Momentary mood response to natural outdoor environments in four European cities

Meadows or asphalt road - Does momentary affective well-being vary with immediate physical environment? Results from a geographic ecological momentary assessment study in three metropolitan areas in Germany

We investigated the association between the immediate physical environment of individuals and individual fluctuations of momentary affective well-being in everyday life with a focus on medium sized metropolitan areas in Europe representing a typical living environment of a large proportion of the world's population. The sample comprised 365 individuals (54.8 % female) with participants ranging from 14.08 to 88.27 years of age (M = 43.9, SD = 20.9). In an geographic ecological momentary assessment (GEMA), participants were prompted six times a day on at least 9 days over the course of 3 weeks, covering a total of six weekdays and three weekend days on mobile phones to report their momentary affective well-being. Urban land use categories (forest, water, urban green) were assessed with GPS-localization as environmental variables. Additionally, sunshine, rainfall, whether participants were inside or outside as well as whether they were alone or had company were included into the analyses. We used dynamic structural equation modelling to model the inter- and intraindividual differences as well as fluctuations and assess potential covariates while acknowledging the autoregressive nature of affect. The results showed that on individual level, fluctuations of momentary affective well-being were associated with sunshine, having company and travelling. No significant association emerged for urban green, forest, and water neither within individuals nor between. Methodological as well as conceptual implications are discussed and an interpretation of the present findings are provided.

Quantifying physiological health efficiency and benefit threshold of greenspace exposure in typical urban landscapes

Although greenspace exposure has physiological health benefits, there is insufficient research on the threshold effect of health benefits in typical urban landscapes. Here we selected five typical urban landscapes (open greenspace, semi-closed greenspace, closed greenspace, bluespace, grey space) in 15 urban parks in Xiamen, China, and applied the physiological health threshold model to calculate the efficiency threshold and benefit threshold of greenspace exposure by continuously monitoring the changes of two physiological indicators-electroencephalography (EEG) and heart rate (HR). (1) The EEG threshold results show that compared with greenspace exposure, bluespace exposure can reach the physiological health efficiency threshold faster (4-5 min) but does not show an advantage in terms of benefit threshold. The more open the greenspace, the faster it can reach the efficiency threshold (5-6 min), but the higher the canopy density of the (closed) greenspace, the shorter the time to reach the efficiency threshold (8-9 min). (2) The HR threshold shows that bluespace and open greenspace are the fastest to reach the efficiency threshold (1 min), with the remaining greenspace reaching it after 6-7 min. The benefit threshold was reached faster in the bluespace (11 min) than in the greenspace (18-21 min), and the degree of openness of the greenspace has no significant effect on the speed of benefit thresholds. (3) Combining the results of EEG and HR thresholds, it can be seen that bluespace is better at reducing stress, while open greenspace can reach efficiency thresholds more quickly. This study confirms the physiological health threshold model, offering a reference for urban greenspace planning to enhance residents' stress management and health.

Outdoor physical activity is not associated with better mental health in a sample of predominantly Black people, but spending time in parks is

Spending time outdoors may bolster mental health via relaxation and physical activity. Yet, most studies use self-report and involve majority White samples from higher income areas. Findings may not hold true using device-derived measurement, among minoritized participants, or in low-income neighborhoods. Our objectives were to test whether: i) time spent outdoors in physical activity is associated with mental health; ii) the effect is modified by the positive or negative outdoor conditions (amount of greenness or vacant houses/lots encountered while outdoors); iii) there is a correlation between our measures of outdoor conditions and perceived neighborhood conditions; and iv) there is a different relationship between time spent outdoors in parks (as an indicator of intentional nature exposure) and mental health. The sample of 112 participants (87% Black/African American persons) from 11 Detroit, MI neighborhoods wore a GPS and accelerometer for one week (May-Oct 2021) and completed a survey. We calculated exposure to greenness, vacant lots/houses while outdoors, and perceived neighborhood aesthetics. We fitted regression models for mental health measures separately and included time spent outdoors in PA, age, sex, and days with high precipitation. We then fitted models stratified by outdoor conditions. Last, we examined whether a similar relationship could be detected for time spent outdoors in parks. On average, ~30% of PA was conducted outdoors, and 56% of outdoor time involved PA. We observed an unexpected positive association between outdoor PA and anxiety (coef: 0.33, 95% CI: 0.14-0.51), depression (coef: 0.31, 95% CI: 0.15-0.47), and perceived stress score (coef: 0.18, 95% CI: 0.07-0.29). When stratified, we found consistent and/or larger associations for those exposed to high levels of vacant homes, high greenness (both aerial and street-level), low levels of vacant lots, and low perceived neighborhood aesthetics. Importantly and in contrast, we observed the opposite trend when examining time spent in parks (coef: -0.05, 95% CI: -0.10--0.01). These results contrast many studies showing positive relationships between time outdoors and mental health and highlight the need for research with diverse populations and better measures of outdoor conditions and intentionality of greenspace contact.

Assessing momentary stress responses to dynamic real-time greenspace exposure: Unveiling algorithmic uncertainty and the temporality of exposure context

Mental stress issues are emerging among residents of modern cities. Among environmental factors associated with stress mitigation, greenspace has consistently been shown to have significant stress-reducing properties. However, the temporality of greenspace exposure, particularly the cumulative threshold effect in urban environments, has been largely neglected in past studies. In addition, different algorithms and their related measurements of greenspace have led to inconsistent mental health outcomes. To address both gaps, we evaluated the dynamic greenspace exposure of 221 Hong Kong residents by integrating three distinct green space measurements: the Normalized Difference Vegetation Index (NDVI), the Green Space Area Ratio (GSAR), and the Eye-level Green View Index (GVI) based on individual real-time GPS data. We subsequently gauged individual momentary stress levels via Ecological Momentary Assessment (EMA) and modeled its association with dynamic green space exposure using mixed ordinal logistic regression across diverse cumulative time frames. The results reveal great disparities in greenspace-stress association between different greenspace measurements and different cumulative time frames: (1) Among the three measurements, GVI is the most robust and effective measurement in assessing the stress-reducing effect in urban environments. (2) Within specific time frames, cumulative exposure has a more pronounced stress-reducing influence than momentary exposure. (3) The stress-reducing effects of cumulative eye-level greenspace exposure exhibit two temporal phases: A continuous exposure spanning 12-36 min leads to a progressive enhancement in the stress-mitigating effect of eye-level greenspace, peaking initially and then diminishing after 36 min. Upon extended exposure reaching 2.3 h, the stress-alleviating impact of eye-level green space peaks once again before gradually waning. Our research underscores the need for multiple measurements of environmental exposure to address the algorithmic uncertainty in environmental health research and deeper insights into the temporality of the greenspace-mental relationship.

ECO-MIND: enhancing pro-environmental behaviours and mental health through nature contact for urban youth - a research protocol for a multi-country study using geographic ecological momentary assessment and mental models

INTRODUCTION

Urban youth are experiencing increasing mental health problems due to diverse personal, social and environmental concerns. Youths' detachment from natural environments, including green and blue spaces, may intensify such issues further. Contact with nature can benefit mental health and promote pro-environmental behaviour (PEB). Yet, only a few studies assess these relationships among the youth usually ignoring effects of living in diverse urban contexts, and everyday nature experiences. ECO-MIND will investigate whether urban youth's dynamic greenspace exposure and their mental models about nature connectedness explain the associations between greenspace exposure, mental health and PEB in multiple urban contexts.

METHODS AND ANALYSIS

We will collect data from university students from the Global South (ie, Dhaka, Kampala) and Global North cities (ie, Utrecht). Participants aged 18-24 will be recruited through stratified random sampling. We will use geographic ecological momentary assessment to assess respondents' everyday experiences and exposure to greenspaces. Our definition of greenspace exposure will be based on the availability, accessibility and visibility of greenspaces extracted from satellite and street view images. We will administer a baseline questionnaire to participants about mental health, nature connectedness and PEB characteristics. Further, we will ask participants to build mental models to show their perception of nature connectedness. Finally, we will fit partial least square structural equation models and multi-level models to our longitudinal geographic momentary assessment data.

ETHICS AND DISSEMINATION

The study was approved by the Ethical Review Board of the Utrecht University (Geo S-23221). Informed consent must be given freely, without coercion and based on a clear understanding of the participation in the study. Findings will be disseminated in peer-reviewed journals and at conferences. Furthermore, we will implement public engagement activities (eg, panel discussion) to share results among local stakeholders and policymakers and cocreate policy briefs.

Relationship between sun exposure and seasonal affective disorder symptoms in rural older people with different personalities: a cross-sectional study

OBJECTIVES

Evidence suggests that environmental support, personality traits, and psychological factors can influence seasonal changes in human mood and behavior, particularly in rural middle-aged women and older people. This study aimed to quantify the associations between personality traits, seasonal affective disorder symptoms, and sun exposure in rural older people.

METHODS

This study is a cross-sectional analytical study, the participants were 300 rural older persons from 12 natural villages and 5 geriatric service centers in 4 different cities in Jiangxi Province, China. The Eysenck Personality Questionnaire (EPQ), the Personal Inventory of Depression and Seasonal Affective Disorder (PIDS-SA-SimpChi), and the Sunlight Exposure Scale were used to conduct follow-up interviews throughout the year. Spatial analysis was performed using ArcGIS and Geodetic Probes. The data were analyzed using SPSS 21 and Amos 23.0 mediated models.

RESULTS

Rural older people with low sun exposure exhibited higher personality trait scores (p < 0.001). Personality traits were directly associated with seasonal affective disorder symptoms(p < 0.01); Sun exposure mediated this effect in rural older people (p < 0.05).

CONCLUSION

High-scoring personalities are more typical of rural older people with low sun exposure, and there is a greater risk of emotional and behavioral instability. Latitudinal differences are not a determinant of SAD. Increased sun exposure is associated with symptom relief. The promotion of light therapy devices in rural areas with low sunlight is warranted.

Association between cognitive insight and anxiety among community-dwelling schizophrenia patients: the chain mediating effects of family cohesion and chronotype

Objective

To investigate the effect of cognitive insight on anxiety in community-dwelling schizophrenia patients and to construct a chain mediating model to determine the underlying mechanisms of the relationship between cognitive insight and anxiety through family cohesion and chronotype.

Methods

The Beck Cognitive Insight Scale, the Chinese version of the Family Adaptability and Cohesion Scale, the Morningness-Eveningness Scale, and the Generalized Anxiety Disorder Scale were used to assess cognitive insight, family cohesion, chronotype, and anxiety in a sample of 785 individuals with schizophrenia living in the community. Spearman correlation analysis, multiple linear regression and Bootstrap methods were employed to analyze the four variables.

Results

Residential region, current employment status, and family economic status impacted anxiety among community-dwelling schizophrenia patients. All variables were associated with each other, but self-certainty was not significantly associated with anxiety. Cognitive insight and self-reflection had direct effects on anxiety, as well as indirect effects on anxiety through the partial mediating effect of chronotype, the suppressing effect of family cohesion, and the chain mediating effect of family cohesion and chronotype.

Conclusions

Family cohesion and chronotype can mediate the relationship between cognitive insight and anxiety. Improving family functioning, promoting emotional relationships within families, and correcting non-circadian sleep patterns can reduce anxiety in community-dwelling schizophrenia patients, with important implications for improving adverse mental health outcomes.

The integration of geographic methods and ecological momentary assessment in public health research: A systematic review of methods and applications

With the widespread prevalence of mobile devices, ecological momentary assessment (EMA) can be combined with geospatial data acquired through geographic techniques like global positioning system (GPS) and geographic information system. This technique enables the consideration of individuals' health and behavior outcomes of momentary exposures in spatial contexts, mostly referred to as "geographic ecological momentary assessment" or "geographically explicit EMA" (GEMA). However, the definition, scope, methods, and applications of GEMA remain unclear and unconsolidated. To fill this research gap, we conducted a systematic review to synthesize the methodological insights, identify common research interests and applications, and furnish recommendations for future GEMA studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to systematically search peer-reviewed studies from six electronic databases in 2022. Screening and eligibility were conducted following inclusion criteria. The risk of bias assessment was performed, and narrative synthesis was presented for all studies. From the initial search of 957 publications, we identified 47 articles included in the review. In public health, GEMA was utilized to measure various outcomes, such as psychological health, physical and physiological health, substance use, social behavior, and physical activity. GEMA serves multiple research purposes: 1) enabling location-based EMA sampling, 2) quantifying participants' mobility patterns, 3) deriving exposure variables, 4) describing spatial patterns of outcome variables, and 5) performing data linkage or triangulation. GEMA has advanced traditional EMA sampling strategies and enabled location-based sampling by detecting location changes and specified geofences. Furthermore, advances in mobile technology have prompted considerations of additional sensor-based data in GEMA. Our results highlight the efficacy and feasibility of GEMA in public health research. Finally, we discuss sampling strategy, data privacy and confidentiality, measurement validity, mobile applications and technologies, and GPS accuracy and missing data in the context of current and future public health research that uses GEMA.

STROBE-GEMA: a STROBE extension for reporting of geographically explicit ecological momentary assessment studies

CONTEXT

While a growing body of research has been demonstrating how exposure to social and built environments relate to various health outcomes, specific pathways generally remain poorly understood. But recent technological advancements have enabled new study designs through continuous monitoring using mobile sensors and repeated questionnaires. Such geographically explicit momentary assessments (GEMA) make it possible to link momentary subjective states, behaviors, and physiological parameters to momentary environmental conditions, and can help uncover the pathways linking place to health. Despite its potential, there is currently no review of GEMA studies detailing how location data is used to measure environmental exposure, and how this in turn is linked to momentary outcomes of interest. Moreover, a lack of standard reporting of such studies hampers comparability and reproducibility.

AIMS

The objectives of this research were twofold: 1) conduct a systematic review of GEMA studies that link momentary measurement with environmental data obtained from geolocation data, and 2) develop a STROBE extension guideline for GEMA studies.

METHOD

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria consisted of a combination of repeated momentary measurements of a health state or behavior with GPS coordinate collection, and use of these location data to derive momentary environmental exposures. To develop the guideline, the variables extracted for the systematic review were compared to elements of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) and CREMAS (CRedibility of Evidence from Multiple Analyses of the Same data) checklists, to provide a new guideline for GEMA studies. An international panel of experts participated in a consultation procedure to collectively develop the proposed checklist items. RESULTS AND DEVELOPED TOOLS: A total of 20 original GEMA studies were included in the review. Overall, several key pieces of information regarding the GEMA methods were either missing or reported heterogeneously. Our guideline provides a total of 27 categories (plus 4 subcategories), combining a total of 70 items. The 22 categories and 32 items from the original STROBE guideline have been integrated in our GEMA guideline. Eight categories and 6 items from the CREMAS guideline have been included to our guideline. We created one new category (namely "Consent") and added 32 new items specific to GEMA studies.

CONCLUSIONS AND RECOMMENDATIONS

This study offers a systematic review and a STROBE extension guideline for the reporting of GEMA studies. The latter will serve to standardize the reporting of GEMA studies, as well as facilitate the interpretation of results and their generalizability. In short, this work will help researchers and public health professionals to make the most of this method to advance our understanding of how environments influence health.

How mood is affected by environment and upsetting events: The moderating role of psychological flexibility

OBJECTIVE

Patients suffering from psychological disorders report decreased quality of life and low mood. The relationship of these symptoms to daily upsetting events or environments, and in the context of active coping mechanisms is poorly understood. The present study thus investigates the association between mood, psychological flexibility, upsetting events, and environment in the daily life of outpatients.

METHOD

We investigated 80 outpatients at the beginning of treatment, using event sampling methodology (ESM). Patients' mood, occurrence of upsetting events, current environment, and psychological flexibility were sampled six times per day during a one-week intensive longitudinal examination. Data were analyzed using linear mixed models (LMMs).

RESULTS

Participants reported worse mood the more upsetting events they experienced. Further, participants reported better mood when in private environments (e.g., with friends), and worse mood when at the hospital, compared to being at home. Higher levels of psychological flexibility, however, were associated with better mood, irrespective of the occurrence of upsetting events or current environment.

CONCLUSION

Results suggest that mood is positively associated with psychological flexibility, not despite, but especially during the dynamic and context-specific challenges of daily life. Psychological flexibility may thus potentially act as a buffer against distress-provoking situations as patients go about their daily lives.

TRIAL REGISTRATION

ISRCTN.org identifier: ISRCTN11209732.

Current methodologies of greenspace exposure and mental health research-a scoping review

Introduction

Greenspaces can provide an important resource for human mental health. A growing body of literature investigates the interaction and the influence of diverse greenspace exposures. In order to gain a comprehensive understanding of the complex connection between greenspace and mental health, a variety of perspectives and methodological combinations are needed. The aim of this review is to assess the current methodologies researching greenspace and mental health.

Methods

A scoping review was conducted. Four electronic databases (Pubmed, Embase, PsycInfo, Web of Science) were searched for relevant studies. A wide range of greenspace and mental health keywords were included to provide a comprehensive representation of the body of research. Relevant information on publication characteristics, types of greenspaces, mental health outcomes, and measurements of greenspace exposure and mental health was extracted and assessed.

Results

338 studies were included. The included studies encompassed a multitude of methods, as well as outcomes for both greenspace and mental health. 28 combinations were found between seven categories each for greenspace and mental health assessment. Some pairings such as geoinformation systems for greenspace assessment and questionnaires investigating mental health were used much more frequently than others, implying possible research gaps. Furthermore, we identified problems and inconsistences in reporting of greenspace types and mental health outcomes.

Discussion

The identified methodological variety is a potential for researching the complex connections between greenspace and mental health. Commonly used combinations can provide important insights. However, future research needs to emphasize other perspectives in order to understand how to create living environments with mental health benefits. For this purpose, interdisciplinary research is necessary.

Dynamic greenspace exposure, individual mental health status and momentary stress level: A study using multiple greenspace measurements

Previous research on the relationship between greenspace exposure and mental health has largely taken a residence-based approach to exposure assessment, ignoring the dynamic nature of people's daily movements. Moreover, most studies evaluated greenspace from an overhead perspective, whereas an eye-level perspective could potentially offer a more comprehensive understanding of individuals' encounters with greenspaces. Based on our survey in two communities in Hong Kong (Sham Shui Po and Tin Shui Wai), we captured people's eye-level greenspace exposure based on their travel routes and visited places using GPS trajectories, streetscape images, and deep learning methods. We then compared the results with those obtained with an overhead greenness exposure measure (the normalized difference vegetation index [NDVI]). The results indicate that these two greenspace measurements are not associated with each other, implying that they encompass distinct facets of greenspace, which may have different effects on mental health. Further, we examined the associations between various greenspace exposure measures and mental health using GPS trajectories and ecological momentary assessment data. The results reveal a negative association between eye-level greenspace exposure and momentary stress, while no similar association was observed when using the top-down NDVI as an indicator of greenspace exposure. Moreover, compared to the total volume of greenspace exposure, the distance-weighted average of greenspace exposure based on dynamic mobility contexts has a stronger association with individual overall mental health. Lastly, the relationship between greenspace exposure and mental health varies between the two communities with different socio-economic attributes. The study indicates that policymakers should focus not only on residential neighborhoods and overhead greenspace but also consider the dynamic environments and socio-economic contexts that people are embedded in.

Systematic review of best practices for GPS data usage, processing, and linkage in health, exposure science and environmental context research

Global Positioning System (GPS) technology is increasingly used in health research to capture individual mobility and contextual and environmental exposures. However, the tools, techniques and decisions for using GPS data vary from study to study, making comparisons and reproducibility challenging.

OBJECTIVES

The objectives of this systematic review were to (1) identify best practices for GPS data collection and processing; (2) quantify reporting of best practices in published studies; and (3) discuss examples found in reviewed manuscripts that future researchers may employ for reporting GPS data usage, processing and linkage of GPS data in health studies.

DESIGN

A systematic review.

DATA SOURCES

Electronic databases searched (24 October 2023) were PubMed, Scopus and Web of Science (PROSPERO ID: CRD42022322166).

ELIGIBILITY CRITERIA

Included peer-reviewed studies published in English met at least one of the criteria: (1) protocols involving GPS for exposure/context and human health research purposes and containing empirical data; (2) linkage of GPS data to other data intended for research on contextual influences on health; (3) associations between GPS-measured mobility or exposures and health; (4) derived variable methods using GPS data in health research; or (5) comparison of GPS tracking with other methods (eg, travel diary).

DATA EXTRACTION AND SYNTHESIS

We examined 157 manuscripts for reporting of best practices including wear time, sampling frequency, data validity, noise/signal loss and data linkage to assess risk of bias.

RESULTS

We found that 6% of the studies did not disclose the GPS device model used, only 12.1% reported the per cent of GPS data lost by signal loss, only 15.7% reported the per cent of GPS data considered to be noise and only 68.2% reported the inclusion criteria for their data.

CONCLUSIONS

Our recommendations for reporting on GPS usage, processing and linkage may be transferrable to other geospatial devices, with the hope of promoting transparency and reproducibility in this research.

PROSPERO REGISTRATION NUMBER

CRD42022322166.

Designing daily-life research combining experience sampling method with parallel data

BACKGROUND

Ambulatory monitoring is gaining popularity in mental and somatic health care to capture an individual's wellbeing or treatment course in daily-life. Experience sampling method collects subjective time-series data of patients' experiences, behavior, and context. At the same time, digital devices allow for less intrusive collection of more objective time-series data with higher sampling frequencies and for prolonged sampling periods. We refer to these data as parallel data. Combining these two data types holds the promise to revolutionize health care. However, existing ambulatory monitoring guidelines are too specific to each data type, and lack overall directions on how to effectively combine them.

METHODS

Literature and expert opinions were integrated to formulate relevant guiding principles.

RESULTS

Experience sampling and parallel data must be approached as one holistic time series right from the start, at the study design stage. The fluctuation pattern and volatility of the different variables of interest must be well understood to ensure that these data are compatible. Data have to be collected and operationalized in a manner that the minimal common denominator is able to answer the research question with regard to temporal and disease severity resolution. Furthermore, recommendations are provided for device selection, data management, and analysis. Open science practices are also highlighted throughout. Finally, we provide a practical checklist with the delineated considerations and an open-source example demonstrating how to apply it.

CONCLUSIONS

The provided considerations aim to structure and support researchers as they undertake the new challenges presented by this exciting multidisciplinary research field.

Short-term exposure sequences and anxiety symptoms: a time series clustering of smartphone-based mobility trajectories

BACKGROUND

Short-term environmental exposures, including green space, air pollution, and noise, have been suggested to affect health. However, the evidence is limited to aggregated exposure estimates which do not allow the capture of daily spatiotemporal exposure sequences. We aimed to (1) determine individuals' sequential exposure patterns along their daily mobility paths and (2) examine whether and to what extent these exposure patterns were associated with anxiety symptoms.

METHODS

We cross-sectionally tracked 141 participants aged 18-65 using their global positioning system (GPS) enabled smartphones for up to 7 days in the Netherlands. We estimated their location-dependent exposures for green space, fine particulate matter, and noise along their moving trajectories at 10-min intervals. The resulting time-resolved exposure sequences were then partitioned using multivariate time series clustering with dynamic time warping as the similarity measure. Respondents' anxiety symptoms were assessed with the Generalized Anxiety Disorders-7 questionnaire. We fitted linear regressions to assess the associations between sequential exposure patterns and anxiety symptoms.

RESULTS

We found four distinctive daily sequential exposure patterns across the participants. Exposure patterns differed in terms of exposure levels and daily variations. Regression results revealed that participants with a "moderately health-threatening" exposure pattern were significantly associated with fewer anxiety symptoms than participants with a "strongly health-threatening" exposure pattern.

CONCLUSIONS

Our findings support that environmental exposures' daily sequence and short-term magnitudes may be associated with mental health. We urge more time-resolved mobility-based assessments in future analyses of environmental health effects in daily life.

In situ psycho-cognitive assessments support self-determined urban green exercise time

Prescribed nature walks frequently yield improvements to mood and cognition as observed in experimental studies. Research that uses real life settings such as self-determined time exercising outdoors for restorative health benefits may more accurately elicit effects than time-specified study protocols. This study examined in situ psycho-cognitive outcomes of routine walks in urban greenspace to test the concept that self-set exposure duration and not context alone is related to magnitude of psycho-cognitive benefit. Pre-post measurements taken on a diverse participant pool of individuals walking in urban parks and recruited on random days over a two-week period found significant associations between outdoor activity duration and cognitive and mood improvements. Greater outdoor walking duration linearly predicted stronger processing speeds but non-linearly in tests of other cognitive domains. Results of fixed effects model for mean mood change following green exercise show outdoor walking influenced mood change at highest levels of significance, even after accounting for individual level variability in duration. Mood improved for all durations of outdoor walking under a random effects model with high significance. Untethering fixed intervals of outdoor exercise from formal study design revealed briefer but more frequent nature engagement aligned with nature affinity. The influence of unmeasured factors, e.g., nature affinity or restorative conditioning, for prescriptive durations of urban green exercise merits further investigation toward designing wellbeing interventions directed at specific urban populations.

Micro urban spaces and mental well-being: Measuring the exposure to urban landscapes along daily mobility paths and their effects on momentary depressive symptomatology among older population

The urban environment plays an important role for the mental health of residents. Researchers mainly focus on residential neighbourhoods as exposure context, leaving aside the effects of non-residential environments. In order to consider the daily experience of urban spaces, a people-based approach focused on mobility paths is needed. Applying this approach, (1) this study investigated whether individuals' momentary mental well-being is related to the exposure to micro-urban spaces along the daily mobility paths within the two previous hours; (2) it explored whether these associations differ when environmental exposures are defined considering all location points or only outdoor location points; and (3) it examined the associations between the types of activity and mobility and momentary depressive symptomatology. Using a geographically-explicit ecological momentary assessment approach (GEMA), momentary depressive symptomatology of 216 older adults living in the Ile-de-France region was assessed using smartphone surveys, while participants were tracked with a GPS receiver and an accelerometer for seven days. Exposure to multiple elements of the streetscape was computed within a street network buffer of 25 m of each GPS point over the two hours prior to the questionnaire. Mobility and activity type were documented from a GPS-based mobility survey. We estimated Bayesian generalized mixed effect models with random effects at the individual and day levels and took into account time autocorrelation. We also estimated fixed effects. A better momentary mental wellbeing was observed when residents performed leisure activities or were involved in active mobility and when they were exposed to walkable areas (pedestrian dedicated paths, open spaces, parks and green areas), water elements, and commerce, leisure and cultural attractors over the previous two hours. These relationships were stronger when exposures were defined based only on outdoor location points rather than all location points, and when we considered within-individual differences compared to between-individual differences.

The temporality of geographic contexts: Individual environmental exposure has time-related effects on mood

Research on environmental exposure and its impacts on people's mood has attracted increasing attention. Most studies focus on the spatiality of geographic contexts, but they neglect the influence of temporality in the relationships between environments and mood. To this end, a survey was conducted in January 2019 in Guangzhou, China, and measured data (micro-environments, built environments, EMA records, GPS trajectories, and activity logs) covering a weekday were collected from 125 participants. Then, multiple linear regression models are employed to examine and compare the associations between environments and mood based on three possible types of temporal responses (cumulative response, momentary response, and time-lagged response). The results indicate that there are great differences in environmental mood effects based on different types of temporal responses. Specifically, (i) for three types of temporal responses, exposure to PM_2.5 and noise have mood-blunting effects, whereas exposure to green spaces has mood-augmenting effects. (ii) For two types of temporal responses, higher temperature (in winter) may positively influence individual mood based on cumulative and time-lagged response, and higher POI density can positively affect mood based on cumulative and momentary response. (iii) Relative humidity may not have time-related effects on mood. Although all three types of temporal responses are observed in this study, the most significant manifestation is momentary response. These findings not only enrich theoretical research on environmental mood effects and temporality, but also inform the practice of more refined and humanistic urban planning, environmental governance, and public services.

What is the impact of nature on human health? A scoping review of the literature

Background

The burden of non-communicable diseases (including poor mental health) is increasing, and some practitioners are turning to nature to provide the solution. Nature-based interventions (NBIs) could offer cost-effective solutions by reconnecting individuals with nature, but the success of these interventions depends partially on the way in which people engage with blue and green spaces.

Methods

We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Cochrane guidelines to establish the evidence base for treating poor mental and physical health with NBIs. We searched five databases and the grey literature. Exposure was the active engagement with natural environments. The primary outcome was mental health and the secondary outcome was physical health defined using established metrics. All data were extracted to a charting table and reported as a narrative synthesis.

Results

952 studies were identified, of which 39 met the inclusion criteria. 92% demonstrated consistent improvements across any health outcome where individuals engaged with natural outdoor environments. Mental health outcomes improved across 98% of studies while physical and cognitive health outcomes showed improvement across 83% and 75% of studies respectively. Additionally, we identified 153 factors affecting engagement with nature, 78% of which facilitated engagement compared with 22% that reduced engagement. Aspects such as the sense of wilderness, accessibility, opportunities for physical activity and the absence of noise/ air pollution all increased engagement.

Conclusions

Further research (accompanied by a global improvement in study design) is needed to establish the magnitude and relative effect of nature-based interventions, and to quantify the compounding effect of factors that improve engagement with green and blue spaces. Nevertheless, this review has documented the increasing body of evidence in support of NBIs as effective tools to improve mental, physical, and cognitive health outcomes, and highlighted key factors that improve engagement with the natural world.

Registration

Open Science Framework: https://doi.org/10.17605/OSF.IO/8J5Q3.

Do Greener Urban Streets Provide Better Emotional Experiences? An Experimental Study on Chinese Tourists

Compared to the usual environment, the potential momentary emotional benefits of exposure to street-level urban green spaces (UGS) in the unusual environment have not received much academic attention. This study applies an online randomized control trial (RCT) with 299 potential tourists who have never visited Xi'an and proposes a regression model with mixed effects to scrutinize the momentary emotional effects of three scales (i.e., small, medium and large) and street types (i.e., traffic lanes, commercial pedestrian streets and culture and leisure walking streets). The results identify the possibility of causality between street-level UGS and tourists' momentary emotional experiences and indicate that tourists have better momentary emotional experiences when urban streets are intervened with large-scale green vegetation. The positive magnitude of the effect varies in all three types of streets and scales of intervention, while the walking streets with typical cultural attractions, have a larger impact relative to those with daily commute elements. These research results can provide guidance for UGS planning and the green design of walking streets in tourism.

The Role of the Context of Physical Activity for Its Association with Affective Well-Being: An Experience Sampling Study in Young Adults

Physical activity and being outdoors both improve affective well-being. However, little is known about the synergistic effects between them and the influences of contextual factors such as the life domain of physical activity (work-, chores-, leisure, or sports-related) or the type of the outdoor environment (green space, blue space, or city area) on mood. This study investigates the synergistic effects of physical activity and being outdoors as well as the potential role of contextual factors on mood. A total of 158 individuals aged 18-25 years (133 females) participated in a 14-day experience sampling study. Participants received seven prompts per day and answered questions about their physical activity, contextual factors, and affective well-being. Physical activity and being outdoors were associated with concurrent higher levels of positive and lower levels of negative affect compared to being physically inactive or being indoors, respectively. However, no synergistic effects were found. Being outdoors in a city area was associated with a less positive and more negative affect than being in nature. Work- and chores-related physical activity was associated with less positive affect and more negative affect compared to sports- or leisure-related physical activity. To foster positive affect, people should schedule leisure-related physical activity in nature.

Daily space-time activities, multiple environmental exposures, and anxiety symptoms: A cross-sectional mobile phone-based sensing study

BACKGROUND

Few mobility-based studies have investigated the associations between multiple environmental exposures, including social exposures, and mental health.

OBJECTIVE

To assess how exposure to green space, blue space, noise, air pollution, and crowdedness along people's daily mobility paths are associated with anxiety symptoms.

METHODS

358 participants were cross-sectionally tracked with Global Positioning System (GPS)-enabled mobile phones. Anxiety symptoms were measured at baseline using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Green space, blue space, noise, and air pollution were assessed based on concentric buffers of 50 m and 100 m around each GPS point. Crowdedness was measured by the number of nearby Bluetooth-enabled devices detected along the mobility paths. Multiple linear regressions with full covariate adjustment were fitted to examine anxiety-environmental exposures associations. Random forest models were applied to explore possible nonlinear associations and exposure interactions.

RESULTS

Regression results showed null linear associations between GAD-7 scores and environmental exposures. Random forest models indicated that GAD-7-environment associations varied nonlinearly with exposure levels. We found a negative association between green space and GAD-7 scores only for participants with moderate green space exposure. We observed a positive association between GAD-7 scores and noise levels above 60 dB and air pollution concentrations above 17.2 μg m^-3. Crowdedness was positively associated with GAD-7 scores, but exposure-response functions flattened out with pronounced crowdedness of >7.5. Blue space tended to be positively associated with GAD-7 scores. Random forest models ranked environmental exposures as more important to explain GAD-7 scores than linear models.

CONCLUSIONS

Our findings indicate possible nonlinear associations between mobility-based environmental exposures and anxiety symptoms. More studies are needed to obtain an in-depth understanding of underlying anxiety-environment mechanisms during daily life.

Changes in affect from non-eating activity engagement as predictors of loss of control eating: an ecological momentary assessment study

PURPOSE

Loss of control eating (LOCE) is supported as a maladaptive regulation strategy for high negative affect (NA) and low positive affect (PA). Yet, little is known about the day-to-day activities outside of eating that may precipitate such changes in affect and impact risk for LOCE. The current ecological momentary assessment study sought to examine whether (1) low NA and high PA at a given survey would prospectively predict lower likelihood of a LOCE episode at the next survey, and (2) having recently engaged in various non-eating activities would be associated with changes in average NA and PA levels at the same survey.

METHODS

Data collected from 66 participants with LOCE over 7-14 days were analyzed using generalized estimating equations.

RESULTS

High NA but not low PA at a given survey prospectively predicted lower likelihood of a LOCE episode at the next survey. Having recently engaged in outdoor recreation and socializing was associated with lower than one's usual NA and higher than one's usual PA at the same survey, social media was associated with higher than one's usual NA and lower than one's usual PA, self-care was associated with higher than one's usual PA, and napping was associated with lower than one's usual PA.

CONCLUSION

Individuals may benefit from increasing the frequency of daily non-eating activities that reduce NA, since it appears to be a more salient predictor of LOCE than PA. Further research is needed to elucidate this LOCE maintenance model, particularly in regard to the role of PA.

LEVEL OF EVIDENCE

Level IV, multiple time series without intervention.

Housing environment and mental health of Europeans during the COVID-19 pandemic: a cross-country comparison

Many studies have investigated the impact of the COVID-19 pandemic on mental health. Throughout the pandemic, time spent at home increased to a great extent due to restrictive measures. Here we set out to investigate the relationship between housing conditions and the mental health of populations across European countries. We analyzed survey data collected during spring 2020 from 69,136 individuals from four cohorts from Denmark, France, and the UK. The investigated housing conditions included household density, composition, and crowding, access to outdoor facilities, dwelling type, and urbanicity. The outcomes were loneliness, anxiety, and life satisfaction. Logistic regression models were used, and results were pooled using random-effects meta-analysis. In the meta-analysis, living alone was associated with higher levels of loneliness (OR = 3.08, 95% CI 1.87–5.07), and lower life satisfaction (OR = 1.27, 95% CI 1.05–0.55), compared to living with others. Not having access to an outdoor space and household crowding were suggestively associated with worse outcomes. Living in crowded households, living alone, or lacking access to outdoor facilities may be particularly important in contributing to poor mental health during a lockdown. Addressing the observed fundamental issues related to housing conditions within society will likely have positive effects in reducing social inequalities, as well as improving preparedness for future pandemics.

Use of the Natural Outdoor Environment in Different Populations in Europe in Relation to Access: Implications for Policy

This cross-cultural study explores the relationship of natural outdoor environment (NOE) use with NOE access. Most urban planning recommendations suggest optimal accessibility to be 300 m-500 m straight distance to spaces with vegetation of at least 1 hectare. Exploring this recommendation, we used data (n = 3947) from four European cities collected in the framework of the PHENOTYPE study: Barcelona (Spain), Doetinchem (The Netherlands), Kaunas (Lithuania) and Stoke-on-Trent (United Kingdom) to obtain residential access to NOE (straight or network distances, using 300 m and 150 m buffers, to NOE larger than 1 hectare or 0.5 hectare) and use of NOE (i.e., self-reported time spent in NOE). Poisson regression models were used to examine the associations between residential access and use of NOE. The models with the strongest association with time spent in NOE in the combined sample were for those living within 300 m straight line distance to either 0.5 ha or 1 ha NOE. Noting that the only indicator that was consistent across all individual cities was living with 150 m network buffer of NOE (of at least 1 ha), this warrants further exploration in reducing recommendations of 300 m straight-line distance to 150 m network distance to 1 ha of NOE for a general indicator for cities within Europe.

Multiple environmental exposures along daily mobility paths and depressive symptoms: A smartphone-based tracking study

Few studies go beyond the residential environment in assessments of the environment-mental health association, despite multiple environments being encountered in daily life. This study investigated 1) the associations between multiple environmental exposures and depressive symptoms, both in the residential environment and along the daily mobility path, 2) examined differences in the strength of associations between residential- and mobility-based models, and 3) explored sex as a moderator. Depressive symptoms of 393 randomly sampled adults aged 18-65 were assessed using the Patient Health Questionnaire (PHQ-9). Respondents were tracked via global positioning systems- (GPS) enabled smartphones for up to 7 days. Exposure to green space (normalized difference vegetation index (NDVI)), blue space, noise (Lden) and air pollution (particulate matter (PM_2.5)) within 50 m and 100 m of each residential address and GPS point was computed. Multiple linear regression analyses were conducted separately for the residential- and mobility-based exposures. Wald tests were used to assess if the coefficients differed across models. Interaction terms were entered in fully adjusted models to determine if associations varied by sex. A significant negative relationship between green space and depressive symptoms was found in the fully adjusted residential- and mobility-based models using the 50 m buffer. No significant differences were observed in coefficients across models. None of the interaction terms were significant. Our results suggest that exposure to green space in the immediate environment, both at home and along the daily mobility path, is associated with a reduction in depressive symptoms. Further research is required to establish the utility of dynamic approaches to exposure assessment in studies on the environment and mental health.

Mental Health Outcomes in Barcelona: The Interplay between Gentrification and Greenspace

Greenspace is widely related to mental health benefits, but this relationship may vary by social group. Gentrification, as linked to processes of unequal urban development and conflict, potentially impacts health outcomes. This study explores the relationships between greenspace and mental health and between gentrification and mental health associations. It also further examines gentrification as an effect modifier in the greenspace-mental health association and SES as an effect modifier in the gentrification-mental health association. We used cross-sectional Barcelona (Spain) data from 2006, which included perceived mental health status and self-reported depression/anxiety from the Barcelona Health Survey. Greenspace exposure was measured as residential access to (1) all greenspace, (2) greenways and (3) parks in 2006. Census-tract level gentrification was measured using an index including changes in sociodemographic indicators between 1991 and 2006. Logistic regression models revealed that only greenways were associated with better mental health outcomes, with no significant relationship between mental health and parks or all greenspace. Living in gentrifying neighborhoods was protective for depression/anxiety compared to living in non-gentrifying neighborhoods. However, only residents of gentrifiable census tracts benefited from the exposure to greenways. SES was not found to be an effect modifier in the association between gentrification and mental health. Future research should tackle this study's limitations by incorporating a direct measure of displacement in the gentrification status indicator, accounting for qualitative aspects of greenspace and user's perceptions. Gentrification may undermine the health benefits provided by greenspace interventions.

Associations of the residential built environment with adolescent sleep outcomes

STUDY OBJECTIVES

Over 75% of US high school students obtain insufficient sleep, placing them at risk for adverse health outcomes. Identification of modifiable determinants of adolescent sleep is needed to inform prevention strategies, yet little is known about the influence of the built environment on adolescent sleep.

METHODS

In this prospective study, actigraphy was used to assess sleep outcomes among 110 adolescents for 14 days each in eighth and ninth grades: duration (hours/night), onset and offset, and sleeping ≥8 hours. Home addresses were linked to built environment exposures: sound levels, tree canopy cover, street density, intersection density, population density, and housing density. Mixed-effects regression estimated associations of built environment measures with sleep outcomes, adjusting for sex, race, parent education, household income, household size, grade, weeknight status, and neighborhood poverty.

RESULTS

A 1-standard deviation (SD) increase in neighborhood sound was associated with 16 minutes later sleep onset (β = 0.28; 95% confidence interval (CI): 0.06, 0.49) and 25% lower odds of sleeping for ≥8 hours (odds ratio (OR) = 0.75, 95% CI: 0.59, 0.96). A 1-SD increase in neighborhood tree canopy was associated with 18 minutes earlier sleep onset (β = -0.31, 95% CI: -0.49, -0.13) and 10 minutes earlier sleep offset (β= -0.17, 95% CI: -0.28, -0.05). No associations were observed for density-based exposures.

CONCLUSIONS

Higher neighborhood sound level was associated with lower odds of sufficient sleep, while higher tree canopy cover was associated with more favorable sleep timing. Neighborhood sound levels and tree canopy cover are potential targets for policies and interventions to support healthier sleep among adolescents.

Investigating the mental health implications of urban environments with neuroscientific methods and mobile technologies: A systematic literature review

Urbanization is an ongoing global process that is influencing and shaping individual mental health and well-being. This paper aims to provide an overview of the current literature containing state-of-the-art neuroscientific and mobile technologies that have been used to investigate the mental health implications of urban environments. Searches for peer-reviewed primary research articles were conducted in PubMed and SCOPUS, returning 33,443 papers; 90 empirical articles published from 1981 to 2021 were included in the final synthesis. Central findings suggest virtual reality and mobile electroencephalography to be the most commonly used methods, and demanding mood, affect, and health phenomena or states to be the most common concepts of study in both physical built settings and natural urban spaces. Recommendations for both future practice and study noting particular opportunities for future methodological contributions are discussed.

Associations between Nature Exposure and Health: A Review of the Evidence

There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course.

Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review

Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.

Linking physical and social environments with mental health in old age: a multisensor approach for continuous real-life ecological and emotional assessment

Background

Urban stress is mentioned as a plausible mechanism leading to chronic stress, which is a risk factor of depression. Yet, an accurate assessment of urban stressors in environmental epidemiology requires new methods. This article discusses methods for the sensor-based continuous assesment of geographic environments, stress and depressive symptoms in older age. We report protocols of the promoting mental well-being and healthy ageing in cities (MINDMAP) and Healthy Aging and Networks in Cities (HANC) studies nested in the RECORD Cohort as a background for a broad discussion about the theoretical foundation and monitoring tools of mobile sensing research in older age. Specifically, these studies allow one to compare how older people with and without depression perceive, navigate and use their environment; and how the built environments, networks of social contacts, and spatial mobility patterns influence the mental health of older people.

Methods

Our research protocol combines (1) Global Positioning System (GPS) and accelerometer tracking and a GPS-based mobility survey to assess participants’ mobility patterns, activity patterns and environmental exposures; (2) proximity detection to assess whether household members are close to each other; (3) ecological momentary assessment to track momentary mood and stress and environmental perceptions; and (4) electrodermal activity for the tentative prediction of stress. Data will be compared within individuals (at different times) and between persons with and without depressive symptoms.

Conclusion

The development of mobile sensing and survey technologies opens an avenue to improve understanding of the role of momentary stressors and resourcing features of residential and non-residential environments for older populations’ mental health. However, validation, privacy and ethical aspects are important issues to consider.

Smartphone-Based Ecological Momentary Assessment of Well-Being: A Systematic Review and Recommendations for Future Studies

Feelings of well-being and happiness fluctuate over time and contexts. Ecological Momentary Assessment (EMA) studies can capture fluctuations in momentary behavior, and experiences by assessing these multiple times per day. Traditionally, EMA was performed using pen and paper. Recently, due to technological advances EMA studies can be conducted more easily with smartphones, a device ubiquitous in our society. The goal of this review was to evaluate the literature on smartphone-based EMA in well-being research in healthy subjects. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searching PubMed and Web of Science, we identified 53 studies using smartphone-based EMA of well-being. Studies were heterogeneous in designs, context, and measures. The average study duration was 12.8 days, with well-being assessed 2-12 times per day. Half of the studies included objective data (e.g. location). Only 47.2% reported compliance, indicating a mean of 71.6%. Well-being fluctuated daily and weekly, with higher well-being in evenings and weekends. These fluctuations disappeared when location and activity were accounted for. On average, being in nature and physical activity relates to higher well-being. Working relates to lower well-being, but workplace and company do influence well-being. The important advantages of using smartphones instead of other devices to collect EMAs are the easier data collection and flexible designs. Smartphone-based EMA reach far larger maximum sample sizes and more easily add objective data to their designs than palm-top/PDA studies. Smartphone-based EMA research is feasible to gain insight in well-being fluctuations and its determinants and offers the opportunity for parallel objective data collection. Most studies currently focus on group comparisons, while studies on individual differences in well-being patterns and fluctuations are lacking. We provide recommendations for future smartphone-based EMA research regarding measures, objective data and analyses.

Earth Observation Data Supporting Non-Communicable Disease Research: A Review

A disease is non-communicable when it is not transferred from one person to another. Typical examples include all types of cancer, diabetes, stroke, or allergies, as well as mental diseases. Non-communicable diseases have at least two things in common—environmental impact and chronicity. These diseases are often associated with reduced quality of life, a higher rate of premature deaths, and negative impacts on a countries’ economy due to healthcare costs and missing work force. Additionally, they affect the individual’s immune system, which increases susceptibility toward communicable diseases, such as the flu or other viral and bacterial infections. Thus, mitigating the effects of non-communicable diseases is one of the most pressing issues of modern medicine, healthcare, and governments in general. Apart from the predisposition toward such diseases (the genome), their occurrence is associated with environmental parameters that people are exposed to (the exposome). Exposure to stressors such as bad air or water quality, noise, extreme heat, or an overall unnatural surrounding all impact the susceptibility to non-communicable diseases. In the identification of such environmental parameters, geoinformation products derived from Earth Observation data acquired by satellites play an increasingly important role. In this paper, we present a review on the joint use of Earth Observation data and public health data for research on non-communicable diseases. We analyzed 146 articles from peer-reviewed journals (Impact Factor ≥ 2) from all over the world that included Earth Observation data and public health data for their assessments. Our results show that this field of synergistic geohealth analyses is still relatively young, with most studies published within the last five years and within national boundaries. While the contribution of Earth Observation, and especially remote sensing-derived geoinformation products on land surface dynamics is on the rise, there is still a huge potential for transdisciplinary integration into studies. We see the necessity for future research and advocate for the increased incorporation of thematically profound remote sensing products with high spatial and temporal resolution into the mapping of exposomes and thus the vulnerability and resilience assessment of a population regarding non-communicable diseases.

Serial Mediation of Environmental Preference and Place Attachment in the Relationship between Perceived Street Walkability and Mood of the Elderly

Urban streets are important public spaces for daily activities that play a crucial role in promoting health in the elderly. The purpose of this study was to investigate the association between perceived street walkability and mood in the elderly, and specifically, the mediating effect of environmental preference and place attachment. We surveyed a total of 269 elderly residents from six streets in Guangzhou, China. We collected assessments of the street environments, environmental preferences, place attachment, and mood status from the elderly. A serial multiple mediator model was constructed using the structural equation modeling method. The results showed that the perceived street walkability was sequentially associated first with an increased level of place attachment (β = 0.798, SE = 0.358, p < 0.000) and then environmental preference (β = 0.191, SE = 0.033, p = 0.038), which was in turn related to improvement of positive mood in the elderly (β = 0.595 SE = 0.341, p < 0.000). Environmental preference alone was found to be significantly associated with positive mood (β = 0.595, SE = 0.341, p < 0.000), while no significant effect of place attachment was found when considered individually (β = -0.075, SE = 0.089, p = 0.395). These findings provide a greater understanding of the possible mechanism through which street environment impacts mood in the elderly. Therefore, when promoting the emotional experience of the elderly, we might consider not only physical environment factors but also psychological conditions in street environments.

Study on the Impact of Residential Outdoor Environments on Mood in the Elderly in Guangzhou, China

Understanding the relationship between mood and the environment among the elderly is important for the healthy aging agenda. This study aimed to investigate the relationship between residential outdoor environments of different qualities and mood in the elderly. Nine residential neighborhoods across three different quality levels of the outdoor environment in Guangzhou, China, were surveyed. Measures included demographic characteristics, assessment of the residential outdoor environment, and mood status of the elderly. We constructed a group of multiple regression models to investigate influencing environmental factors of participants’ mood. Results revealed that the environmental factors influencing mood in the elderly are different across the three types of residential outdoor environments: function and cleanliness of the site showed a significant correlation with mood in high-quality residences, while pavement was significantly correlated with mood in medium-quality residences. In contrast, transparency, enclosure, greenness, temperature, and humidity were significantly correlated with mood in poor-quality residences. To promote mental health in the elderly, we recommend that different qualities of residential outdoor environments should be considered individually rather than aggregated as simply “outdoor space.” The findings of this study are expected to contribute to create age-friendly communities for an aging society.