Exploring children's perceptions of barriers and facilitators to physical activity in rural Northwestern Ontario, Canada.

INTRODUCTION: Low levels of physical activity among children are a significant public health concern in several industrialized nations. The current research body has failed to gather adequate information on various geographic regions. Understanding barriers and facilitators in different rural regions is imperative for creating successful physical activity interventions for children in rural areas. The purpose of this study is to explore rural children's perspectives on physical activity and to discuss barriers or facilitators to physical activity participation in rural Northwestern Ontario, Canada. METHODS: Children (n=84) in Grades 4-8 (ages 8-14 years) in rural Northwestern Ontario participated in focus groups to discuss barriers and facilitators to physical activity. Twenty focus groups were conducted in schools. The focus groups were audio-recorded and transcribed verbatim. Transcripts were analyzed using thematic analysis. Subthemes were created based on the explicit content of the data and grouped to form broader themes. RESULTS: Three key themes were identified: environment, social environment, and perceptions of safety. Environmental features include weather and the built environment. Social environment includes the role of friends and adults to either facilitate or restrict children's play. The fear of wildlife was pervasive across all focus groups and resulted in restricted independent mobility and physical activity. CONCLUSION: Rural children are typically under-represented in physical activity research. The findings of this study reveal that rural children experience some barriers to physical activity that are distinct from those of urban children. The findings suggest that researchers need to understand contextual nuances of the rural environment. Specific to the setting of Northwestern Ontario, these rural children could benefit from the addition of a skate park, indoor places to play, and more wildlife education.

Mental health benefits of interactions with nature in children and teenagers: a systematic review.

BACKGROUND: It is commonly believed that nature has positive impacts on children's health, including physical, mental and social dimensions. This review focuses on how accessibility to, exposure to and engagement with nature affects the mental health of children and teenagers. METHODS: Ten academic databases were used to systematically search and identify primary research papers in English or French from 1990 to 1 March 2017. Papers were included for review based on their incorporation of nature, children and teenagers (0-18 years), quantitative results and focus on mental health. RESULTS: Of the 35 papers included in the review, the majority focused on emotional well-being and attention deficit disorder/hyperactivity disorder. Other outcome measures included overall mental health, self-esteem, stress, resilience, depression and health-related quality of life. About half of all reported findings revealed statistically significant positive relationships between nature and mental health outcomes and almost half reported no statistical significance. CONCLUSIONS: Findings support the contention that nature positively influences mental health; however, in most cases, additional research with more rigorous study designs and objective measures of both nature and mental health outcomes are needed to confirm statistically significant relationships. Existing evidence is limited by the cross-sectional nature of most papers.

Children and Nature: Linking Accessibility of Natural Environments and Children's Health-Related Quality of Life.

A growing body of research suggests that increasing children's nature interactions can have positive benefits for their health-related quality of life (HRQOL); however, researchers have yet to examine how geographical context influences this relationship. The purpose of this study was to examine individual-level and environmental factors that are associated with HRQOL of children from different geographical contexts. Data were collected for 851 children from 34 elementary schools in Ontario, Canada. The natural environments around each child's home were computed using geospatial analyses in a geographic information system. Natural environment measures were combined with HRQOL and the demographics from child surveys to be used in a series of step-wise linear regression models. These models explored the relationship between children's HRQOL and the natural environment in urban/suburban and rural populations. In addition to important individual-level determinants, the findings revealed that characteristics of the natural environment, including the amount of greenness, park, and water, show significant relationships in the urban/suburban population. Interpersonal variables were the key predictors of HRQOL in the rural population. Where children live influences relationships between nature and HRQOL. These findings have implications for policymakers, health practitioners, educators, and parents in the design and the promotion of nature for children's HRQOL.