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Stage A, Vermund MC, Bølling M, Otte CR, Oest Müllertz AL, Bentsen P, Nielsen G, Elsborg P. The impact of a school garden program on children's food literacy, climate change literacy, school motivation, and physical activity: A study protocol. PLoS One 2025; 20:e0320574. [PMID: 40273231 PMCID: PMC12021283 DOI: 10.1371/journal.pone.0320574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 02/19/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVE FoodACT aims to investigate how school gardens affect children's food literacy (FL), climate change literacy (CCL), school motivation (SM), and physical activity (PA). DESIGN It comprises a multimethod, quasi-experimental inquiry into an existing Danish school garden program, Gardens to Bellies (GtB). Data will be collected using surveys, accelerometry, semi-structured and focus-group interviews. The study is preregistered with ClinicalTrials.gov (#NCT05839080). SETTING Six GtB school garden locations across Region Zealand and Region of Southern Denmark. PARTICIPANTS Fourth grade pupils attending GtB (approx. 1600) are recruited to the intervention group. Fourth grade pupils from schools not attending GtB (approx. 1600) are recruited to the control group. INTERVENTION Pupils grow, prepare and cook foods for meals in the school garden during eight garden sessions. MAIN OUTCOME MEASURES FL, CCL and SM are measured using pre- and post-intervention surveys in both groups. Pupils participating in GtB have their PA assessed using accelerometery, and acute SM by text-message-surveys. Semi-structured and focus-groups interviews are held with garden facilitators and pupils focusing on the implementation of GtB and mechanisms related to developing FL and CCL. ANALYSIS The effect on FL, CCL and SM is assessed using linear mixed models. PA and acute SM are assessed by comparing data on days with and without GtB in a subsample of 900 pupils. Qualitative data will be analysed using thematic analysis.
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Affiliation(s)
- Anna Stage
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Marie Caroline Vermund
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Haver til Maver, Copenhagen, Denmark
| | - Mads Bølling
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- VIA University College, Research Centre for Pedagogy and Bildung, Program on Outdoor Pedagogy, Aarhus, Denmark
| | | | - Alberte Laura Oest Müllertz
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark
| | - Glen Nielsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Haataja E, Leppä H, Huhtiniemi M, Nedelec R, Soini T, Jaakkola T, Niemelä M, Tammelin T, Kantomaa M. Social inequalities in the effects of school-based well-being interventions: a systematic review. Eur J Public Health 2025; 35:302-311. [PMID: 39977576 PMCID: PMC11967906 DOI: 10.1093/eurpub/ckaf005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2025] Open
Abstract
Rising public concern about comprehensive child and adolescent well-being has led to the development of school-based interventions with the potential for high-reaching and effective support. While some interventions have shown effectiveness, limited understanding exists regarding how social inequalities are considered and evidenced in such interventions. This study examines how social inequalities are considered in universal school-based interventions and their potential to affect inequalities through differential effects. A systematic review following the PRISMA protocol was conducted using the following databases: PubMed, Web of Science, CINAHL, Scopus, ProQuest and APA PsycArticles. Studies published between 2014 and 2023 were included. Screening and data extraction were conducted independently by two researchers. Of 10 028 initial articles, 44 were included in the final analysis. These studies primarily involved physical activity and mindfulness interventions in schools. Despite many studies including information regarding students' social backgrounds, such as socioeconomic position and immigrant background, the analysis of differential intervention effects among demographic groups was limited and mostly based on sex. Most differential effect analyses showed no significant differences based on social background, and no clear differences were found based on intervention type. While some universal school-based interventions show promise in reducing social inequalities in students' well-being, more empirical research is needed to explicitly target these questions. This review highlights the critical need for comprehensive intervention studies to consider and report relevant dimensions of social background and their interactions with intervention effects. TRIAL REGISTRATION PROSPERO; registration no. CRD42023423448.
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Affiliation(s)
- Eetu Haataja
- Research Unit of Population Health (PopH), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Heidi Leppä
- LIKES, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Mikko Huhtiniemi
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Rozenn Nedelec
- Research Unit of Population Health (PopH), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tiina Soini
- Faculty of Education and Culture, Tampere University, Tampere, Finland
| | - Timo Jaakkola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mika Niemelä
- Research Unit of Population Health (PopH), Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Marko Kantomaa
- Research Unit of Population Health (PopH), Faculty of Medicine, University of Oulu, Oulu, Finland
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Chikha AB, Hawani A, Eken Ö, Goumni C, Zoghlami W, Mrayeh M, Kurtoğlu A, Souissi N, Aldhahi MI. The impact of the "treasure game" on geometric thinking and post-learning mood in first-grade children. Medicine (Baltimore) 2024; 103:e40695. [PMID: 39686503 PMCID: PMC11651442 DOI: 10.1097/md.0000000000040695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Accepted: 11/07/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND This study aimed to investigate the effect of the motor game "Treasure Game" (TG) on first-grade children's level of geometric thinking and post-learning mood tracking (PLMT). METHODS The study employed 24 first-grade children aged 6.1 ± 0.7 years from a public primary school in Tunisia, all classified at Level 1 of van Hiele geometric thinking (GT). Participants were randomly in a counterbalanced, randomized crossover design in 2 groups and engaged in both the TG during physical education sessions and the conventional geometry course (CGC) during mathematics sessions over a 3-week period, with sessions counterbalanced to avoid order effects. The Van Hiele geometry test was administered to assess GT, and a mood chart was used to track PLMT. Data were analyzed using the SPSS software (Chicago), applying paired and independent samples t-tests to compare the effects of TG and CGC on GT and mood, with significance set at P < .05 and effect sizes calculated using Cohen D and Hedges g. RESULTS The results indicated that the TG had a significant positive impact on both GT and PLMT in first-grade children. In group 1, there was no significant difference in GT after the CGC compared to TG; however, group 2 showed a significant improvement in GT after TG compared to CGC, with a large effect size. Additionally, PLMT scores were significantly higher after TG than after CGC in both groups, with mood scores increasing when transitioning from CGC to TG and decreasing when transitioning from TG to CGC. Overall, the data demonstrate that TG significantly enhances both cognitive and emotional outcomes in young learners compared to traditional geometry instruction. CONCLUSION The study confirms that participation in the TG significantly enhances GT and improves post-learning mood in first-grade children. This suggests that integrating motor activities like TG into the curriculum could be a viable strategy for enhancing early geometric education. Further research with larger sample sizes and considerations of gender differences is recommended.
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Affiliation(s)
- Anis Ben Chikha
- Higher Institute of Sport and Physical Education (Ksar Saïd), University of Manouba, Manouba, Tunisia
- Research Unit ECOTIDI (UR16ES10), Virtual University, Tunisia
| | - Aymen Hawani
- Higher Institute of Sport and Physical Education (Ksar Saïd), University of Manouba, Manouba, Tunisia
- Physical Activity, Sport and Health, Research Unit (UR18JS01), National Observatory of Sport, Tunis, Tunisia
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Faculty of Sports Sciences, Inonu University, Malatya, Türkiye
| | - Chiraz Goumni
- Higher Institute of Sport and Physical Education (Ksar Saïd), University of Manouba, Manouba, Tunisia
| | - Wael Zoghlami
- High Institute of Sport and Physical Education, Sfax University, Sfax, Tunisia
| | - Maher Mrayeh
- Higher Institute of Sport and Physical Education (Ksar Saïd), University of Manouba, Manouba, Tunisia
| | - Ahmet Kurtoğlu
- Department of Coaching Education, Faculty of Sport Science, Bandirma Onyedi Eylul University, Balikesir, Türkiye
| | - Nizar Souissi
- Physical Activity, Sport and Health, Research Unit (UR18JS01), National Observatory of Sport, Tunis, Tunisia
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Elsborg P, Mygind L, Bølling M, Klinker CD, Melby PS, Andreasen AH, Brønd JC, Bentsen P, Nielsen G. Efficacy of education outside the classroom to increase adolescent physical activity. Sci Rep 2024; 14:28213. [PMID: 39548298 PMCID: PMC11568335 DOI: 10.1038/s41598-024-79138-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/05/2024] [Indexed: 11/17/2024] Open
Abstract
Physical inactivity increases risks of cardiovascular disease, poor mental health, and morbidity. School-based physical activity (PA) promotion can reach children from differing backgrounds in a large proportion of their waking hours. Education outside the classroom (EOtC) is an PA-integrating pedagogical approach that aligns PA with the primary goals of schools and is therefore thought to present an acceptable, feasible, and efficacious model for school-based PA. This registered report used a cluster randomised wait list design to evaluate the efficacy of an EOtC intervention that aims to increase adolescents' (ages 10-16 years) school-based (school week) and overall (full week) PA by providing a course on the pedagogical and didactic methods of EOtC to teachers across 30 Danish schools, and subsequently the teachers implementing EOtC in their classes > 5 h weekly over the course of one school year. Across 20 schools, 503 pupils aged 9-14 years were enrolled. The intervention group classes delivered a weekly mean of 238 (± 50) minutes of EOtC per-protocol and engaged in 20.4% moderate-to-vigorous school-based PA above the control group, however with no effect on overall PA. Enhancing effectiveness on overall PA, supplementing the intervention with additional PA activities, or adjusting its delivery and implementation is necessary.Protocol registration The stage 1 protocol for this Registered Report was accepted in principle on 22/08/22. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/NTM9K .
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Affiliation(s)
- Peter Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark.
- Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | - Lærke Mygind
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark.
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia.
- Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Mads Bølling
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
- Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
- Research Centre for Pedagogy and Bildung, Program on Outdoor Pedagogy, VIA University College, Aarhus, Denmark
| | | | - Paulina S Melby
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Helms Andreasen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
| | - Jan Christian Brønd
- Department of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark
| | - Glen Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Loose T, Fuoco J, Malboeuf-Hurtubise C, Ayotte-Beaudet JP, Gauvin L, Chadi N, Ouellet-Morin I, Mâsse B, Côté SM, Geoffroy MC. A Nature-Based Intervention and Mental Health of Schoolchildren: A Cluster Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2444824. [PMID: 39546315 PMCID: PMC11568460 DOI: 10.1001/jamanetworkopen.2024.44824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 09/20/2024] [Indexed: 11/17/2024] Open
Abstract
Importance Nature-based therapeutic or preventive interventions for mental health are increasingly popular, but their effectiveness for improving mental health is not well documented. Objective To investigate the effectiveness of the Open Sky School Program (École à Ciel Ouvert), a 12-week nature-based intervention for elementary schoolchildren in grades 5 and 6, for reducing mental health symptoms. Design, Setting, and Participants This 2-arm, cluster randomized clinical trial was conducted from February 27 to June 16, 2023, in French-language elementary schools in Quebec, Canada, with green space within 1 km. Participants were teachers and students in grades 5 and 6. Intervention In the intervention group, for 2 hours per week for 12 weeks, classes were taught outdoors in a nearby park or wooded area. Teachers were encouraged to engage students in basic subjects and in 10 or more mental health activities (mindfulness, philosophy, and/or art therapy). Control group schools conducted classes as usual. Main Outcomes and Measures The primary outcome was change in student mental health (internalizing and externalizing symptoms, social problems) based on teacher- and student-reported 30-item Social Behavior Questionnaire (SBQ) scores (3-point scale) from baseline to the immediate postintervention follow-up, assessed in per-protocol and intent-to-treat mixed-model analyses. Secondary outcomes were student self-reported changes in depressive symptoms, positive or negative affect, pro-environmental efforts and/or attitudes, and nature connectedness. Results A total of 33 schools participated (53 teachers, 1015 students), including 16 schools (25 teachers, 515 students) in the intervention group and 17 schools (28 teachers, 500 students) in the control group. Student mean (SD) age was 10.9 (0.75) years; 507 (50.7%) were girls. Per-protocol and intent-to-treat mixed-model analyses showed no differences in mental health symptom change between groups; for example, the adjusted mean difference in SBQ scores between the intervention and control groups for externalizing symptoms was -0.04 (95% CI, -0.13 to 0.04) in the intent-to-treat analysis and -0.06 (95% CI, -0.16 to 0.04) in the per-protocol analysis. Post hoc analyses revealed low mental health symptoms at baseline, with low variability. Slightly greater reductions in symptoms were observed in the intervention group, but only for children with higher mental health symptoms at baseline (P < .05 for interaction). For example, for children with internalizing symptoms 1 SD above the mean at baseline, internalizing symptoms decreased by 0.38 SD (mean change, -0.15; P < .001) in the intervention group vs the control group. Conclusions and Relevance In this large cluster randomized clinical trial in daily-life elementary school settings, 12 weeks of classes in green space for 2 hours per week did not reduce mental health symptoms in students aged 10 to 12 years in either the per-protocol or the intent-to-treat analysis. However, this low-cost, safe outdoor intervention may provide unmeasured or longer-term benefits for children with higher risk of mental health symptoms. Trial Registration ClinicalTrials.gov Identifier: NCT05662436.
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Affiliation(s)
- Tianna Loose
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Sainte Justine Hospital (CHU Sainte-Justine) Research Centre, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Julia Fuoco
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Catherine Malboeuf-Hurtubise
- Department of Psychology, Bishop’s University, Sherbrooke, Quebec, Canada
- Sherbrooke Hospital Research Centre, Sherbrooke, Quebec, Canada
| | | | - Lise Gauvin
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Centre (Centre de Recherche du Centre Hospitalier de l’Université de Montréal), Montreal, Quebec, Canada
| | - Nicholas Chadi
- Sainte Justine Hospital (CHU Sainte-Justine) Research Centre, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Montreal Mental Health University Institute (Institut Universitaire en Santé Mentale de Montréal), Montreal, Quebec, Canada
| | - Benoît Mâsse
- Sainte Justine Hospital (CHU Sainte-Justine) Research Centre, Montreal, Quebec, Canada
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Sylvana M. Côté
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Sainte Justine Hospital (CHU Sainte-Justine) Research Centre, Montreal, Quebec, Canada
| | - Marie-Claude Geoffroy
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Bølling M, Mygind L, Elsborg P, Melby PS, Barfod KS, Brønd JC, Klinker CD, Nielsen G, Bentsen P. Efficacy and mechanisms of an education outside the classroom intervention on pupils' health and education: the MOVEOUT study protocol. BMC Public Health 2023; 23:1825. [PMID: 37726771 PMCID: PMC10510120 DOI: 10.1186/s12889-023-16618-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Education can create better opportunities for health, and vice versa. Using a so-called 'add-in' approach, school-based physical activity (PA) promotion and prevention of sedentary behaviours can increase pupils' wellbeing and learning and, on the longer term, reduce the risk of non-communicable diseases. A PA 'add-in' approach involves integrating PA into teachers' curricular obligations without being an extra burden as opposed to an 'add-on' approach which requires additional operational resources and include activities that do not explicitly contribute towards curricular targets making them less long-term acceptable in a school-based context. Previous studies investigating education outside the classroom (EOtC) show mutual benefits for both health and education outcomes among children and adolescents. However, the evidence is of mixed quality and questionable certainty, which calls for further investigation. The aim of this study protocol is to describe and discuss the study design and methods to investigate the efficacy and mechanisms of EOtC as a vehicle for health and education. The study investigates the intervention developed and conducted in the TEACHOUT study with updated and strengthened design and measures. METHODS The efficacy of EOtC will be investigated in a cluster randomised waitlist design. Participants will be pupils in ~54 classes, grades 4-10 (ages 10-15 years) in ~30 Danish elementary schools. Fifteen schools will be randomised to the intervention: a two-day EOtC training course targeting teachers followed by the teachers implementing EOtC >5 hours weekly over the course of one school year. Pre- and post-measures of health (PA and wellbeing) and learning (school motivation and academic achievement) will be collected. Investigation of pedagogical and motivational mechanisms will be based on observations of EOtC. DISCUSSION The updated randomised controlled design will provide firmer evidence for the efficacy and mechanisms of EOtC and provide knowledge about how mutual benefits of health and education can be obtained. TRIAL REGISTRATION Registered with ClinicalTrials.gov (ID NCT05237674 ) [University of Copenhagen. MOVEOUT: a Cluster RCT of the Efficacy, Mechanisms, and Mediation of an Education Outside the Classroom Intervention on Adolescents' Physical Activity, 2023], February 14, 2022. Most recently updated on November 23, 2022 (Version 2).
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Affiliation(s)
- Mads Bølling
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark.
- Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
- Research Centre for Pedagogy and Bildung, Program on Outdoor Pedagogy, VIA University College, Aarhus, Denmark.
| | - Lærke Mygind
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
| | - Peter Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
| | - Paulina S Melby
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Karen S Barfod
- Research Centre for Pedagogy and Bildung, Program on Outdoor Pedagogy, VIA University College, Aarhus, Denmark
| | - Jan Christian Brønd
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Charlotte Demant Klinker
- Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Glen Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, the Capital Region of Denmark, Copenhagen, Denmark
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark
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Protocol for the Open Sky School: a two-arm clustered randomized controlled trial to test the effectiveness of a nature-based intervention on mental health of elementary school children. BMC Public Health 2023; 23:236. [PMID: 36737725 PMCID: PMC9896439 DOI: 10.1186/s12889-023-15033-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This article outlines the protocol for a trial to test the effectiveness of a nature-based intervention called Open Sky School to reduce mental health problems among elementary school children. Experimental studies show that contact with nature (e.g. walks in parks) improve mental health. A growing number of teachers have been applying outdoor education within the regular school curriculum and evidence suggests that such teaching methods could improve students' mental health but a randomized controlled trial has never been conducted. METHODS A two-arm clustered randomized controlled trial will be conducted in elementary schools across Québec, Canada. Following informed consent by teachers, parents and students, schools will be randomly assigned 1:1 to the intervention or the control group with a total of 2500 5-6th grade students and 100 teachers expected to participate. The intervention will take place outdoors in a green-space (2 h per week for 12 weeks) and include a toolkit of 30 activities to foster well-being (e.g. mindfulness) and academic competencies (e.g. mathematics). Questionnaires will be administered to teachers and students before, immediately after and 3 months after the intervention. The primary outcome will be reductions of mental health problems in children from pre-to-post test (Social Behavior Questionnaire: self and teacher reports). Secondary outcomes include depression, positive and negative affect, nature connectedness, and pro-environmental behaviors among children. We will explore, immediate benefits on teacher's well-being and positive and negative affect and sustained benefits among students at 3 months follow-up. For the primary outcome, we will explore moderators including child's sex, child's disability status, the green-space of neighbourhoods, the school's socio-economic position and teacher's experience. DISCUSSION In conducting the first randomized controlled trial of the Open Sky School, our results could provide empirical evidence on the effectiveness of nature-based interventions in reducing mental health problems among elementary school children. TRIAL REGISTRATION This study was registered with clinicaltrials.gov: NCT05662436 on December 22, 2022.
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Improving Body Mass Index of School-Aged Children Using a Nine-Week Rope Skipping Training Intervention: A One-Group Pre-Test Post-Test Design. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111715. [PMID: 36360443 PMCID: PMC9689075 DOI: 10.3390/children9111715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
Studies examining the effectiveness of rope skipping training to improve the body mass index (BMI) of school children are scarce. Hence, this study examined the effectiveness of nine-week skipping training on the BMI of primary six school-aged children (n = 77). The participants underwent 30 min of skipping training three days per week over a nine-week period. The participants’ BMI was measured at the baseline and during weeks 3, 6 and 9. The results from a one-way ANOVA with repeated measures indicated a statistically significant difference in the BMI for both males [F(3,111) = 9.42, p < 0.001, ηp2 = 0.203] and females [F(3,114) = 7.35, p < 0.001, ηp2 = 0.162], suggesting an improvement in BMI. Post hoc comparisons with a Bonferroni adjustment revealed significant differences in BMI after nine weeks of intervention for males between the pre-test (M = 21.47, SD = 4.94) and the 9-week post-test (M = 20.15, SD = 4.36), and for females between the pre-test (M = 21.56, SD = 5.80) and the 9-week post-test (M = 20.68, SD = 5.32). This study demonstrated that regular participation in vigorous physical activity such as skipping training could promote child health by preventing the likelihood of young children being overweight. This result has implications for the inclusion of skipping training into the school life of school-aged children to help manage their BMI levels.
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Beauchamp AA, Lacoste Y, Kingsbury C, Gadais T. When are you taking us outside? An exploratory study of the integration of the outdoor learning in preschool and primary education in Quebec. Front Psychol 2022; 13:955549. [PMID: 36337541 PMCID: PMC9631936 DOI: 10.3389/fpsyg.2022.955549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Recent research investigating the benefits of being outdoors and contact with nature in children showed strong associations with children’s health and development. More teachers are choosing to integrate outdoor learning (OL) into their practice in Quebec, but few studies have focused on OL in the school environment, particularly in Canada and more specifically in Quebec, despite the fact that the school context lends itself favorably to this practice. Objective The purpose of this study was to portray OL in preschool and primary schools in Québec by identifying three key elements: (1) teachers’ perception of the outdoors, (2) the uses of OL in schools, and (3) teaching strategies and factors that influence teachers’ integration of OL. Methodology Semi-structured group interviews (n = 4) conducted with 14 teachers and participant observations (n = 4) were used for data collection. Inclusion criteria were to be a preschool or primary school teacher, to have taught at least eight sessions of OL in the past year, and to have no connection or contact with the research team prior to the start of the study. Results First, the results showed that teachers commonly understood the outdoors as being in the open air, practicing a physical activity, having the presence of nature, providing physical freedom and targeting a pedagogical intention. Second, teachers appeared to incorporate a variety of pedagogical intentions in OL (e.g., environmental awareness, interdisciplinary learning), in a variety of settings (e.g., city parks, woodlands), and with a variety of academic subjects (e.g., French, mathematics) and learning tasks (e.g., walking, nature shelter building). Third, teachers used a wide range of teaching strategies in OL (e.g., flexible planning, well-established routines). Participants also identified multiple factors specific to their setting that appeared to facilitate (e.g., parental support) or limit (e.g., storage of materials) their integration of OL into the school environment. Conclusion This study provided a better understanding of the current use of the OL in the Quebec school environment by identifying the common characteristics, limitations and winning strategies of its use in schools. Teachers and schools interested in OL could benefit from the results of this study, particularly those interested in adopting a Forest School or Udeskole approach.
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Affiliation(s)
- Audrey-Anne Beauchamp
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
- Chaire UNESCO en développement curriculaire (CUDC), Université du Québec à Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire sur la Formation et la Profession Enseignante (CRIFPE), Université du Québec à Montréal, Montréal, QC, Canada
- *Correspondence: Audrey-Anne Beauchamp,
| | - Yannick Lacoste
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire sur la Formation et la Profession Enseignante (CRIFPE), Université du Québec à Montréal, Montréal, QC, Canada
| | - Célia Kingsbury
- École de Santé Publique de l’Université de Montréal (ESPUM), Montréal, QC, Canada
- Centre de Recherche de l’Institut de Santé Mentale de Montréal (CRIUSMM), Montréal, QC, Canada
| | - Tegwen Gadais
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
- Chaire UNESCO en développement curriculaire (CUDC), Université du Québec à Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire sur la Formation et la Profession Enseignante (CRIFPE), Université du Québec à Montréal, Montréal, QC, Canada
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10
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Yu T, Xu J, Jiang Y, Hua H, Zhou Y, Guo X. School educational models and child mental health among K-12 students: a scoping review. Child Adolesc Psychiatry Ment Health 2022; 16:32. [PMID: 35477408 PMCID: PMC9047301 DOI: 10.1186/s13034-022-00469-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The promotion of mental health among children and adolescents is a public health imperative worldwide, and schools have been proposed as the primary and targeted settings for mental health promotion for students in grades K-12. This review sought to provide a comprehensive understanding of key factors involved in models of school education contributing to student mental health development, interrelationships among these factors and the cross-cultural differences across nations and societies. METHODS This scoping review followed the framework of Arksey and O'Malley and holistically reviewed the current evidence on the potential impacts of school-related factors or school-based interventions on student mental health in recent 5 years based on the PubMed, Web of Science, Embase and PsycExtra databases. RESULTS/FINDINGS After screening 558 full-texts, this review contained a total of 197 original articles on school education and student mental health. Based on the five key factors (including curriculum, homework and tests, physical activities, interpersonal relationships and after-school activities) identified in student mental development according to thematic analyses, a multi-component school educational model integrating academic, social and physical factors was proposed so as to conceptualize the five school-based dimensions for K-12 students to promote student mental health development. CONCLUSIONS The lessons learned from previous studies indicate that developing multi-component school strategies to promote student mental health remains a major challenge. This review may help establish appropriate school educational models and call for a greater emphasis on advancement of student mental health in the K-12 school context among different nations or societies.
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Affiliation(s)
- Ting Yu
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Jian Xu
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China.
| | - Yining Jiang
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Hui Hua
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Yulai Zhou
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Xiangrong Guo
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
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11
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Are Physically Active Breaks in School-Aged Children Performed Outdoors? A Systematic Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14073713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
(1) Background: Children spend an ever-increasing amount of time performing sedentary behaviors, and an important part of their daily life is at school. Learning in an outdoor environment improves children’s physical activity levels, and their cognitive and social spheres. Furthermore, physically active breaks are a solution to reduce sedentary behaviors and improve well-being and academic performance. The study evaluated the published literature on physically active breaks during school hours and explored (a) if the interventions were proposed in an outdoor context and (b) the outcomes of these interventions. (2) Methods: This review collected 31,559 articles from different electronic databases. After the screening, the results were analyzed narratively. (3) Results: 41 studies have been included in the analysis. As reported by the results, most of the interventions took place in the classroom, and only three studies were performed outside. A common aspect of all studies is the feasibility of active breaks, assessing positive outcomes. (4) Conclusions: Physically active outdoor breaks are poorly adopted, highlighting the necessity for deeper study on this topic. Although the protocols considered present differences, generally breaks increase physical activity levels, present positive learning outcomes, and improve social well-being. Furthermore, they are sustainable in terms of time, cost, and effort of the teacher.
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12
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Troy D, Anderson J, Jessiman PE, Albers PN, Williams JG, Sheard S, Geijer-Simpson E, Spencer L, Kaner E, Limmer M, Viner R, Kidger J. What is the impact of structural and cultural factors and interventions within educational settings on promoting positive mental health and preventing poor mental health: a systematic review. BMC Public Health 2022; 22:524. [PMID: 35300632 PMCID: PMC8927746 DOI: 10.1186/s12889-022-12894-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
Mental health (MH) difficulties are on the increase among children and young people (CYP). Evidence has shown that educational settings contain both risk and protective factors for MH. This review investigated which structural and cultural factors and interventions within educational settings promote positive MH and prevent poor MH in 4–18 year olds. Searches were conducted in PsychINFO, Embase, ERIC, ASSIA and British Education Index, and reference lists from key studies and relevant systematic reviews were hand-searched. Intervention, cohort, and qualitative studies were included. Of the 62 included papers, 36 examined cultural factors (30 social/relational and six value-related) while 12 studies examined structural factors (eight organisational and four physical) and 14 studies examined multiple factors. There was strong evidence for the impact of positive classroom management techniques, access to physical activity, and peer mentoring on student MH. Studies examining the impact of positive school culture, teacher training in MH and parent involvement in school MH activities also found predominantly positive results for student MH, albeit the evidence was of lower quality or from a low number of studies. Few studies explicitly examined the impact of interventions on MH inequalities; those that did indicated limited if any reduction to inequalities. A very small number of studies suggested that interventions targeting those at risk of poor MH due to socioeconomic factors could successfully improve wellbeing and reduce depression, anxiety and behavioural problems. Studies exploring the effect of management and leadership strategies within schools, policies, and aspects of the physical environment other than green space were scarce or absent in the literature. This review highlights the need to consider the ways in which educational settings are organised, the culture that is created and the physical space in order to improve the MH of CYP.
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Affiliation(s)
- David Troy
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.
| | - Joanna Anderson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Patricia E Jessiman
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Patricia N Albers
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Joanna G Williams
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | | | | | - Liam Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Mark Limmer
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Russell Viner
- Population, Policy and Practice Department, University College London, London, UK
| | - Judi Kidger
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
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13
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Petrigna L, Thomas E, Scardina A, Rizzo F, Brusa J, Camarazza G, Galassi C, Palma A, Bellafiore M. Methodological Considerations for Movement Education Interventions in Natural Environments for Primary School Children: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1505. [PMID: 35162531 PMCID: PMC8835137 DOI: 10.3390/ijerph19031505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Education is the ideal setting for carrying out projects to improve primary students' capacities. In recent years, interventions in natural environments have been more frequently proposed, but there is still a lack of standardization, making deeper study of the topic necessary. This review aims to report on what previous scientific research has been carried out, and eventually, to propose standard operating procedures for future interventions. METHODS This is a scoping review that adopted the PRISMA guidelines. Primary school children have been included, and the interventions had to be proposed adopting nature as the primary element of the learning process. RESULTS A total of 19 studies have been included, and a wide range of methodological differences has been detected regarding the included intervention protocols. CONCLUSIONS Learning in nature is a feasible intervention that, despite the high heterogeneity of interventions, demonstrates positive outcomes in the learning sphere of children.
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Affiliation(s)
- Luca Petrigna
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
| | - Antonino Scardina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
| | - Federica Rizzo
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
| | - Jessica Brusa
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
| | - Giovanni Camarazza
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
- Regional School Office of Sicily (USR Sicilia), Via San Lorenzo Colli n° 312/g, 90146 Palermo, Italy
| | - Claudia Galassi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
- Regional School Office of Sicily (USR Sicilia), Via San Lorenzo Colli n° 312/g, 90146 Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
| | - Marianna Bellafiore
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Pascoli 6, 90144 Palermo, Italy; (E.T.); (A.S.); (F.R.); (J.B.); (G.C.); (C.G.); (A.P.); (M.B.)
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Ellinger J, Mess F, Blaschke S, Mall C. Health-related quality of life, motivational regulation and Basic Psychological Need Satisfaction in Education Outside the Classroom: an explorative longitudinal pilot study. BMC Public Health 2022; 22:49. [PMID: 34998374 PMCID: PMC8742160 DOI: 10.1186/s12889-021-12450-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/20/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Given a suboptimal state of mental health among children, an urgent need exists to seek approaches related to health promotion in this population's settings, such as in schools. Increased health-related quality of life (HRQoL) and improved school motivation could be crucial for children's mental health. Based on self-determination theory, paths can be identified that could lead to such improvements by strengthening the basic psychological needs (BPN). This study aimed to examine the impact on and the relationships among HRQoL, school motivation and BPN within the promising concept of education outside the classroom (EOtC). METHODS In this exploratory study, we employed a between-subjects cohort study design with no blinding or randomisation. We surveyed fifth graders (mean = 10.1 years) attending EOtC (experimental group [EG], n = 25) and normal indoor lessons (control group, [CG], n = 41) at the beginning (T1) and end (T2) of a semester. We used the translations of validated questionnaires and established linear mixed-effects models to evaluate whether the students in EOtC show higher scores of HRQoL and school motivation and, whether the satisfaction of BPN of autonomy (PAut), competence (PCom), social relatedness with classmates (PSRC) and teachers (PSRT) show associations with these outcomes. RESULTS Regarding intrinsic and identified motivational regulation, results showed significant increases over time in the overall sample and significant higher scores in the EG than in the CG. For HRQoL, no group differences were found, but a significant decrease over time in the EG. Regarding possible associations between the outcomes and BPN, such could only be found between HRQoL and PSRC, but not for the other BPN and not for motivational regulation and BPN. CONCLUSIONS Without having been able to explain this on the basis of increased BPN values, our results show that EOtC can support improvements in specific regulation types of school motivation. This could contribute to an improvement in the mental health situation in children, as school represents a major stressor for them. Future steps in terms of researching HRQoL in this setting are discussed, as this pilot study does preliminary work for necessary examinations, e.g. in structural equation approaches.
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Affiliation(s)
- Jan Ellinger
- Department of Sport and Health Sciences, Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany.
| | - Filip Mess
- Department of Sport and Health Sciences, Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Simon Blaschke
- Department of Sport and Health Sciences, Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Christoph Mall
- Department of Sport and Health Sciences, Associate Professorship of Didactics in Sport and Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
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15
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Bølling M, Mygind E, Mygind L, Bentsen P, Elsborg P. The Association between Education Outside the Classroom and Physical Activity: Differences Attributable to the Type of Space? CHILDREN-BASEL 2021; 8:children8060486. [PMID: 34200485 PMCID: PMC8227423 DOI: 10.3390/children8060486] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/17/2022]
Abstract
Education outside the classroom (EOtC) has become an attractive approach, not only for learning but also for health. This explorative, cross-sectional study investigated children’s sedentary behaviours (SED), light physical activity (LPA) and moderate-to-vigorous PA (MVPA) on school days with an EOtC session in green space compared to school days with EOtC in other environments and without EOtC. Teachers from 17 Danish school classes practised EOtC for one school year on a weekly basis and self-reported the characteristics of the EOtC environment. The pupils’ PA was device-measured for seven consecutive days in a random period during the school year with AX3 accelerometers. Across 617 pupils (age 9–13 years), PA intensity cases (N = 2264) on school days (8:10–14:00 h) with (n = 317) or without (n = 1947) EOtC were included in a mixed-effects regression analysis. Mean exposure to EOtC was 262 min per session. School days with green EOtC (e.g., parks, forests and nature schools) were associated with (mean, [95% CI]) −24.3 [−41.8, −7.7] min SED and +21.3 [7.7, 36.4] min LPA compared to school days with non-green EOtC (e.g., cultural and societal institutions or companies) and with +6.2 [−0.11, 11.48] min MVPA compared to school days with a school-ground EOtC. No sex differences were found. In conclusion, school days with green EOtC must be considered promising to counteract children’s sedentary behaviours during school hours.
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Affiliation(s)
- Mads Bølling
- Health Promotion Research, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark;
- Correspondence:
| | - Erik Mygind
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark; (E.M.); (P.B.)
| | - Lærke Mygind
- Center for Clinical Research and Prevention, Copenhagen University Hospital—Bispebjerg and Frederiksberg, The Capital Region of Denmark, DK-2000 Frederiksberg, Denmark;
- School of Psychology, Cognitive Neuroscience Unit, Deakin University, Waurn Ponds, VIC 3216, Australia
- Department of Public Health, Unit of Medical Psychology, University of Copenhagen, DK-1014 Copenhagen, Denmark
| | - Peter Bentsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark; (E.M.); (P.B.)
- Center for Clinical Research and Prevention, Copenhagen University Hospital—Bispebjerg and Frederiksberg, The Capital Region of Denmark, DK-2000 Frederiksberg, Denmark;
| | - Peter Elsborg
- Health Promotion Research, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark;
- Center for Clinical Research and Prevention, Copenhagen University Hospital—Bispebjerg and Frederiksberg, The Capital Region of Denmark, DK-2000 Frederiksberg, Denmark;
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Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:196-215. [PMID: 33979106 DOI: 10.1097/hrp.0000000000000294] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). METHODS We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. RESULTS 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. CONCLUSION Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.
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Bentsen P, Mygind L, Elsborg P, Nielsen G, Mygind E. Education outside the classroom as upstream school health promotion: 'adding-in' physical activity into children's everyday life and settings. Scand J Public Health 2021; 50:303-311. [PMID: 33624553 DOI: 10.1177/1403494821993715] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION It is central for public health to answer questions related to how to change health and wellbeing in populations through interdisciplinarity and health in all policies and sectors. For a school physical activity promotion initiative to be acceptable and thus feasible, the buy-in of teachers is fundamental. Therefore, school physical activity promotion should be integrated into and support teaching activities. AIMS We discuss the use of education outside the classroom as a feasible pedagogical approach that integrates and promotes physical activity for school children. METHODS We present and discuss theoretical arguments and empirical evidence to argue and illustrate that education outside the classroom is a promising approach for promoting physical activity. RESULTS Education outside the classroom is characterised by regular curriculum-based experiential teaching activities outside the classroom with the inclusion of physical activity as a means to pedagogical ends. School subjects are taught outside the classroom drawing on problem-based learning and experiential education. Here, physical activity is integrated without compromising curriculum goals which increases teacher buy-in and thereby intervention acceptability and feasibility. Empirical evidence suggests that education outside the classroom increases boys' moderate to vigorous physical activity and girls' light intensity physical activity. We contend that the mechanisms are a mix of place, pedagogy and pupil motivations. CONCLUSIONS Education outside the classroom is a feasible and acceptable approach to public health and physical activity promotion because it is integrated into children's everyday settings through curriculum time and applied broadly to child populations at a low cost. The practice of education outside the classroom is context-dependent and culturally bound, and practices therefore need to be adapted to the individual sociocultural context.
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Affiliation(s)
- Peter Bentsen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Geoscience and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark
| | - Lærke Mygind
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Cognitive Neuroscience Unit, Deakin University, Melbourne, Australia.,Unit of Medical Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Peter Elsborg
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Glen Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Erik Mygind
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Copenhagen, Denmark
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Mann J, Gray T, Truong S, Sahlberg P, Bentsen P, Passy R, Ho S, Ward K, Cowper R. A Systematic Review Protocol to Identify the Key Benefits and Efficacy of Nature-Based Learning in Outdoor Educational Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031199. [PMID: 33572827 PMCID: PMC7908363 DOI: 10.3390/ijerph18031199] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
Outdoor Learning in natural environments is a burgeoning approach in the educational sector. However, the evidence-base of research has not kept pace with teacher perceptions and increased practitioner usage. Anecdotal evidence and formal research suggest the significant health and wellbeing benefits of nature connection. Offering low-cost, non-invasive pedagogical solutions to public health challenges—particularly around mental health, wellbeing, physical literacy, and increasing physical activity–the pedagogical benefits of Outdoor Learning are yet to be fully enunciated. The proposed systematic review will search for studies across eight academic databases which measure the academic and socio-emotional benefits of Outdoor Learning, with a focus on school-aged educational settings. Using the inclusion criteria set out in this paper (and registered with PROSPERO: CRD42020153171), relevant studies will be identified then summarised to provide a synthesis of the current literature on Outdoor Learning. The goal of this review is to document the widespread international investigation into Outdoor Learning and its associated benefits for development, wellbeing, and personal growth. The systematic review will provide insights for teacher-training institutions, educational policy makers, and frontline teachers to improve the learning experiences of future students.
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Affiliation(s)
- Jeff Mann
- Centre for Educational Research, Western Sydney University, Sydney, NSW 2751, Australia;
- The Scots College, Bellevue Hill, Sydney, NSW 2023, Australia
- Correspondence: ; Tel.: +61-401-168047
| | - Tonia Gray
- Centre for Educational Research, Western Sydney University, Sydney, NSW 2751, Australia;
| | - Son Truong
- Faculty of Health, School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Pasi Sahlberg
- Gonski Institute, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Bispebjerg and Frederiksberg, 2000 Frederiksberg, Denmark;
- Department of Geosciences and Natural Resource Management, University of Copenhagen, 1958 Frederiksberg C, Denmark
| | - Rowena Passy
- Plymouth Institute of Education, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK;
| | - Susanna Ho
- Singapore University of Social Sciences, Singapore 599494, Singapore;
| | - Kumara Ward
- School of Education and Social Work, University of Dundee, Nethergate, Dundee DD1 4HN, UK;
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Is It a Good Idea for Chemistry and Sustainability Classes to Include Industry Visits as Learning Outside the Classroom? An Initial Perspective. SUSTAINABILITY 2021. [DOI: 10.3390/su13020752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Learning outside the classroom (LOtC) activities are part of pedagogical methodologies that are currently applied in the development of student skills. The objective of this study is to determine the perceptions of faculty and undergraduate students concerning industrial visits and define the advantages and disadvantages of these activities. A survey was designed with 17 questions, from a sample of 296 students and 32 professors from various chemistry and sustainability courses. The statistical samples correspond to a population of 2275 students and 246 professors. Descriptive statistics were used to analyze and compare participant perceptions on industrial visits, as LOtC activities. Results indicated a positive perception for making industrial visits, generating more interest in the class material and helping students acquire knowledge. Despite this positive perception, it was found that professors are unlikely to organize industrial visits frequently due to the work required to plan, perform, and evaluate these activities. This issue suggests that approximately 40% of the students may lose the advantages that LOtC activities could offer. Professors must be motivated and supported by administrators to include industrial visits in their courses as a teaching strategy to provide a beneficial experience to the majority of students enrolled in chemistry and sustainability undergraduate programs.
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Mygind L, Kurtzhals M, Nowell C, Melby PS, Stevenson MP, Nieuwenhuijsen M, Lum JAG, Flensborg-Madsen T, Bentsen P, Enticott PG. Landscapes of becoming social: A systematic review of evidence for associations and pathways between interactions with nature and socioemotional development in children. ENVIRONMENT INTERNATIONAL 2021; 146:106238. [PMID: 33189991 DOI: 10.1016/j.envint.2020.106238] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Existing research indicates that spending time in nature is associated with diverse aspects of children's health and wellbeing. Although fundamental to later life chances and health, no systematic reviews, to our knowledge, have focused specifically on the effects of interaction with nature on socioemotional functioning in childhood. OBJECTIVES Amongst children, what is the consistency of associations between the availability of or spending time in nature on socioemotional function and development? Furthermore, which child behaviours and states independently associate with socioemotional function and availability of or spending time in nature, and what is the consistency of associations between these behaviours and states and contact with nature? DATA SOURCES Embase, Environment Complete, MEDLINE, and APA PsycINFO. Eligible studies were backward and forward snowball-searched. STUDY ELIGIBILITY CRITERIA Studies investigating effects of, or associations between, availability of or interaction with nature on socioemotional or proximal outcomes in children under the age of 12 years were included in this review. STUDY APPRAISAL AND SYNTHESIS METHODS The internal validity of studies investigating socioemotional outcomes were based on assessments of elements of study design, conduct, and reporting to identify potential issues related to confounding or other biases. The number of analyses indicating positive, negative, and non-significant associations between availability or interaction with green space and the outcomes were summed. RESULTS A total of 223 eligible full-texts, of which 43 pertained to socioemotional outcomes and 180 to proximal outcomes, met eligibility criteria. Positive associations between availability of and spending time in green space were found with children's intra- and interpersonal socioemotional function and development. Proportions of positive findings ranged from 13.9% to 55% across experimental and observational research, exposures, populations, and contexts. Modifying and mediating factors were identified. We found consistent evidence for improved aspects of cognition and, for children over six years, reduced risk of obesity and overweight in association with green space; consistent links between movement behaviours in the experimental, but not observational research; tentative trends suggesting associations with play, motor skills, language, screen time, and communication skills; little evidence for positive associations between green space and mood, physical wellbeing, and stress; some evidence for associations with healthy birth outcomes, and little evidence for direct associations between availability of green space and asthma and allergy prevalence, however, mediation via, for example, air pollution was likely. LIMITATIONS We identified few studies without either probable or severe risk of bias in at least one item. Improved study quality may therefore result in different results. Restricting analyses to include only studies considered at low risk of bias indicated similar or slightly lower proportions of positive findings. Risk of bias in proximal outcomes was not assessed. CONCLUSIONS The empirical evidence for benefits of availability of and interaction green space for child socioemotional function and development must currently be considered limited. A number of proximal indicators were identified. Systematic review registration number. PROSPERO ID CRD42019135016.
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Affiliation(s)
- Lærke Mygind
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark.
| | - Mette Kurtzhals
- Health Promotion Research, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Gentofte, Denmark
| | - Clare Nowell
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Paulina S Melby
- Section of Sport, Individual and Society, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Matt P Stevenson
- Health Promotion Research, Steno Diabetes Center Copenhagen, The Capital Region of Denmark, Gentofte, Denmark
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Publica, Madrid, Spain
| | - Jarrad A G Lum
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Trine Flensborg-Madsen
- Unit of Medical Psychology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark; Department of Geoscience and Natural Resource Management, University of Copenhagen, Frederiksberg, Denmark
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
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Promoting Sustainable Wellbeing: Integrating Positive Psychology and Environmental Sustainability in Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196968. [PMID: 32977640 PMCID: PMC7579264 DOI: 10.3390/ijerph17196968] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 01/23/2023]
Abstract
This article proposes an integrative policy approach to defining and promoting wellbeing through the joint lenses of positive psychology and environmental sustainability. The study suggests that while both positive education and environmental education address various aspects of wellbeing, a common definition is still absent. The study proposes a framework for advancing a mutual concept of wellbeing: “sustainable wellbeing”, integrating aspects of individual wellbeing and the wellbeing of the environment. Sustainable wellbeing is achieved when improving individual wellbeing is correlated with improving the wellbeing of other members of society and the natural environment. It suggests a framework for integrating the benefits of positive education and environmental education into a coherent approach for exploring, discussing, and experiencing sustainable wellbeing. The paper mainly develops, explores, and demonstrates ten rules for implementing sustainable wellbeing literacy in schools, based on cognitive behavioral therapy and positive psychology insights. It contributes to the development and understanding of wellbeing, highlights the benefits of parallel developments of two distinct educational fields, and offers practical guidelines for implementing educational programs. Furthermore, the paper contributes to developing 21st century educational systems and further develops the emerging field of positive sustainability.
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Oswald TK, Rumbold AR, Kedzior SGE, Moore VM. Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review. PLoS One 2020; 15:e0237725. [PMID: 32886665 PMCID: PMC7473739 DOI: 10.1371/journal.pone.0237725] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/31/2020] [Indexed: 12/14/2022] Open
Abstract
Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.
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Affiliation(s)
- Tassia K. Oswald
- School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Alice R. Rumbold
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sophie G. E. Kedzior
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vivienne M. Moore
- School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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