Effect of exposure to natural environment on health inequalities: an observational population study
.
Lancet
.
2008
;
372
(
9650
):
1655
1660
16
Mitchell
RJ
,
Richardson
EA
,
Shortt
NK
,
Pearce
JR
.
Neighborhood environments and socioeconomic inequalities in mental well-being
.
Am J Prev Med
.
2015
;
49
(
1
):
80
84
17
Wheeler
BW
,
Lovell
R
,
Higgins
SL
, et al
.
Beyond greenspace: an ecological study of population general health and indicators of natural environment type and quality
.
Int J Health Geogr
.
2015
;
14
(
1
):
17
18
American Public Health Association
.
Improving Health and Wellness through Access to Nature
.
Washington, DC
:
American Public Health Association
;
2013
19
Moher
D
,
Liberati
A
,
Tetzlaff
J
,
Altman
DG
;
PRISMA Group
.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
.
PLoS Med
.
2009
;
6
(
7
):
e1000097
20
Booth
A
,
Clarke
M
,
Dooley
G
, et al
.
The nuts and bolts of PROSPERO: an international prospective register of systematic reviews
.
Syst Rev
.
2012
;
1
:
2
21
Covidence Systematic Review Software [computer program]
.
Melbourne, Australia
:
Veritas Health Innovation
22
Pluye
P
,
Hong
QN
.
Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews
.
Annu Rev Public Health
.
2014
;
35
:
29
45
23
Sterne
JA
,
Hernán
MA
,
Reeves
BC
, et al
.
ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions
.
BMJ
.
2016
;
355
:
i4919
24
Sterne
JAC
,
Savović
J
,
Page
MJ
, et al
.
RoB 2: a revised tool for assessing risk of bias in randomised trials
.
BMJ
.
2019
;
366
:
l4898
25
Gledhill
A
,
Forsdyke
D
,
Murray
E
.
Psychological interventions used to reduce sports injuries: a systematic review of real-world effectiveness
.
Br J Sports Med
.
2018
;
52
(
15
):
967
971
26
Sarmento
H
,
Anguera
MT
,
Pereira
A
,
Araújo
D
.
Talent identification and development in male football: a systematic review
.
Sports Med
.
2018
;
48
(
4
):
907
931
27
Kondo
MC
,
Fluehr
JM
,
McKeon
T
,
Branas
CC
.
Urban green space and its impact on human health
.
Int J Environ Res Public Health
.
2018
;
15
(
3
):
445
28
Ekkel
ED
,
de Vries
S
.
Nearby green space and human health: evaluating accessibility metrics
.
Landsc Urban Plan
.
2017
;
157
:
214
220
29
Bratman
GN
,
Anderson
CB
,
Berman
MG
, et al
.
Nature and mental health: an ecosystem service perspective
.
Sci Adv
.
2019
;
5
(
7
):
eaax0903
30
Rothman
KJ
,
Greenland
S
,
Lash
TL
.
Modern Epidemiology
.
Philadelphia, PA
:
Wolters Kluwer Health/Lippincott Williams & Wilkins
;
2015
31
Burgoine
T
,
Jones
AP
,
Namenek Brouwer
RJ
,
Benjamin Neelon
SE
.
Associations between BMI and home, school and route environmental exposures estimated using GPS and GIS: do we see evidence of selective daily mobility bias in children?
Int J Health Geogr
.
2015
;
14
:
8
32
Dadvand
P
,
Nieuwenhuijsen
MJ
,
Esnaola
M
, et al
.
Green spaces and cognitive development in primary schoolchildren
.
Proc Natl Acad Sci U S A
.
2015
;
112
(
26
):
7937
7942
33
Dadvand
P
,
Sunyer
J
,
Alvarez-Pedrerol
M
, et al
.
Green spaces and spectacles use in schoolchildren in Barcelona
.
Environ Res
.
2017
;
152
:
256
262
34
de Vries
SI
,
Bakker
I
,
van Mechelen
W
,
Hopman-Rock
M
.
Determinants of activity-friendly neighborhoods for children: results from the SPACE study
.
Am J Health Promot
.
2007
;
21
(
4
,
suppl
):
312
316
35
Eichinger
M
,
Schneider
S
,
De Bock
F
.
Subjectively and objectively assessed social and physical environmental correlates of preschoolers’ accelerometer-based physical activity
.
Int J Behav Nutr Phys Act
.
2017
;
14
(
1
):
153
36
Fjørtoft
I
.
The natural environment as a playground for children: the impact of outdoor play activities in pre-primary school children
.
Early Child Educ J
.
2001
;
29
(
2
):
111
117
37
Greenwood
A
,
Gatersleben
B
.
Let’s go outside! Environmental restoration amongst adolescents and the impact of friends and phones
.
J Environ Psychol
.
2016
;
48
:
131
139
38
Gubbels
JS
,
Kremers
SPJ
,
Droomers
M
, et al
.
The impact of greenery on physical activity and mental health of adolescent and adult residents of deprived neighborhoods: a longitudinal study
.
Health Place
.
2016
;
40
:
153
160
39
Igarashi
M
,
Aga
M
,
Ikei
H
,
Namekawa
T
,
Miyazaki
Y
.
Physiological and psychological effects on high school students of viewing real and artificial pansies
.
Int J Environ Res Public Health
.
2015
;
12
(
3
):
2521
2531
40
Li
D
,
Sullivan
WC
.
Impact of views to school landscapes on recovery from stress and mental fatigue
.
Landsc Urban Plan
.
2016
;
148
:
149
158
41
Mennis
J
,
Mason
M
,
Ambrus
A
.
Urban greenspace is associated with reduced psychological stress among adolescents: a geographic ecological momentary assessment (GEMA) analysis of activity space
.
Landsc Urban Plan
.
2018
;
174
:
1
9
42
Reis
RS
,
Hino
AAF
,
Florindo
AA
,
Añez
CRR
,
Domingues
MR
.
Association between physical activity in parks and perceived environment: a study with adolescents
.
J Phys Act Health
.
2009
;
6
(
4
):
503
509
43
Schultz
CL
,
Wilhelm Stanis
SA
,
Sayers
SP
,
Thombs
LA
,
Thomas
IM
.
A longitudinal examination of improved access on park use and physical activity in a low-income and majority African American neighborhood park
.
Prev Med
.
2017
;
95
(
suppl
):
S95
S100
44
Wilhelm Stanis
SA
,
Oftedal
A
,
Schneider
I
.
Association of outdoor recreation availability with physical activity and weight status in Minnesota youth
.
Prev Med
.
2014
;
60
:
124
127
45
Taylor
AF
,
Kuo
FE
,
Sullivan
WC
.
Views of nature and self-discipline: evidence from inner city children
.
J Environ Psychol
.
2002
;
22
(
1–2
):
49
63
46
Wells
NM
,
Evans
GW
.
Nearby nature: a buffer of life stress among rural children
.
Environ Behav
.
2003
;
35
(
3
):
311
330
47
Wood
C
,
Gladwell
V
,
Barton
J
.
A repeated measures experiment of school playing environment to increase physical activity and enhance self-esteem in UK school children
.
PLoS One
.
2014
;
9
(
9
):
e108701
48
Spero
MA
,
Balster
NJ
,
Bajcz
AW
.
Effects of childhood setting and interaction with nature on academic performance in introductory college-level courses in the environmental sciences
.
Environ Educ Res
.
2019
;
25
(
3
):
422
442
49
Yar
MA
,
Kazemi
F
.
The role of dish gardens on the physical and neuropsychological improvement of hospitalized children
.
Urban For Urban Green
.
2020
;
53
:
126713
50
Bjørgen
K
.
Physical activity in light of affordances in outdoor environments: qualitative observation studies of 3-5 years olds in kindergarten
.
Springerplus
.
2016
;
5
(
1
):
950
51
Buck
C
,
Tkaczick
T
,
Pitsiladis
Y
, et al
.
Objective measures of the built environment and physical activity in children: from walkability to moveability
.
J Urban Health
.
2015
;
92
(
1
):
24
38
52
Blair
CK
,
Madan-Swain
A
,
Locher
JL
, et al
.
Harvest for health gardening intervention feasibility study in cancer survivors
.
Acta Oncol
.
2013
;
52
(
6
):
1110
1118
53
Nolan
GA
,
McFarland
AL
,
Zajicek
JM
,
Waliczek
TM
.
The effects of nutrition education and gardening on attitudes, preferences, and knowledge of minority second to fifth graders in the Rio Grande Valley toward fruit and vegetables
.
Horttechnology
.
2012
;
22
(
3
):
299
304
54
van Lier
LE
,
Utter
J
,
Denny
S
,
Lucassen
M
,
Dyson
B
,
Clark
T
.
Home gardening and the health and well-being of adolescents
.
Health Promot Pract
.
2017
;
18
(
1
):
34
43
55
Waliczek
TM
,
Bradley
JC
,
Zajicek
JM
.
The effect of school gardens on children’s interpersonal relationships and attitudes toward school
.
Horttechnology
.
2001
;
11
(
3
):
466
468
56
Utter
J
,
Denny
S
,
Dyson
B
.
School gardens and adolescent nutrition and BMI: results from a national, multilevel study
.
Prev Med
.
2016
;
83
:
1
4
57
van den Berg
AE
,
Wesselius
JE
,
Maas
J
,
Tanja-Dijkstra
K
.
Green walls for a restorative classroom environment: a controlled evaluation study
.
Environ Behav
.
2017
;
49
(
7
):
791
813
58
Bowen
DJ
,
Neill
JT
.
Effects of the PCYC vatalyst outdoor adventure intervention program on youths’ life skills, mental health, and delinquent behaviour
.
Int J Adolesc Youth
.
2016
;
21
(
1
):
34
55
59
Hignett
A
,
White
MP
,
Pahl
S
,
Jenkin
R
,
Le Froy
M
.
Evaluation of a surfing programme designed to increase personal well-being and connectedness to the natural environment among “at risk” young people
.
Journal of Adventure Education and Outdoor Learning
.
2018
;
18
(
1
):
53
69
60
Wu
J
,
Jackson
L
.
Inverse relationship between urban green space and childhood autism in California elementary school districts
.
Environ Int
.
2017
;
107
:
140
146
61
Kyttä
AM
,
Broberg
AK
,
Kahila
MH
.
Urban environment and children’s active lifestyle: softGIS revealing children’s behavioral patterns and meaningful places
.
Am J Health Promot
.
2012
;
26
(
5
):
e137
e148
62
Maas
J
,
Verheij
RA
,
de Vries
S
,
Spreeuwenberg
P
,
Schellevis
FG
,
Groenewegen
PP
.
Morbidity is related to a green living environment
.
J Epidemiol Community Health
.
2009
;
63
(
12
):
967
973
63
McCracken
DS
,
Allen
DA
,
Gow
AJ
.
Associations between urban greenspace and health-related quality of life in children
.
Prev Med Rep
.
2016
;
3
:
211
221
64
Feng
X
,
Astell-Burt
T
.
Do greener areas promote more equitable child health?
Health Place
.
2017
;
46
:
267
273
65
Dadvand
P
,
Pujol
J
,
Macià
D
, et al
.
The association between lifelong greenspace exposure and 3-dimensional brain magnetic resonance imaging in Barcelona schoolchildren
.
Environ Health Perspect
.
2018
;
126
(
2
):
027012
66
Tillmann
S
,
Clark
AF
,
Gilliland
JA
.
Children and nature: linking accessibility of natural environments and children’s health-related quality of life
.
Int J Environ Res Public Health
.
2018
;
15
(
6
):
1072
67
Schild
C
,
Reed
EA
,
Hingston
T
,
Dennis
CH
,
Wilson
AC
.
Neighborhood characteristics: influences on pain and physical function in youth at risk for chronic pain
.
Children (Basel)
.
2016
;
3
(
4
):
35
68
Huys
N
,
Cardon
G
,
De Craemer
M
, et al
.
Effect and process evaluation of a real-world school garden program on vegetable consumption and its determinants in primary schoolchildren
.
PLoS One
.
2019
;
14
(
3
):
e0214320
69
Feng
X
,
Flexeder
C
,
Markevych
I
, et al
.
Impact of residential green space on sleep quality and sufficiency in children and adolescents residing in Australia and Germany
.
Int J Environ Res Public Health
.
2020
;
17
(
13
):
4894
70
Lambert
KA
,
Markevych
I
,
Yang
BY
, et al
.
Association of early life and acute pollen exposure with lung function and exhaled nitric oxide (FeNO). A prospective study up to adolescence in the GINIplus and LISA cohort
.
Sci Total Environ
.
2021
;
763
:
143006
71
Liao
J
,
Zhang
B
,
Xia
W
, et al
.
Residential exposure to green space and early childhood neurodevelopment
.
Environ Int
.
2019
;
128
:
70
76
72
Kim
SO
,
Park
SA
.
Garden-based integrated intervention for improving children’s eating behavior for vegetables
.
Int J Environ Res Public Health
.
2020
;
17
(
4
):
1257
73
Sobko
T
,
Liang
S
,
Cheng
WHG
,
Tun
HM
.
Impact of outdoor nature-related activities on gut microbiota, fecal serotonin, and perceived stress in preschool children: the Play&Grow randomized controlled trial
.
Sci Rep
.
2020
;
10
(
1
):
21993
74
James
M
,
Fry
R
,
Mannello
M
,
Anderson
W
,
Brophy
S
.
How does the built environment affect teenagers (aged 13-14) physical activity and fitness? A cross-sectional analysis of the ACTIVE Project
.
PLoS One
.
2020
;
15
(
8
):
e0237784
75
Pagels
P
,
Wester
U
,
Mårtensson
F
, et al
.
Pupils’ use of school outdoor play settings across seasons and its relation to sun exposure and physical activity
.
Photodermatol Photoimmunol Photomed
.
2020
;
36
(
5
):
365
372
76
Sheldrick
MP
,
Maitland
C
,
Mackintosh
KA
, et al
.
Associations between the home physical environment and children’s home-based physical activity and sitting
.
Int J Environ Res Public Health
.
2019
;
16
(
21
):
4178
77
Khan
M
,
Bell
R
.
Effects of a school based intervention on children’s physical activity and healthy eating: a mixed-methods study
.
Int J Environ Res Public Health
.
2019
;
16
(
22
):
4320
78
Ribeiro
AI
,
Tavares
C
,
Guttentag
A
,
Barros
H
.
Association between neighbourhood green space and biological markers in school-aged children. Findings from the Generation XXI birth cohort
.
Environ Int
.
2019
;
132
:
105070
79
Shrestha
A
,
Schindler
C
,
Odermatt
P
, et al
.
Nutritional and health status of children 15 months after integrated school garden, nutrition, and water, sanitation and hygiene interventions: a cluster-randomised controlled trial in Nepal
.
BMC Public Health
.
2020
;
20
(
1
):
158
80
Paciência
I
,
Rufo
JC
,
Silva
D
, et al
.
School environment associates with lung function and autonomic nervous system activity in children: a cross-sectional study
.
Sci Rep
.
2019
;
9
(
1
):
15156
81
Miri
M
,
de Prado-Bert
P
,
Alahabadi
A
, et al
.
Association of greenspace exposure with telomere length in preschool children
.
Environ Pollut
.
2020
;
266
(
pt 1
):
115228
82
Kim
JH
,
Lee
C
,
Sohn
W
.
Urban natural environments, obesity, and health-related quality of life among Hispanic children living in inner-city neighborhoods
.
Int J Environ Res Public Health
.
2016
;
13
(
1
):
121
83
Boone-Heinonen
J
,
Casanova
K
,
Richardson
AS
,
Gordon-Larsen
P
.
Where can they play? Outdoor spaces and physical activity among adolescents in U.S. urbanized areas
.
Prev Med
.
2010
;
51
(
3–4
):
295
298
84
Bringolf-Isler
B
,
Kriemler
S
,
Mäder
U
, et al
.
Relationship between the objectively-assessed neighborhood area and activity behavior in Swiss youth
.
Prev Med Rep
.
2014
;
1
:
14
20
85
Bringolf-Isler
B
,
Grize
L
,
Mäder
U
,
Ruch
N
,
Sennhauser
FH
,
Braun-Fahrländer
C
;
SCARPOL team
.
Built environment, parents’ perception, and children’s vigorous outdoor play
.
Prev Med
.
2010
;
50
(
5–6
):
251
256
86
Flouri
E
,
Papachristou
E
,
Midouhas
E
.
The role of neighbourhood greenspace in children’s spatial working memory
.
Br J Educ Psychol
.
2019
;
89
(
2
):
359
373
87
Jenkin
GL
,
Pearson
AL
,
Bentham
G
,
Day
P
,
Kingham
S
.
Neighbourhood influences on children’s weight-related behaviours and body mass index
.
AIMS Public Health
.
2015
;
2
(
3
):
501
515
88
Kabisch
N
,
Haase
D
,
Annerstedt van den Bosch
M
.
Adding natural areas to social indicators of intra-urban health inequalities among children: a case study from Berlin, Germany
.
Int J Environ Res Health
.
2016
;
13
(
8
):
783
89
Lovasi
GS
,
Schwartz-Soicher
O
,
Quinn
JW
, et al
.
Neighborhood safety and green space as predictors of obesity among preschool children from low-income families in New York City
.
Prev Med
.
2013
;
57
(
3
):
189
193
90
Richardson
EA
,
Pearce
J
,
Shortt
NK
,
Mitchell
R
.
The role of public and private natural space in children’s social, emotional and behavioural development in Scotland: a longitudinal study
.
Environ Res
.
2017
;
158
:
729
736
91
Ruokolainen
L
,
von Hertzen
L
,
Fyhrquist
N
, et al
.
Green areas around homes reduce atopic sensitization in children
.
Allergy
.
2015
;
70
(
2
):
195
202
92
Schalkwijk
AAH
,
van der Zwaard
BC
,
Nijpels
G
,
Elders
PJM
,
Platt
L
.
The impact of greenspace and condition of the neighbourhood on child overweight
.
Eur J Public Health
.
2018
;
28
(
1
):
88
94
93
Armstrong
B
,
Lim
CS
,
Janicke
DM
.
Park density impacts weight change in a behavioral intervention for overweight rural youth
.
Behav Med
.
2015
;
41
(
3
):
123
130
94
Feng
X
,
Astell-Burt
T
.
The relationship between neighbourhood green space and child mental wellbeing depends upon whom you ask: multilevel evidence from 3083 children aged 12-13 years
.
Int J Environ Res Public Health
.
2017
;
14
(
3
):
235
95
Feng
X
,
Astell-Burt
T
.
Is neighborhood green space protective against associations between child asthma, neighborhood traffic volume and perceived lack of area safety? Multilevel analysis of 4447 Australian children
.
Int J Environ Res Public Health
.
2017
;
14
(
5
):
543
96
Feng
X
,
Astell-Burt
T
.
Residential green space quantity and quality and child well-being: a longitudinal study
.
Am J Prev Med
.
2017
;
53
(
5
):
616
624
97
Galvez
MP
,
McGovern
K
,
Knuff
C
, et al
.
Associations between neighborhood resources and physical activity in inner-city minority children
.
Acad Pediatr
.
2013
;
13
(
1
):
20
26
98
Mitchell
CA
,
Clark
AF
,
Gilliland
JA
.
Built environment influences of children’s physical activity: examining differences by neighbourhood size and sex
.
Int J Environ Res Public Health
.
2016
;
13
(
1
):
130
99
Morgan Hughey
S
,
Kaczynski
AT
,
Child
S
,
Moore
JB
,
Porter
D
,
Hibbert
J
.
Green and lean: is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity
.
Prev Med
.
2017
;
95
(
suppl
):
S101
S108
100
Potestio
ML
,
Patel
AB
,
Powell
CD
,
McNeil
DA
,
Jacobson
RD
,
McLaren
L
.
Is there an association between spatial access to parks/green space and childhood overweight/obesity in Calgary, Canada?
Int J Behav Nutr Phys Act
.
2009
;
6
:
77
101
Potwarka
LR
,
Kaczynski
AT
,
Flack
AL
.
Places to play: association of park space and facilities with healthy weight status among children
.
J Community Health
.
2008
;
33
(
5
):
344
350
102
Prins
RG
,
Ball
K
,
Timperio
A
, et al
.
Associations between availability of facilities within three different neighbourhood buffer sizes and objectively assessed physical activity in adolescents
.
Health Place
.
2011
;
17
(
6
):
1228
1234
103
Prins
RG
,
Oenema
A
,
van der Horst
K
,
Brug
J
.
Objective and perceived availability of physical activity opportunities: differences in associations with physical activity behavior among urban adolescents
.
Int J Behav Nutr Phys Act
.
2009
;
6
:
70
104
Ries
AV
,
Voorhees
CC
,
Roche
KM
,
Gittelsohn
J
,
Yan
AF
,
Astone
NM
.
A quantitative examination of park characteristics related to park use and physical activity among urban youth
.
J Adolesc Health
.
2009
;
45
(
3
,
suppl
):
S64
S70
105
Sanders
T
,
Feng
X
,
Fahey
PP
,
Lonsdale
C
,
Astell-Burt
T
.
The influence of neighbourhood green space on children’s physical activity and screen time: findings from the longitudinal study of Australian children
.
Int J Behav Nutr Phys Act
.
2015
;
12
:
126
106
Tucker
P
,
Irwin
JD
,
Gilliland
J
,
He
M
,
Larsen
K
,
Hess
P
.
Environmental influences on physical activity levels in youth
.
Health Place
.
2009
;
15
(
1
):
357
363
107
Wall
MM
,
Larson
NI
,
Forsyth
A
, et al
.
Patterns of obesogenic neighborhood features and adolescent weight: a comparison of statistical approaches
.
Am J Prev Med
.
2012
;
42
(
5
):
e65
e75
108
Wolch
J
,
Jerrett
M
,
Reynolds
K
, et al
.
Childhood obesity and proximity to urban parks and recreational resources: a longitudinal cohort study
.
Health Place
.
2011
;
17
(
1
):
207
214
109
Schüle
SA
,
Fromme
H
,
Bolte
G
.
Built and socioeconomic neighbourhood environments and overweight in preschool aged children. A multilevel study to disentangle individual and contextual relationships
.
Environ Res
.
2016
;
150
:
328
336
110
Scott
MM
,
Cohen
DA
,
Evenson
KR
, et al
.
Weekend schoolyard accessibility, physical activity, and obesity: the Trial of Activity in Adolescent Girls (TAAG) study
.
Prev Med
.
2007
;
44
(
5
):
398
403
111
Almanza
E
,
Jerrett
M
,
Dunton
G
,
Seto
E
,
Pentz
MA
.
A study of community design, greenness, and physical activity in children using satellite, GPS and accelerometer data
.
Health Place
.
2012
;
18
(
1
):
46
54
112
Andrusaityte
S
,
Grazuleviciene
R
,
Kudzyte
J
,
Bernotiene
A
,
Dedele
A
,
Nieuwenhuijsen
MJ
.
Associations between neighbourhood greenness and asthma in preschool children in Kaunas, Lithuania: a case-control study
.
BMJ Open
.
2016
;
6
(
4
):
e010341
113
Balseviciene
B
,
Sinkariova
L
,
Grazuleviciene
R
, et al
.
Impact of residential greenness on preschool children’s emotional and behavioral problems
.
Int J Environ Res Public Health
.
2014
;
11
(
7
):
6757
6770
114
Bell
JF
,
Wilson
JS
,
Liu
GC
.
Neighborhood greenness and 2-year changes in body mass index of children and youth
.
Am J Prev Med
.
2008
;
35
(
6
):
547
553
115
Bezold
CP
,
Banay
RF
,
Coull
BA
, et al
.
The association between natural environments and depressive symptoms in adolescents living in the United States
.
J Adolesc Health
.
2018
;
62
(
4
):
488
495
116
Bezold
CP
,
Banay
RF
,
Coull
BA
, et al
.
The relationship between surrounding greenness in childhood and adolescence and depressive symptoms in adolescence and early adulthood
.
Ann Epidemiol
.
2018
;
28
(
4
):
213
219
117
Chen
E
,
Miller
GE
,
Shalowitz
MU
, et al
.
Difficult family relationships, residential greenspace, and childhood asthma
.
Pediatrics
.
2017
;
139
(
4
):
e20163056
118
Dadvand
P
,
Villanueva
CM
,
Font-Ribera
L
, et al
.
Risks and benefits of green spaces for children: a cross-sectional study of associations with sedentary behavior, obesity, asthma, and allergy
.
Environ Health Perspect
.
2014
;
122
(
12
):
1329
1335
119
Dadvand
P
,
Tischer
C
,
Estarlich
M
, et al
.
Lifelong residential exposure to green space and attention: a population-based prospective study
.
Environ Health Perspect
.
2017
;
125
(
9
):
097016
120
Donovan
GH
,
Gatziolis
D
,
Longley
I
,
Douwes
J
.
Vegetation diversity protects against childhood asthma: results from a large New Zealand birth cohort
.
Nat Plants
.
2018
;
4
(
6
):
358
364
121
Grigsby-Toussaint
DS
,
Chi
SH
,
Fiese
BH
;
STRONG Kids Project Writing Group
.
Where they live, how they play: neighborhood greenness and outdoor physical activity among preschoolers
.
Int J Health Geogr
.
2011
;
10
:
66
122
Liu
GC
,
Wilson
JS
,
Qi
R
,
Ying
J
.
Green neighborhoods, food retail and childhood overweight: differences by population density
.
Am J Health Promot
.
2007
;
21
(
4
,
suppl
):
317
325
123
Markevych
I
,
Tiesler
CM
,
Fuertes
E
, et al
.
Access to urban green spaces and behavioural problems in children: results from the GINIplus and LISAplus studies
.
Environ Int
.
2014
;
71
:
29
35
124
Markevych
I
,
Standl
M
,
Sugiri
D
, et al
.
Residential greenness and blood lipids in children: a longitudinal analysis in GINIplus and LISAplus
.
Environ Res
.
2016
;
151
:
168
173
125
Markevych
I
,
Smith
MP
,
Jochner
S
, et al
.
Neighbourhood and physical activity in German adolescents: GINIplus and LISAplus
.
Environ Res
.
2016
;
147
:
284
293
126
Petraviciene
I
,
Grazuleviciene
R
,
Andrusaityte
S
,
Dedele
A
,
Nieuwenhuijsen
MJ
.
Impact of the social and natural environment on preschool-age children weight
.
Int J Environ Res Public Health
.
2018
;
15
(
3
)
449
127
Thiering
E
,
Markevych
I
,
Bruske
I
, et al
.
Associations of residential long-term air pollution exposures and satellite-derived greenness with insulin resistance in German adolescents
.
Environ Health Perspect
.
2016
;
124
(
8
):
1291
1298
128
Tischer
C
,
Gascon
M
,
Fernández-Somoano
A
, et al
.
Urban green and grey space in relation to respiratory health in children
.
Eur Respir J
.
2017
;
49
(
6
):
1502112
129
Younan
D
,
Tuvblad
C
,
Li
L
, et al
.
Environmental determinants of aggression in adolescents: role of urban neighborhood greenspace
.
J Am Acad Child Adolesc Psychiatry
.
2016
;
55
(
7
):
591
601
130
Akpinar
A
,
Cankurt
M
.
Parental influence on children’s physical activity in urban green spaces
.
Journal of the Faculty of Forestry Istanbul University
.
2016
;
66
(
2
):
471
482
131
Akpinar
A
.
Urban green spaces for children: a cross-sectional study of associations with distance, physical activity, screen time, general health, and overweight
.
Urban For Urban Green
.
2017
;
25
:
66
73
132
Magalhães
APTDF
,
Pina
MFRP
,
Ramos
EDCP
.
The role of urban environment, social and health determinants in the tracking of leisure-time physical activity throughout adolescence
.
J Adolesc Health
.
2017
;
60
(
1
):
100
106
133
Markevych
I
,
Thiering
E
,
Fuertes
E
, et al
.
A cross-sectional analysis of the effects of residential greenness on blood pressure in 10-year old children: results from the GINIplus and LISAplus studies
.
BMC Public Health
.
2014
;
14
:
477
134
Timperio
A
,
Giles-Corti
B
,
Crawford
D
, et al
.
Features of public open spaces and physical activity among children: findings from the CLAN study
.
Prev Med
.
2008
;
47
(
5
):
514
518
135
Wood
SL
,
Demougin
PR
,
Higgins
S
,
Husk
K
,
Wheeler
BW
,
White
M
.
Exploring the relationship between childhood obesity and proximity to the coast: a rural/urban perspective
.
Health Place
.
2016
;
40
:
129
136
136
Edwards
NJ
,
Giles-Corti
B
,
Larson
A
,
Beesley
B
.
The effect of proximity on park and beach use and physical activity among rural adolescents
.
J Phys Act Health
.
2014
;
11
(
5
):
977
984
137
Esposito
S
,
Galeone
C
,
Lelii
M
, et al
.
Impact of air pollution on respiratory diseases in children with recurrent wheezing or asthma
.
BMC Pulm Med
.
2014
;
14
:
130
138
Goldsby
TU
,
George
BJ
,
Yeager
VA
, et al
.
Urban park development and pediatric obesity rates: a quasi-experiment using electronic health record data
.
Int J Environ Res Public Health
.
2016
;
13
(
4
):
411
139
Kowaleski-Jones
L
,
Fan
JX
,
Wen
M
,
Hanson
H
.
Neighborhood context and youth physical activity: differential associations by gender and age
.
Am J Health Promot
.
2017
;
31
(
5
):
426
434
140
Grow
HM
,
Saelens
BE
,
Kerr
J
,
Durant
NH
,
Norman
GJ
,
Sallis
JF
.
Where are youth active? Roles of proximity, active transport, and built environment
.
Med Sci Sports Exerc
.
2008
;
40
(
12
):
2071
2079
141
Marino
AJ
,
Fletcher
EN
,
Whitaker
RC
,
Anderson
SE
.
Amount and environmental predictors of outdoor playtime at home and school: a cross-sectional analysis of a national sample of preschool-aged children attending Head Start
.
Health Place
.
2012
;
18
(
6
):
1224
1230
142
Wells
N
.
At home with nature: Effects of “greenness” on children’s cognitive functioning
.
Environ Behav
.
2000
;
32
(
6
):
775
795
143
Zach
A
,
Meyer
N
,
Hendrowarsito
L
, et al
.
Association of sociodemographic and environmental factors with the mental health status among preschool children-results from a cross-sectional study in Bavaria, Germany
.
Int J Hyg Environ Health
.
2016
;
219
(
4–5
):
458
467
144
Evans
GW
,
Jones-Rounds
ML
,
Belojevic
G
,
Vermeylen
F
.
Family income and childhood obesity in eight European cities: the mediating roles of neighborhood characteristics and physical activity
.
Soc Sci Med
.
2012
;
75
(
3
):
477
481
145
Aarts
MJ
,
Mathijssen
JJ
,
van Oers
JAM
,
Schuit
AJ
.
Associations between environmental characteristics and active commuting to school among children: a cross-sectional study
.
Int J Behav Med
.
2013
;
20
(
4
):
538
555
146
Markevych
I
,
Feng
X
,
Astell-Burt
T
, et al
.
Residential and school greenspace and academic performance: evidence from the GINIplus and LISA longitudinal studies of German adolescents
.
Environ Pollut
.
2019
;
245
(
245
):
71
76
147
Lee
M
,
Kim
S
,
Ha
M
.
Community greenness and neurobehavioral health in children and adolescents
.
Sci Total Environ
.
2019
;
672
:
381
388
148
Bijnens
EM
,
Derom
C
,
Thiery
E
,
Weyers
S
,
Nawrot
TS
.
Residential green space and child intelligence and behavior across urban, suburban, and rural areas in Belgium: a longitudinal birth cohort study of twins
.
PLoS Med
.
2020
;
17
(
8
):
e1003213
149
Asta
F
,
Michelozzi
P
,
Cesaroni
G
,
De Sario
M
,
Davoli
M
,
Porta
D
.
Green spaces and cognitive development at age 7 years in a Rome birth cohort: the mediating role of nitrogen dioxide
.
Environ Res
.
2021
;
196
:
110358
150
Reuben
A
,
Arseneault
L
,
Belsky
DW
, et al
.
Residential neighborhood greenery and children’s cognitive development
.
Soc Sci Med
.
2019
;
230
:
271
279
151
Dzhambov
AM
,
Lercher
P
,
Rüdisser
J
,
Browning
MHEM
,
Markevych
I
.
Allergic symptoms in association with naturalness, greenness, and greyness: a cross-sectional study in schoolchildren in the Alps
.
Environ Res
.
2021
;
198
:
110456
152
Eldeirawi
K
,
Kunzweiler
C
,
Zenk
S
, et al
.
Associations of urban greenness with asthma and respiratory symptoms in Mexican American children
.
Ann Allergy Asthma Immunol
.
2019
;
122
(
3
):
289
295
153
Gernes
R
,
Brokamp
C
,
Rice
GE
, et al
.
Using high-resolution residential greenspace measures in an urban environment to assess risks of allergy outcomes in children
.
Sci Total Environ
.
2019
;
668
:
760
767
154
Hsieh
CJ
,
Yu
PY
,
Tai
CJ
, et al
.
Association between the first occurrence of asthma and residential greenness in children and teenagers in Taiwan
.
Int J Environ Res Public Health
.
2019
;
16
(
12
):
2076
155
DePriest
K
,
Butz
A
,
Curriero
FC
,
Perrin
N
,
Gross
D
.
Associations among neighborhood greenspace, neighborhood violence, and children’s asthma control in an urban city
.
Ann Allergy Asthma Immunol
.
2019
;
123
(
6
):
608
610
156
Parmes
E
,
Pesce
G
,
Sabel
CE
, et al
.
Influence of residential land cover on childhood allergic and respiratory symptoms and diseases: evidence from 9 European cohorts
.
Environ Res
.
2020
;
183
:
108953
157
Paciência
I
,
Moreira
A
,
Moreira
C
, et al
.
Neighbourhood green and blue spaces and allergic sensitization in children: a longitudinal study based on repeated measures from the Generation XXI cohort
.
Sci Total Environ
.
2021
;
772
:
145394
158
Markevych
I
,
Ludwig
R
,
Baumbach
C
, et al
.
Residing near allergenic trees can increase risk of allergies later in life: LISA Leipzig study
.
Environ Res
.
2020
;
191
:
110132
159
Lee
HY
,
Wu
YH
,
Asri
AK
, et al
.
Linkage between residential green spaces and allergic rhinitis among Asian children (case study: Taiwan)
.
Landsc Urban Plan
.
2020
;
202
:
103868
160
Li
L
,
Hart
JE
,
Coull
BA
,
Cao
SJ
,
Spengler
JD
,
Adamkiewicz
G
.
Effect of residential greenness and nearby parks on respiratory and allergic diseases among middle school adolescents in a Chinese city
.
Int J Environ Res Public Health
.
2019
;
16
(
6
):
991
161
Squillacioti
G
,
Bellisario
V
,
Levra
S
,
Piccioni
P
,
Bono
R
.
Greenness availability and respiratory health in a population of urbanised children in north-western Italy
.
Int J Environ Res Public Health
.
2019
;
17
(
1
):
108
162
Cilluffo
G
,
Ferrante
G
,
Fasola
S
, et al
.
Associations of greenness, greyness and air pollution exposure with children’s health: a cross-sectional study in southern Italy
.
Environ Health
.
2018
;
17
(
1
):
86
163
Cavaleiro Rufo
J
,
Paciência
I
,
Hoffimann
E
,
Moreira
A
,
Barros
H
,
Ribeiro
AI
.
The neighbourhood natural environment is associated with asthma in children: a birth cohort study
.
Allergy
.
2021
;
76
(
1
):
348
358
164
Alasauskas
S
,
Ustinaviciene
R
,
Kavaliauskas
M
.
Residential links to air pollution and school children with asthma in Vilnius (population study)
.
Medicina (Kaunas)
.
2020
;
56
(
7
):
346
165
Aerts
R
,
Dujardin
S
,
Nemery
B
, et al
.
Residential green space and medication sales for childhood asthma: a longitudinal ecological study in Belgium
.
Environ Res
.
2020
;
189
:
109914
166
Jimenez
MP
,
Oken
E
,
Gold
DR
, et al
.
Early life exposure to green space and insulin resistance: an assessment from infancy to early adolescence
.
Environ Int
.
2020
;
142
:
105849
167
Bloemsma
LD
,
Gehring
U
,
Klompmaker
JO
, et al
.
Green space, air pollution, traffic noise and cardiometabolic health in adolescents: the PIAMA birth cohort
.
Environ Int
.
2019
;
131
:
104991
168
Abbasi
B
,
Pourmirzaei
M
,
Hariri
S
, et al
.
Subjective proximity to green spaces and blood pressure in children and adolescents: the CASPIAN-V Study
.
J Environ Public Health
.
2020
;
2020
:
8886241
169
Donovan
GH
,
Michael
YL
,
Gatziolis
D
,
Mannetje
A
,
Douwes
J
.
Association between exposure to the natural environment, rurality, and attention-deficit hyperactivity disorder in children in New Zealand: a linkage study
.
Lancet Planet Health
.
2019
;
3
(
5
):
e226
e234
170
Hartley
K
,
Perazzo
J
,
Brokamp
C
, et al
.
Residential surrounding greenness and self-reported symptoms of anxiety and depression in adolescents
.
Environ Res
.
2021
;
194
:
110628
171
Franklin
M
,
Yin
X
,
McConnell
R
,
Fruin
S
.
Association of the built environment with childhood psychosocial stress
.
JAMA Netw Open
.
2020
;
3
(
10
):
e2017634
172
Wang
P
,
Meng
YY
,
Lam
V
,
Ponce
N
.
Green space and serious psychological distress among adults and teens: a population-based study in California
.
Health Place
.
2019
;
56
:
184
190
173
Putra
IGNE
,
Astell-Burt
T
,
Cliff
DP
,
Vella
SA
,
Feng
X
.
Association between green space quality and prosocial behaviour: a 10-year multilevel longitudinal analysis of Australian children
.
Environ Res
.
2021
;
196
:
110334
174
Nordbø
ECA
,
Raanaas
RK
,
Nordh
H
,
Aamodt
G
.
Disentangling how the built environment relates to children’s well-being: participation in leisure activities as a mediating pathway among 8-year-olds based on the Norwegian Mother and Child Cohort Study
.
Health Place
.
2020
;
64
:
102360
175
Madzia
J
,
Ryan
P
,
Yolton
K
, et al
.
Residential greenspace association with childhood behavioral outcomes
.
J Pediatr
.
2019
;
207
:
233
240
176
Mueller
MAE
,
Flouri
E
,
Kokosi
T
.
The role of the physical environment in adolescent mental health
.
Health Place
.
2019
;
58
:
102153
177
Markevych
I
,
Tesch
F
,
Datzmann
T
,
Romanos
M
,
Schmitt
J
,
Heinrich
J
.
Outdoor air pollution, greenspace, and incidence of ADHD: a semi-individual study
.
Sci Total Environ
.
2018
;
642
:
1362
1368
178
Van Aart
CJC
,
Michels
N
,
Sioen
I
, et al
.
Residential landscape as a predictor of psychosocial stress in the life course from childhood to adolescence
.
Environ Int
.
2018
;
120
:
456
463
179
Larson
LR
,
Barger
B
,
Ogletree
S
, et al
.
Gray space and green space proximity associated with higher anxiety in youth with autism
.
Health Place
.
2018
;
53
:
94
102
180
McEachan
RRC
,
Yang
TC
,
Roberts
H
, et al
.
Availability, use of, and satisfaction with green space, and children’s mental wellbeing at age 4 years in a multicultural, deprived, urban area: results from the Born in Bradford cohort study
.
Lancet Planet Health
.
2018
;
2
(
6
):
e244
e254
181
Li
DY
,
Deal
B
,
Zhou
X
,
Slavenas
M
,
Sullivan
WC
.
Moving beyond the neighborhood: daily exposure to nature and adolescents’ mood
.
Landsc Urban Plan
.
2018
;
173
:
33
43
182
Thygesen
M
,
Engemann
K
,
Holst
GJ
, et al
.
The association between residential green space in childhood and development of attention deficit hyperactivity disorder: a population-based cohort study
.
Environ Health Perspect
.
2020
;
128
(
12
):
127011
183
Scott
JT
,
Kilmer
RP
,
Wang
C
,
Cook
JR
,
Haber
MG
.
Natural environments near schools: potential benefits for socio-emotional and behavioral development in early childhood
.
Am J Community Psychol
.
2018
;
62
(
3–4
):
419
432
184
Andrusaityte
S
,
Grazuleviciene
R
,
Dedele
A
,
Balseviciene
B
.
The effect of residential greenness and city park visiting habits on preschool children’s mental and general health in Lithuania: a cross-sectional study
.
Int J Hyg Environ Health
.
2020
;
223
(
1
):
142
150
185
Jimenez
MP
,
Wellenius
GA
,
James
P
, et al
.
Associations of types of green space across the life-course with blood pressure and body mass index
.
Environ Res
.
2020
;
185
:
109411
186
Hayes
JF
,
Balantekin
KN
,
Conlon
RPK
, et al
.
Home and neighbourhood built environment features in family-based treatment for childhood obesity
.
Pediatr Obes
.
2019
;
14
(
3
):
e12477
187
Zhou
Y
,
Buck
C
,
Maier
W
,
von Lengerke
T
,
Walter
U
,
Dreier
M
.
Built environment and childhood weight status: a multi-level study using population-based data in the city of Hannover, Germany
.
Int J Environ Res Public Health
.
2020
;
17
(
8
):
2694
188
Wilding
S
,
Ziauddeen
N
,
Smith
D
,
Roderick
P
,
Chase
D
,
Alwan
NA
.
Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England
.
BMC Med
.
2020
;
18
(
1
):
43
189
White
MJ
,
McClure
E
,
Killeen
J
, et al
.
Changes in the recreational built environment and youth body mass index
.
Acad Pediatr
.
2021
;
21
(
1
):
76
83
190
Mears
M
,
Brindley
P
,
Baxter
I
,
Maheswaran
R
,
Jorgensen
A
.
Neighbourhood greenspace influences on childhood obesity in Sheffield, UK
.
Pediatr Obes
.
2020
;
15
(
7
):
e12629
191
Manandhar
S
,
Suksaroj
TT
,
Rattanapan
C
.
The association between green space and the prevalence of overweight/obesity among primary school children
.
Int J Occup Environ Med
.
2019
;
10
(
1
):
1
10
192
van der Zwaard
BC
,
Schalkwijk
AAH
,
Elders
PJM
,
Platt
L
,
Nijpels
G
.
Does environment influence childhood BMI? A longitudinal analysis of children aged 3-11
.
J Epidemiol Community Health
.
2018
;
72
(
12
):
1110
1116
193
Bloemsma
LD
,
Wijga
AH
,
Klompmaker
JO
, et al
.
The associations of air pollution, traffic noise and green space with overweight throughout childhood: the PIAMA birth cohort study
.
Environ Res
.
2019
;
169
:
348
356
194
Bringolf-Isler
B
,
Schindler
C
,
de Hoogh
K
, et al;
SOPHYA Study Group
.
Association of objectively measured and perceived environment with accelerometer-based physical activity and cycling: a Swiss population-based cross-sectional study of children
.
Int J Public Health
.
2019
;
64
(
4
):
499
510
195
Hunter
S
,
Rosu
A
,
Hesketh
KD
, et al
.
Objectively measured environmental correlates of toddlers’ physical activity and sedentary behavior
.
Pediatr Exerc Sci
.
2019
;
31
(
4
):
480
487
196
Hunter
S
,
Carson
V
,
Timperio
A
,
Salmon
J
,
Carver
A
,
Veitch
J
.
Moderators of parents’ perceptions of the neighborhood environment and children’s physical activity, time outside, and screen time
.
J Phys Act Health
.
2020
;
17
(
5
):
557
565
197
Queralt
A
,
Molina-García
J
.
Physical activity and active commuting in relation to objectively measured built-environment attributes among adolescents
.
J Phys Act Health
.
2019
;
16
(
5
):
371
374
198
Zahl-Thanem
T
,
Steinsbekk
S
,
Wichstrøm
L
.
Predictors of physical activity in middle childhood. A fixed-effects regression approach
.
Front Public Health
.
2018
;
6
:
305
199
Pedroni
C
,
Dujeu
M
,
Moreau
N
, et al
.
Environmental correlates of physical activity among children 10 to 13 years old in Wallonia (Belgium)
.
BMC Public Health
.
2019
;
19
(
1
):
187
200
Poulain
T
,
Sobek
C
,
Ludwig
J
, et al
.
Associations of green spaces and streets in the living environment with outdoor activity, media use, overweight/obesity and emotional wellbeing in children and adolescents
.
Int J Environ Res Public Health
.
2020
;
17
(
17
):
6321
201
Nordbø
ECA
,
Raanaas
RK
,
Nordh
H
,
Aamodt
G
.
Neighborhood green spaces, facilities and population density as predictors of activity participation among 8-year-olds: a cross-sectional GIS study based on the Norwegian mother and child cohort study
.
BMC Public Health
.
2019
;
19
(
1
):
1426
202
Vaccaro
JA
,
Zarini
GG
,
Huffman
FG
.
Parental perceptions of child’s medical care and neighborhood and child’s behavioral risk factors for obesity in U.S. children by body mass index classification
.
J Environ Public Health
.
2019
;
2019
:
3737194
203
Loh
VHY
,
Veitch
J
,
Salmon
J
, et al
.
Built environment and physical activity among adolescents: the moderating effects of neighborhood safety and social support
.
Int J Behav Nutr Phys Act
.
2019
;
16
(
1
):
132
204
Rossi
CE
,
Patrícia de Fragas
H
,
Corrêa
EN
,
das Neves
J
,
de Vasconcelos
FAG
.
Association between food, physical activity, and social assistance environments and the body mass index of schoolchildren from different socioeconomic strata
.
J Public Health (Oxf)
.
2019
;
41
(
1
):
e25
e34
205
Armstrong
GP
,
Maitland
C
,
Lester
L
, et al
.
Associations between the home yard and preschoolers’ outdoor play and physical activity
.
Public Health Res Pract
.
2019
;
29
(
1
):
2911907
206
Akpinar
A
.
Investigating the barriers preventing adolescents from physical activities in urban green spaces
.
Urban For Urban Green
.
2020
;
53
:
126724
207
Remmers
T
,
Thijs
C
,
Ettema
D
,
de Vries
S
,
Slingerland
M
,
Kremers
S
.
Critical hours and important environments: relationships between afterschool physical activity and the physical environment using GPS, GIS and accelerometers in 10-12-year-old children
.
Int J Environ Res Public Health
.
2019
;
16
(
17
):
3116
208
Reuben
A
,
Rutherford
GW
,
James
J
,
Razani
N
.
Association of neighborhood parks with child health in the United States
.
Prev Med
.
2020
;
141
:
106265
209
Flouri
E
,
Midouhas
E
,
Joshi
H
.
The role of urban neighbourhood green space in children’s emotional and behavioural resilience
.
J Environ Psychol
.
2014
;
40
:
179
186
210
Janssen
I
,
Rosu
A
.
Undeveloped green space and free-time physical activity in 11 to 13-year-old children
.
Int J Behav Nutr Phys Act
.
2015
;
12
:
26
211
Lovasi
GS
,
Jacobson
JS
,
Quinn
JW
,
Neckerman
KM
,
Ashby-Thompson
MN
,
Rundle
A
.
Is the environment near home and school associated with physical activity and adiposity of urban preschool children?
J Urban Health
.
2011
;
88
(
6
):
1143
1157
212
Cohen
DA
,
Ashwood
JS
,
Scott
MM
, et al
.
Public parks and physical activity among adolescent girls
.
Pediatrics
.
2006
;
118
(
5
).
213
Epstein
LH
,
Raja
S
,
Gold
SS
,
Paluch
RA
,
Pak
Y
,
Roemmich
JN
.
Reducing sedentary behavior: the relationship between park area and the physical activity of youth
.
Psychol Sci
.
2006
;
17
(
8
):
654
659
214
Amoly
E
,
Dadvand
P
,
Forns
J
, et al
.
Green and blue spaces and behavioral development in Barcelona schoolchildren: the BREATHE project
.
Environ Health Perspect
.
2014
;
122
(
12
):
1351
1358
215
Fuertes
E
,
Markevych
I
,
von Berg
A
, et al
.
Greenness and allergies: evidence of differential associations in two areas in Germany
.
J Epidemiol Community Health
.
2014
;
68
(
8
):
787
790
216
Fuertes
E
,
Markevych
I
,
Bowatte
G
, et al;
MACS
.
Residential greenness is differentially associated with childhood allergic rhinitis and aeroallergen sensitization in seven birth cohorts
.
Allergy
.
2016
;
71
(
10
):
1461
1471
217
Beere
P
,
Kingham
S
.
Assessing the relationship between greenspace and academic achievement in urban New Zealand primary schools
.
N Z Geog
.
2017
;
73
(
3
):
155
165
218
Huynh
Q
,
Craig
W
,
Janssen
I
,
Pickett
W
.
Exposure to public natural space as a protective factor for emotional well-being among young people in Canada
.
BMC Public Health
.
2013
;
13
:
407
219
Massougbodji
J
,
Lebel
A
,
De Wals
P
.
Individual and school correlates of adolescent leisure time physical activity in Quebec, Canada
.
Int J Environ Res Public Health
.
2018
;
15
(
3
):
412
220
Pagels
P
,
Raustorp
A
,
De Leon
AP
,
Mårtensson
F
,
Kylin
M
,
Boldemann
C
.
A repeated measurement study investigating the impact of school outdoor environment upon physical activity across ages and seasons in Swedish second, fifth and eighth graders
.
BMC Public Health
.
2014
;
14
:
803
221
Sivarajah
S
,
Smith
SM
,
Thomas
SC
.
Tree cover and species composition effects on academic performance of primary school students
.
PLos One
.
2018
;
13
(
2
):
e0193254
222
Wilhelmsen
CK
,
Skalleberg
K
,
Raanaas
RK
,
Tveite
H
,
Aamodt
G
.
Associations between green area in school neighbourhoods and overweight and obesity among Norwegian adolescents
.
Prev Med Rep
.
2017
;
7
:
99
105
223
Wu
CD
,
McNeely
E
,
Cedeño-Laurent
JG
, et al
.
Linking student performance in Massachusetts elementary schools with the “greenness” of school surroundings using remote sensing
.
PLoS One
.
2014
;
9
(
10
):
e108548
224
Bezold
CP
,
Stark
JH
,
Rundle
A
, et al
.
Relationship between recreational resources in the school neighborhood and changes in fitness in New York City public school students
.
J Urban Health
.
2017
;
94
(
1
):
20
29
225
Laxer
RE
,
Janssen
I
.
The proportion of youths’ physical inactivity attributable to neighbourhood built environment features
.
Int J Health Geogr
.
2013
;
12
:
31
226
MacNaughton
P
,
Eitland
E
,
Kloog
I
,
Schwartz
J
,
Allen
J
.
Impact of particulate matter exposure and surrounding “greenness” on chronic absenteeism in Massachusetts public schools
.
Int J Environ Res Public Health
.
2017
;
14
(
2
):
207
227
Hinkley
T
,
Salmon
J
,
Crawford
D
,
Okely
AD
,
Hesketh
KD
.
Preschool and childcare center characteristics associated with children’s physical activity during care hours: an observational study
.
Int J Behav Nutr Phys Act
.
2016
;
13
(
1
):
117
228
Donovan
GH
,
Michael
YL
,
Gatziolis
D
,
Hoyer
RW
.
The relationship between the natural environment and individual-level academic performance in Portland, Oregon
.
Environ Behav
.
2020
;
52
(
2
):
164
186
229
Luís
S
,
Dias
R
,
Lima
ML
.
Greener schoolyards, greener futures? Greener schoolyards buffer decreased contact with nature and are linked to connectedness to nature
.
Front Psychol
.
2020
;
11
:
567882
230
Li
DY
,
Chiang
YC
,
Sang
HY
,
Sullivan
WC
.
Beyond the school grounds: links between density of tree cover in school surroundings and high school academic performance
.
Urban For Urban Green
.
2019
;
38
:
42
53
231
Leung
WTV
,
Tam
TYT
,
Pan
WC
,
Wu
CD
,
Lung
SCC
,
Spengler
JD
.
How is environmental greenness related to students’ academic performance in English and mathematics?
Landsc Urban Plan
.
2019
;
181
:
118
124
232
Kuo
M
,
Klein
SE
,
Browning
MHEM
,
Zaplatosch
J
.
Greening for academic achievement: Prioritizing what to plant and where
.
Landsc Urban Plan
.
2021
;
206
:
103962
233
Kuo
M
,
Browning
MHEM
,
Penner
ML
.
Do lessons in nature boost subsequent classroom engagement? Refueling students in flight
.
Front Psychol
.
2018
;
8
:
2253
234
Tallis
H
,
Bratman
GN
,
Samhouri
JF
,
Fargione
J
.
Are California elementary school test scores more strongly associated with urban trees than poverty?
Front Psychol
.
2018
;
9
:
2074
235
Browning
MHEM
,
Locke
DH
.
The greenspace-academic performance link varies by remote sensing measure and urbanicity around Maryland public schools
.
Landsc Urban Plan
.
2020
;
195
:
103706
236
Zeng
XW
,
Lowe
AJ
,
Lodge
CJ
, et al
.
Greenness surrounding schools is associated with lower risk of asthma in schoolchildren
.
Environ Int
.
2020
;
143
:
105967
237
Xiao
X
,
Yang
BY
,
Hu
LW
, et al
.
Greenness around schools associated with lower risk of hypertension among children: findings from the Seven Northeastern Cities Study in China
.
Environ Pollut
.
2020
;
256
:
113422
238
Yang
BY
,
Zeng
XW
,
Markevych
I
, et al
.
Association between greenness surrounding schools and kindergartens and attention-deficit/hyperactivity disorder in children in China
.
JAMA Netw Open
.
2019
;
2
(
12
):
e1917862
239
Liao
J
,
Yang
S
,
Xia
W
, et al
.
Associations of exposure to green space with problem behaviours in preschool-aged children
.
Int J Epidemiol
.
2020
;
49
(
3
):
944
953
240
Amicone
G
,
Petruccelli
I
,
De Dominicis
S
, et al
.
Green breaks: the restorative effect of the school environment’s green areas on children’s cognitive performance
.
Front Psychol
.
2018
;
9
:
1579
241
Paciência
I
,
Cavaleiro Rufo
J
,
Mendes
F
, et al
.
A cross-sectional study of the impact of school neighbourhood on children obesity and body composition
.
Eur J Pediatr
.
2021
;
180
(
2
):
535
545
242
Bao
WW
,
Yang
BY
,
Zou
ZY
, et al
.
Greenness surrounding schools and adiposity in children and adolescents: findings from a national population-based study in China
.
Environ Res
.
2021
;
192
:
110289
243
Fyfe-Johnson
AL
,
Saelens
BE
,
Christakis
DA
,
Tandon
PS
.
Physical activity and parental attitudes and beliefs of children attending a nature preschool
.
International Journal of Early Childhood Environmental Education
.
2019
;
6
(
3
):
3
17
244
Neshteruk
CD
,
Mazzucca
S
,
Østbye
T
,
Ward
DS
.
The physical environment in family childcare homes and children’s physical activity
.
Child Care Health Dev
.
2018
;
44
(
5
):
746
752
245
Ng
M
,
Rosenberg
M
,
Thornton
A
, et al
.
The effect of upgrades to childcare outdoor spaces on preschoolers’ physical activity: findings from a natural experiment
.
Int J Environ Res Public Health
.
2020
;
17
(
2
):
468
246
Määttä
S
,
Lehto
R
,
Konttinen
H
, et al
.
Preschool group practices and preschool children’s sedentary time: a cross-sectional study in Finland
.
BMJ Open
.
2019
;
9
(
12
):
e032210
247
van Dijk-Wesselius
JE
,
Maas
J
,
Hovinga
D
,
van Vugt
M
,
van den Berg
AE
.
The impact of greening schoolyards on the appreciation, and physical, cognitive and social-emotional well-being of schoolchildren: a prospective intervention study
.
Landsc Urban Plan
.
2018
;
180
:
15
26
248
Määttä
S
,
Gubbels
J
,
Ray
C
, et al
.
Children’s physical activity and the preschool physical environment: the moderating role of gender
.
Early Child Res Q
.
2019
;
47
:
39
48
249
Sando
OJ
.
The outdoor environment and children’s health: a multilevel approach
.
Int J Play
.
2019
;
8
(
1
):
39
52
250
Babey
SH
,
Tan
D
,
Wolstein
J
,
Diamant
AL
.
Neighborhood, family and individual characteristics related to adolescent park-based physical activity
.
Prev Med
.
2015
;
76
:
31
36
251
Baek
S
,
Raja
S
,
Park
J
,
Epstein
LH
,
Yin
L
,
Roemmich
JN
.
Park design and children’s active play: a microscale spatial analysis of intensity of play in Olmsted’s Delaware Park
.
Environ Plan B Urban Anal City Sci
.
2015
;
42
(
6
):
1079
1097
252
Barton
J
,
Sandercock
G
,
Pretty
J
,
Wood
C
.
The effect of playground- and nature-based playtime interventions on physical activity and self-esteem in UK school children
.
Int J Environ Health Res
.
2015
;
25
(
2
):
196
206
253
Bocarro
JN
,
Floyd
MF
,
Smith
WR
, et al
.
Social and environmental factors related to boys’ and girls’ park-based physical activity
.
Prev Chronic Dis
.
2015
;
12
:
E97
254
Boldemann
C
,
Dal
H
,
Martensson
F
, et al
.
Preschool outdoor play environment may combine promotion of children’s physical activity and sun protection. Further evidence from Southern Sweden and North Carolina
.
Sci Sports
.
2011
;
26
(
2
):
72
82
255
Bürgi
R
,
Tomatis
L
,
Murer
K
,
de Bruin
ED
.
Spatial physical activity patterns among primary school children living in neighbourhoods of varying socioeconomic status: a cross-sectional study using accelerometry and global positioning system
.
BMC Public Health
.
2016
;
16
:
282
256
Chomitz
VR
,
Aske
DB
,
McDonald
J
,
Cabral
H
,
Hacker
KA
.
The role of recreational spaces in meeting physical activity recommendations among middle school students
.
J Phys Act Health
.
2011
;
8
(
suppl 1
):
S8
S16
257
Coombes
E
,
van Sluijs
E
,
Jones
A
.
Is environmental setting associated with the intensity and duration of children’s physical activity? Findings from the SPEEDY GPS study
.
Health Place
.
2013
;
20
:
62
65
258
Floyd
MF
,
Bocarro
JN
,
Smith
WR
, et al
.
Park-based physical activity among children and adolescents
.
Am J Prev Med
.
2011
;
41
(
3
):
258
265
259
French
SA
,
Sherwood
NE
,
Mitchell
NR
,
Fan
Y
.
Park use is associated with less sedentary time among low-income parents and their preschool child: the NET-Works study
.
Prev Med Rep
.
2016
;
5
:
7
12
260
Haug
E
,
Torsheim
T
,
Samdal
O
.
Physical environmental characteristics and individual interests as correlates of physical activity in Norwegian secondary schools: the health behaviour in school-aged children study
.
Int J Behav Nutr Phys Act
.
2008
;
5
:
47
261
Jones
AP
,
Coombes
EG
,
Griffin
SJ
,
van Sluijs
EM
.
Environmental supportiveness for physical activity in English schoolchildren: a study using global positioning systems
.
Int J Behav Nutr Phys Act
.
2009
;
6
:
42
262
Klinker
CD
,
Schipperijn
J
,
Kerr
J
,
Ersbøll
AK
,
Troelsen
J
.
Context-specific outdoor time and physical activity among school-children across gender and age: using accelerometers and GPS to advance methods
.
Front Public Health
.
2014
;
2
:
20
263
Klinker
CD
,
Schipperijn
J
,
Christian
H
,
Kerr
J
,
Ersbøll
AK
,
Troelsen
J
.
Using accelerometers and global positioning system devices to assess gender and age differences in children’s school, transport, leisure and home based physical activity
.
Int J Behav Nutr Phys Act
.
2014
;
11
:
8
264
Lachowycz
K
,
Jones
AP
,
Page
AS
,
Wheeler
BW
,
Cooper
AR
.
What can global positioning systems tell us about the contribution of different types of urban greenspace to children’s physical activity?
Health Place
.
2012
;
18
(
3
):
586
594
265
Määttä
S
,
Ray
C
,
Vepsäläinen
H
, et al
.
Parental education and pre-school children’s objectively measured sedentary time: the role of co-participation in physical activity
.
Int J Environ Res Public Health
.
2018
;
15
(
2
):
366
266
Mårtensson
F
,
Boldemann
C
,
Söderström
M
,
Blennow
M
,
Englund
JE
,
Grahn
P
.
Outdoor environmental assessment of attention promoting settings for preschool children
.
Health Place
.
2009
;
15
(
4
):
1149
1157
267
Martensson
F
,
Jansson
M
,
Johansson
M
,
Raustorp
A
,
Kylin
M
,
Boldemann
C
.
The role of greenery for physical activity play at school grounds
.
Urban For Urban Green
.
2014
;
13
(
1
):
103
113
268
McMinn
D
,
Oreskovic
NM
,
Aitkenhead
MJ
,
Johnston
DW
,
Murtagh
S
,
Rowe
DA
.
The physical environment and health-enhancing activity during the school commute: global positioning system, geographical information systems and accelerometry
.
Geospat Health
.
2014
;
8
(
2
):
569
572
269
Rainham
DG
,
Bates
CJ
,
Blanchard
CM
,
Dummer
TJ
,
Kirk
SF
,
Shearer
CL
.
Spatial classification of youth physical activity patterns
.
Am J Prev Med
.
2012
;
42
(
5
):
e87
e96
270
Reed
K
,
Wood
C
,
Barton
J
,
Pretty
JN
,
Cohen
D
,
Sandercock
GRH
.
A repeated measures experiment of green exercise to improve self-esteem in UK school children
.
PLoS One
.
2013
;
8
(
7
):
e69176
271
Taylor
AF
,
Kuo
FE
,
Sullivan
WC
.
Coping with add: the surprising connection to green play settings
.
Environ Behav
.
2001
;
33
(
1
):
54
77
272
van den Berg
AE
,
van den Berg
CG
.
A comparison of children with ADHD in a natural and built setting
.
Child Care Health Dev
.
2011
;
37
(
3
):
430
439
273
Ward
JS
,
Duncan
JS
,
Jarden
A
,
Stewart
T
.
The impact of children’s exposure to greenspace on physical activity, cognitive development, emotional wellbeing, and ability to appraise risk
.
Health Place
.
2016
;
40
:
44
50
274
Wheeler
BW
,
Cooper
AR
,
Page
AS
,
Jago
R
.
Greenspace and children’s physical activity: a GPS/GIS analysis of the PEACH project
.
Prev Med
.
2010
;
51
(
2
):
148
152
275
Vales
C
,
States
SL
,
Fisher
AV
.
Experience-driven semantic differentiation: effects of a naturalistic experience on within- and across-domain differentiation in children
.
Child Dev
.
2020
;
91
(
3
):
733
742
276
Dadvand
P
,
Poursafa
P
,
Heshmat
R
, et al
.
Use of green spaces and blood glucose in children; a population-based CASPIAN-V study
.
Environ Pollut
.
2018
;
243
(
pt B
):
1134
1140
277
Song
MK
,
Bang
KS
,
Kim
S
,
Lee
G
,
Jeong
Y
.
Effects of an urban forest-based health promotion program on children living in group homes
.
J Psychosoc Nurs Ment Health Serv
.
2020
;
58
(
6
):
18
29
278
Benita
F
,
Bansal
G
,
Tunçer
B
.
Public spaces and happiness: evidence from a large-scale field experiment
.
Health Place
.
2019
;
56
:
9
18
279
Razani
N
,
Niknam
K
,
Wells
NM
, et al
.
Clinic and park partnerships for childhood resilience: a prospective study of park prescriptions
.
Health Place
.
2019
;
57
:
179
185
280
Akpınar
A
.
Green exercise: how are characteristics of urban green spaces associated with adolescents’ physical activity and health?
Int J Environ Res Public Health
.
2019
;
16
(
21
):
4281
281
Freeman
N
,
Gage
R
,
Chambers
T
, et al
.
Where do the children play? An objective analysis of children’s use of green space [published online ahead of print October 29, 2020]
.
Health Promot Int
.
doi:https://doi.org/10.1093/heapro/daaa106
282
Benjamin-Neelon
SE
,
Platt
A
,
Bacardi-Gascon
M
,
Armstrong
S
,
Neelon
B
,
Jimenez-Cruz
A
.
Greenspace, physical activity, and BMI in children from two cities in northern Mexico
.
Prev Med Rep
.
2019
;
14
:
100870
283
Boldemann
C
,
Blennow
M
,
Dal
H
, et al
.
Impact of preschool environment upon children’s physical activity and sun exposure
.
Prev Med
.
2006
;
42
(
4
):
301
308
284
Bettmann
JE
,
Russell
KC
,
Parry
KJ
.
How substance abuse recovery skills, readiness to change and symptom reduction impact change processes in wilderness therapy participants
.
J Child Fam Stud
.
2013
;
22
(
8
):
1039
1050
285
Combs
KM
,
Hoag
MJ
,
Roberts
SD
,
Javorski
S
.
A multilevel model to examine adolescent outcomes in outdoor behavioral healthcare: the parent perspective
.
Child Youth Care Forum
.
2016
;
45
(
3
):
353
365
286
Combs
KM
,
Hoag
MJ
,
Javorski
S
,
Roberts
SD
.
Adolescent self-assessment of an outdoor behavioral health program: longitudinal outcomes and trajectories of change
.
J Child Fam Stud
.
2016
;
25
(
11
):
3322
3330
287
Davis-Berman
J
,
Berman
DS
.
The wilderness therapy program: an empirical study of its effects with adolescents in an outpatient setting
.
J Contemp Psychother
.
1989
;
19
(
4
):
271
281
288
Fuller
C
,
Powell
D
,
Fox
S
.
Making gains: the impact of outdoor residential experiences on students’ examination grades and self-efficacy
.
Educ Rev (Birm)
.
2017
;
69
(
2
):
232
247
289
Margalit
D
,
Ben-Ari
A
.
The effect of wilderness therapy on adolescents’ cognitive autonomy and self-efficacy: results of a non-randomized trial
.
Child Youth Care Forum
.
2014
;
43
(
2
):
181
194
290
Russell
K
.
An assessment of outcomes in outdoor behavioral healthcare treatment
.
Child Youth Care Forum
.
2003
;
32
(
6
):
355
381
291
Scrutton
RA
.
Outdoor adventure education for children in Scotland: Quantifying the benefits
.
Journal of Adventure Education and Outdoor Learning
.
2015
;
15
(
2
):
123
137
292
Park
SA
,
Lee
AY
,
Lee
KS
,
Son
KC
.
Comparison of the metabolic costs of gardening and common physical activities in children
.
Weonye Gwahag Gisulji
.
2014
;
32
(
1
):
123
128
293
Wells
NM
,
Myers
BM
,
Todd
LE
, et al
.
The effects of school gardens on children’s science knowledge: a randomized controlled trial of low-income elementary schools
.
Int J Sci Educ
.
2015
;
37
(
17
):
2858
2878
294
Davis
JN
,
Pérez
A
,
Asigbee
FM
, et al
.
School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial
.
Int J Behav Nutr Phys Act
.
2021
;
18
(
1
):
18
295
Wells
NM
,
Myers
BM
,
Henderson
CR
 Jr
.
School gardens and physical activity: a randomized controlled trial of low-income elementary schools
.
Prev Med
.
2014
;
69
(
suppl 1
):
S27
S33
296
Mygind
E
.
A comparison between children’s physical activity levels at school and learning in an outdoor environment
.
Journal of Adventure Education and Outdoor Learning
.
2007
;
7
(
2
):
161
176
297
Mygind
L
,
Stevenson
MP
,
Liebst
LS
,
Konvalinka
I
,
Bentsen
P
.
Stress response and cognitive performance modulation in classroom versus natural environments: a quasi-experimental pilot study with children
.
Int J Environ Res Public Health
.
2018
;
15
(
6
):
1098
298
Rees-Punia
E
,
Holloway
A
,
Knauft
D
,
Schmidt
MD
.
Effects of school gardening lessons on elementary school children’s physical activity and sedentary time
.
J Phys Act Health
.
2017
;
14
(
12
):
959
964
299
Roe
J
,
Aspinall
P
.
The restorative outcomes of forest school and conventional school in young people with good and poor behaviour
.
Urban For Urban Green
.
2011
;
10
(
3
):
205
212
300
Storli
R
,
Hagen
TL
.
Affordances in outdoor environments and children’s physically active play in pre-school
.
European Early Childhood Education Research Journal
.
2010
;
18
(
4
):
445
456
301
Aflalo
E
,
Montin
R
,
Raviv
A
.
Learning outdoors or with a computer: the contribution of the learning setting to learning and to environmental perceptions
.
Research in Science and Technological Education
.
2020
;
38
(
2
):
208
226
302
Norwood
MF
,
Lakhani
A
,
Kendall
E
.
Teaching traditional indoor school lessons in nature: the effects on student learning and behaviour
.
Landsc Urban Plan
.
2021
;
206
:
103963
303
Burgess
E
,
Ernst
J
.
Beyond traditional school readiness: how nature preschools help prepare children for academic success
.
International Journal of Early Childhood Environmental Education
.
2020
;
7
(
2
):
17
33
304
Harvey
DJ
,
Montgomery
LN
,
Harvey
H
,
Hall
F
,
Gange
AC
,
Watling
D
.
Psychological benefits of a biodiversity-focussed outdoor learning program for primary school children
.
J Environ Psychol
.
2020
;
67
:
101381
305
Wallner
P
,
Kundi
M
,
Arnberger
A
, et al
.
Reloading pupils’ batteries: impact of green spaces on cognition and well-being
.
Int J Environ Res Public Health
.
2018
;
15
(
6
):
1205
306
Largo-Wight
E
,
Guardino
C
,
Wludyka
PS
,
Hall
KW
,
Wight
JT
,
Merten
JW
.
Nature contact at school: the impact of an outdoor classroom on children’s well-being
.
Int J Environ Health Res
.
2018
;
28
(
6
):
653
666
307
Ekenga
CC
,
Sprague
N
,
Shobiye
DM
.
Promoting health-related quality of life in minority youth through environmental education and nature contact
.
Sustainability
.
2019
;
11
(
13
):
3544
308
Trapasso
E
,
Knowles
Z
,
Boddy
L
,
Newson
L
,
Sayers
J
,
Austin
C
.
Exploring gender differences within forest schools as a physical activity intervention
.
Children (Basel)
.
2018
;
5
(
10
):
138
309
Romar
JE
,
Enqvist
I
,
Kulmala
J
,
Kallio
J
,
Tammelin
T
.
Physical activity and sedentary behaviour during outdoor learning and traditional indoor school days among Finnish primary school students
.
Journal of Adventure Education and Outdoor Learning
.
2019
;
19
(
1
):
28
42
310
Chiumento
A
,
Mukherjee
I
,
Chandna
J
,
Dutton
C
,
Rahman
A
,
Bristow
K
.
A haven of green space: learning from a pilot pre-post evaluation of a school-based social and therapeutic horticulture intervention with children
.
BMC Public Health
.
2018
;
18
(
1
):
836
311
Yildirim
G
,
Özyilmaz Akamca
G
.
The effect of outdoor learning activities on the development of preschool children
.
S Afr J Educ
.
2017
;
37
(
2
):
1378
312
Bagot
KL
,
Allen
FCL
,
Toukhsati
S
.
Perceived restorativeness of children’s school playground environments: nature, playground features and play period experiences
.
J Environ Psychol
.
2015
;
41
:
1
9
313
Brussoni
M
,
Ishikawa
T
,
Brunelle
S
,
Herrington
S
.
Landscapes for play: effects of an intervention to promote nature-based risky play in early childhood centres
.
J Environ Psychol
.
2017
;
54
:
139
150
314
Dyment
JE
,
Bell
AC
,
Lucas
AJ
.
The relationship between school ground design and intensity of physical activity
.
Child Geogr
.
2009
;
7
(
3
):
261
276
315
Nicaise
V
,
Kahan
D
,
Reuben
K
,
Sallis
JF
.
Evaluation of a redesigned outdoor space on preschool children’s physical activity during recess
.
Pediatr Exerc Sci
.
2012
;
24
(
4
):
507
518
316
Khan
M
,
McGeown
S
,
Bell
S
.
Can an outdoor learning environment improve children’s academic attainment? A quasi-experimental mixed methods study in Bangladesh
.
Environ Behav
.
2020
;
52
(
10
):
1079
1104
317
Vert
C
,
Carrasco-Turigas
G
,
Zijlema
W
, et al
.
Impact of a riverside accessibility intervention on use, physical activity, and well-being: a mixed methods pre-post evaluation
.
Landsc Urban Plan
.
2019
;
190
:
103611
318
Raney
MA
,
Hendry
CF
,
Yee
SA
.
Physical activity and social behaviors of urban children in green playgrounds
.
Am J Prev Med
.
2019
;
56
(
4
):
522
529
319
Schutte
AR
,
Torquati
JC
,
Beattie
HL
.
Impact of urban nature on executive functioning in early and middle childhood
.
Environ Behav
.
2017
;
49
(
1
):
3
30
320
Taylor
AF
,
Kuo
FE
.
Children with attention deficits concentrate better after walk in the park
.
J Atten Disord
.
2009
;
12
(
5
):
402
409
321
Johnson
SA
,
Snow
S
,
Lawrence
MA
,
Rainham
DGC
.
Quasi-randomized trial of contact with nature and effects on attention in children
.
Front Psychol
.
2019
;
10
:
2652
322
Stevenson
MP
,
Dewhurst
R
,
Schilhab
T
,
Bentsen
P
.
Cognitive restoration in children following exposure to nature: evidence from the Attention Network Task and mobile eye tracking
.
Front Psychol
.
2019
;
10
:
42
323
Roemmich
JN
,
Epstein
LH
,
Raja
S
,
Yin
L
,
Robinson
J
,
Winiewicz
D
.
Association of access to parks and recreational facilities with the physical activity of young children
.
Prev Med
.
2006
;
43
(
6
):
437
441
324
Bowen
DJ
,
Neill
JT
,
Crisp
SJR
.
Wilderness adventure therapy effects on the mental health of youth participants
.
Eval Program Plann
.
2016
;
58
:
49
59
325
Goodman
R
.
The strengths and difficulties questionnaire: a research note
.
J Child Psychol Psychiatry
.
1997
;
38
(
5
):
581
586
326
Lee
KS
,
Kim
BN
,
Cho
J
, et al
.
Associations between surrounding residential greenness and intelligence quotient in 6-year-old children
.
Sci Total Environ
.
2021
;
759
:
143561
327
Kuo
M
,
Browning
MHEM
,
Sachdeva
S
,
Lee
K
,
Westphal
L
.
Might school performance grow on trees? Examining the link between “greenness” and academic achievement in urban, high-poverty schools
.
Front Psychol
.
2018
;
9
:
1669
328
Pont
SJ
,
Zaplatosch
J
,
Lamar
M
,
Milligan-Toffler
S
,
Louv
R
,
Jordan
C
.
Green schoolyards support healthy bodies, minds and communities
.
Pediatrics
.
2018
;
142
(
1 MeetingAbstract
):
733
329
Cohen
DA
,
Han
B
,
Isacoff
J
, et al
.
Impact of park renovations on park use and park-based physical activity
.
J Phys Act Health
.
2015
;
12
(
2
):
289
295
330
Cohen
DA
,
Han
B
,
Derose
KP
, et al
.
The paradox of parks in low-income areas: park use and perceived threats
.
Environ Behav
.
2016
;
48
(
1
):
230
245
331
Herrington
S
,
Brussoni
M
.
Beyond physical activity: the importance of play and nature-based play spaces for children’s health and development
.
Curr Obes Rep
.
2015
;
4
(
4
):
477
483
332
Piercy
KL
,
Troiano
RP
.
Physical activity guidelines for Americans from the US Department of Health and Human Services
.
Circ Cardiovasc Qual Outcomes
.
2018
;
11
(
11
):
e005263
333
Pretty
J
,
Peacock
J
,
Sellens
M
,
Griffin
M
.
The mental and physical health outcomes of green exercise
.
Int J Environ Health Res
.
2005
;
15
(
5
):
319
337
334
Focht
BC
.
Brief walks in outdoor and laboratory environments: effects on affective responses, enjoyment, and intentions to walk for exercise
.
Res Q Exerc Sport
.
2009
;
80
(
3
):
611
620
335
Thompson Coon
J
,
Boddy
K
,
Stein
K
,
Whear
R
,
Barton
J
,
Depledge
MH
.
Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental well-being than physical activity indoors? A systematic review
.
Environ Sci Technol
.
2011
;
45
(
5
):
1761
1772
336
Kohl
HW
 III
,
Craig
CL
,
Lambert
EV
, et al;
Lancet Physical Activity Series Working Group
.
The pandemic of physical inactivity: global action for public health
.
Lancet
.
2012
;
380
(
9838
):
294
305
337
Caballero
B
.
The global epidemic of obesity: an overview
.
Epidemiol Rev
.
2007
;
29
(
1
):
1
5
338
Zhang
Y
,
Mavoa
S
,
Zhao
J
,
Raphael
D
,
Smith
M
.
The association between green space and adolescents’ mental well-being: a systematic review
.
Int J Environ Res Public Health
.
2020
;
17
(
18
):
1
26
339
Johnson
TJ
.
Intersection of bias, structural racism, and social determinants with health care inequities
.
Pediatrics
.
2020
;
146
(
2
):
e2020003657
340
Trent
M
,
Dooley
DG
,
Dougé
J
;
Section on Adolescent Health; Council on Community Pediatrics; Committee on Adolescence
.
The impact of racism on child and adolescent health
.
Pediatrics
.
2019
;
144
(
2
):
e20191765
341
Paradies
Y
,
Ben
J
,
Denson
N
, et al
.
Racism as a determinant of health: a systematic review and meta-analysis
.
PLoS One
.
2015
;
10
(
9
):
e0138511
342
Mitra
R
,
Moore
SA
,
Gillespie
M
, et al
.
Healthy movement behaviours in children and youth during the COVID-19 pandemic: exploring the role of the neighbourhood environment
.
Health Place
.
2020
;
65
:
102418
343
The Trust For Public Land
.
The heat is on
.
344
Wen
M
,
Zhang
X
,
Harris
CD
,
Holt
JB
,
Croft
JB
.
Spatial disparities in the distribution of parks and green spaces in the USA
.
Ann Behav Med
.
2013
;
45
(
supp 1
):
S18
S27
345
Abercrombie
LC
,
Sallis
JF
,
Conway
TL
,
Frank
LD
,
Saelens
BE
,
Chapman
JE
.
Income and racial disparities in access to public parks and private recreation facilities
.
Am J Prev Med
.
2008
;
34
(
1
):
9
15

Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Supplementary data