Physical activity and social interaction assessments in schoolyard settings using the System for Observing Outdoor Play Environments in Neighborhood Schools (SOOPEN).

BACKGROUND: The schoolyard environment provides key opportunities to promote physical activity and socioemotional development for children. Schoolyards can also serve as a community park resource outside of school hours. We aimed to: (i) implement and evaluate reliability of the System for Observing Outdoor Play Environments in Neighborhood Schools (SOOPEN), (ii) assess schoolyard use by children during recess and community members of all ages outside of school hours, and (iii) investigate relationships of schoolyard and children´s group characteristics with physical activity levels and prosocial interactions. METHODS: In this cross-sectional study, we observed student and community visitor behavior using SOOPEN at three urban elementary schoolyards in Tacoma, Washington, USA, prior to renovations intended to expand each facility's use as a community park in neighborhoods with poor park access. We assessed interrater reliability using intraclass correlation coefficients and described current levels of schoolyard use (at the group level), physical activity, and prosocial behavior. Physical activity was assessed on a five-point scale and dichotomized to indicate moderate-to-vigorous physical activity (MVPA). Social interactions were coded as prosocial, antisocial, or neutral. We examined associations of selected schoolyard features and group characteristics with group MVPA and prosocial behavior during recess using modified Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI). RESULTS: We observed a total of 981 activity-defined, informal groups in the schoolyards, and achieved good to excellent interrater reliability using SOOPEN. Community use of the schoolyards during evenings and weekends was limited (n = 56 groups). During 26, 25-50 min recess periods (n = 833 groups), 19% of groups were engaged in MVPA. Schoolyard areas with paved surfaces were associated with more MVPA (PR = 1.52, 95% CI: 1.04, 2.23) compared to field/grass areas; supervised groups were associated with less MVPA than groups not directly supervised by an adult (PR = 0.59, 95% CI: 0.36, 0.96). Schoolyard characteristics were not associated with prosocial behavior. Mixed-gender groups were associated with more MVPA and more prosocial behavior. CONCLUSIONS: Our study using SOOPEN, a reliable new activity observation tool, highlights the multi-dimensional dynamics of physical activity and social interactions in schoolyards, which could be leveraged to promote healthy behaviors during and outside of school hours.

Park access and mental health among parents and children during the COVID-19 pandemic.

BACKGROUND: Time spent outdoors and in nature has been associated with numerous benefits to health and well-being. We examined relationships between park access and mental health for children and parents during the COVID-19 pandemic. We also explored associations between park access and co-participation of parent and child in time outdoors, and child and parent physical activity. METHODS: We used data from 1,000 respondents to a nationally representative U.S. survey of parent-child dyads during October-November 2020. Park access was defined as an affirmative response to: "do you have a park that you can safely walk to within 10 min of your home?" Child mental health was operationalized as the Strengths and Difficulties Questionnaire (SDQ) total difficulties score. The Patient Health Questionnaire-4 (PHQ-4) total score assessed parent mental health and the International Physical Activity Questionnaire (IPAQ) assessed parent physical activity. Child physical activity and co-participation in outdoor activity were reported as number of days in the prior week. Linear regression was used to examine relationships between park access and health outcomes in models adjusted for child and parent characteristics and COVID-19 impact. RESULTS: Our sample included 500 parents of children ages 6-10 years, and 500 parent-child dyads of children ages 11-17 years. Park access was associated with a lower SDQ total score among children (ß: -1.26, 95% CI: -2.25, -0.27) and a lower PHQ-4 total score among parents (ß: -0.89, 95% CI: -1.39, -0.40). In models stratified by child age, these associations were observed for SDQ scores among adolescents ages 11-17 and for PHQ-4 scores among parents of children ages 6-10 years. Park access was also associated with 0.50 more days/week of co-participation in outdoor time (95% CI: 0.16, 0.84), and higher levels of parent physical activity (ß: 1009 MET-min/week, 95% CI: 301, 1717), but not child physical activity (ß: 0.31 days/week, 95% CI: -0.03, 0.66). CONCLUSIONS: Park access was associated with better mental health among children and parents, and more parent physical activity and parent-child co-participation in outdooractivity during the COVID-19 pandemic. Access to nearby parks may be an important resource to promote health and well-being, for both individuals and families.

Time Spent in Nature Is Associated with Increased Pro-Environmental Attitudes and Behaviors.

Urbanization, screen dependency, and the changing nature of childhood and parenting have led to increased time indoors, creating physical and emotional distancing from nature and time spent in natural environments. Substantial evidence from observational and intervention studies indicates that overall time spent in nature leads to increased perceived value for connectedness to nature and, subsequently, greater pro-environmental attitudes and behaviors (PEAB). This narrative review of the recent literature evaluates associations between time spent in nature with values ascribed to nature and nature connectedness, as well as PEAB. We discuss the influence of nature exposure and education in childhood on subsequent development of PEAB in adulthood. We analyze theoretical frameworks applied to this research as well as metrics employed, populations studied, and individual and societal values before presenting limitations of this research. We conclude with suggestions for future research directions based on current knowledge, underscoring the importance of promoting time spent in nature and PEAB in the face of growing challenges to planetary health. Research indicates that overall time spent in nature, regardless of the quality of environmental conditions, leads to increased perceived values ascribed to nature, which is associated with PEAB; however, this literature is predominantly cross-sectional. Furthermore, personal and social factors may influence PEAB. Thus, more longitudinal studies that consider these factors are needed to assess the duration and frequency of time spent in nature in childhood and its impact on PEAB throughout the life course. Identifying contexts which cultivate PEAB and reverse alienation from nature beginning in childhood may better sensitize adults to the urgency of environmental issues such as climate change, which adversely impact individual and environmental health.

Urban Trees and Human Health: A Scoping Review.

The urban forest is a green infrastructure system that delivers multiple environmental, economic, social and health services, and functions in cities. Environmental benefits of urban trees are well understood, but no review to date has examined how urban trees affect human health. This review provides a comprehensive summary of existing literature on the health impacts of urban trees that can inform future research, policy, and nature-based public health interventions. A systematic search used keywords representing human health, environmental health, and urban forestry. Following screening and appraisal of several thousand articles, 201 studies were conceptually sorted into a three-part framework. Reducing Harm, representing 41% of studies, includes topics such as air pollution, ultraviolet radiation, heat exposure, and pollen. Restoring Capacities, at 31%, includes attention restoration, mental health, stress reduction, and clinical outcomes. Building Capacities, at 28%, includes topics such as birth outcomes, active living, and weight status. The studies that were reviewed show substantial heterogeneity in purpose and method yet indicate important health outcomes associated with people's exposure to trees. This review will help inform future research and practice, and demonstrates why urban forest planning and management should strategically promote trees as a social determinant of public health.

Greening Blocks: A Conceptual Typology of Practical Design Interventions to Integrate Health and Climate Resilience Co-Benefits.

It is increasingly evident that exposure to green landscape elements benefits human health. Urban green space in cities is also recognized as a crucial adaptation response to changes in climate and its subsequent effects. The exploration of conceptual and practical intersections between human health, green spaces, and climate action is needed. Evidence-based guidance is needed for stakeholders, practitioners, designers, and citizens in order to assess and manage urban green spaces that maximize co-benefits for both human health and climate resilience. This paper proposes interventions that provide strategic green space enhancement at the neighborhood and block scale. We propose eight tangible green space interventions and associated metrics to integrate climate resilience and population health co-benefits into urban green space design and planning: View from within, Plant entrances, Bring nature nearby, Retain the mature, Generate diversity, Create refuge, Connect experiences, and Optimize green infrastructure. These interventions represent a hierarchy of functional design concepts that respond to experiential qualities and physical/psychological dimensions of health, and which enhance resilience at a range of social scales from the individual to the neighborhood. The interventions also reveal additional research needs in green space design, particularly in neighborhood-level contexts.

A thought in the park: The influence of naturalness and low-level visual features on expressed thoughts.

Prior research has shown that the physical characteristics of one's environment have wide ranging effects on affect and cognition. Other research has demonstrated that one's thoughts have impacts on mood and behavior, and in this three-part research program we investigated how physical features of the environment can alter thought content. In one study, we analyzed thousands of journal entries written by park visitors to examine how low-level and semantic visual features of the parks correlate with different thought topics. In a second study, we validated our ecological results by conducting an online study where participants were asked to write journal entries while imagining they were visiting a park, to ensure that results from Study 1 were not due to selection bias of park visitors. In the third study, we experimentally manipulated exposure to specific visual features to determine if they induced thinking about the same thought topics under more generalized conditions. Results from Study 3 demonstrated a potential causal role for perceived naturalness and high non-straight edges on thinking about "Nature", with a significant positive interaction. Results also showed a potential causal effect of naturalness and non-straight edges on thinking about topics related to "Spiritual & Life Journey", with perceived naturalness having a negative relationship and non-straight edges having a positive relationship. We also observed a significant positive interaction between non-straight edge density and naturalness in relation to "Spiritual & Life Journey". These results have implications for the design of the built environment to influence human reflection and well-being.

Nature Contact and Human Health: A Research Agenda.

BACKGROUND: At a time of increasing disconnectedness from nature, scientific interest in the potential health benefits of nature contact has grown. Research in recent decades has yielded substantial evidence, but large gaps remain in our understanding. OBJECTIVES: We propose a research agenda on nature contact and health, identifying principal domains of research and key questions that, if answered, would provide the basis for evidence-based public health interventions. DISCUSSION: We identify research questions in seven domains: a) mechanistic biomedical studies; b) exposure science; c) epidemiology of health benefits; d) diversity and equity considerations; e) technological nature; f) economic and policy studies; and g) implementation science. CONCLUSIONS: Nature contact may offer a range of human health benefits. Although much evidence is already available, much remains unknown. A robust research effort, guided by a focus on key unanswered questions, has the potential to yield high-impact, consequential public health insights. https://doi.org/10.1289/EHP1663.

Multiple health benefits of urban tree canopy: The mounting evidence for a green prescription.

The purpose of this study was to enhance the understanding of the health-promoting potential of trees in an urbanized region of the United States. This was done using high-resolution LiDAR and imagery data to quantify tree cover within 250m of the residence of 7910 adult participants in the California Health Interview Survey, then testing for main and mediating associations between tree cover and multiple health measures. The results indicated that more neighborhood tree cover, independent from green space access, was related to better overall health, primarily mediated by lower overweight/obesity and better social cohesion, and to a lesser extent by less type 2 diabetes, high blood pressure, and asthma. These findings suggest an important role for trees and nature in improving holistic population health in urban areas.

Metro nature, environmental health, and economic value.

BACKGROUND: Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. OBJECTIVES: We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. METHODS: We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. DISCUSSION: Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements-collectively termed metro nature-generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. CONCLUSIONS: Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits.