The beach as a setting for families' health promotion: a qualitative study with parents and children living in coastal regions in Southwest England

Survey data linking coastal visit behaviours to socio-demographic and health profiles

Coastal destinations are highly popular for leisure, yet the effects of spending time at the coast on mental and physical health have remained underexplored. To accelerate the research about the effects of the coast on health, we compiled a dataset from a survey on a sample (N = 1939) of the adult Flemish population about their visits to the Belgian coast. The survey queried the number of days spent at the coast in the previous year or before and the following characteristics of their visits: how often they performed specific activities, which of the 14 municipal seaside resorts they visited, who they were with, what they mentally and physically experienced, and what reasons they had for not visiting the coast more often. The respondents' geo-demographic (including residential proximity to the coast), socio-economic, and health profile was also collected. We anticipate that investigations on the data will increase our understanding about the social structuring of coastal visits and give context to the effects of the coast on human health.

Young children's use of blue spaces and the impact on their health, development and environmental awareness: A qualitative study from parents' perspectives

ISSUE ADDRESSED

This study examined how families with young children access and use different types of blue spaces and the health and development benefits, and potential negative effects.

METHODS

Parents(n = 25) of young children across four coastal communities in Western Australia were recruited via purposive sampling to participate in interviews. A generic qualitative study design grounded in the pragmatism paradigm was utilised.

RESULTS

Beaches were the most frequently used blue space for families all year around, however families did not necessarily attend their closest beach. This appears due to certain beach features making them more or less attractive for use regardless of the distance from home. Parents perceived blue spaces as health promoting due to the increased physical activity children did in and around these spaces. They also reported blue spaces could be positive for child development, contributing to the development of identity. Blue spaces were also perceived to promote children's environmental awareness and environmentally friendly behaviours. However, blue spaces could also be potentially risky environments for families with young children.

CONCLUSIONS

The findings highlight blue spaces are an important setting for supporting children's health, development and environmental consciousness. SO WHAT?: It is important to protect natural outdoor environments such as blue spaces for future generations. The findings can be used by governments and policy makers to improve the quality (features and amenities) of blue spaces and positively impact how often families (including those with dogs) use blue spaces and the benefits they experience.

The impact of outdoor blue spaces on the health of the elderly: A systematic review

Research on natural health has identified the potential benefit of outdoor blue spaces for human health and wellbeing. However, the existing evidence has relatively limited attention to the elderly. This study aims to review the available evidence on outdoor blue spaces and health outcomes among older individuals and identify knowledge gaps. In accordance with the PRISMA guidelines, specific keywords were used to search for articles published in English from inception to October 2023. Five databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO) were searched, and 22 studies were identified in this review. We classified articles based on elderly health as general health (e.g., self-reported, perceived health and wellbeing), physical health (e.g., physical activity, physical function index), and mental health and wellbeing (e.g., depression). The findings indicated a positive correlation between outdoor blue space and the health of the elderly. In terms of the characteristics of exposure to outdoor blue spaces, direct contact (e.g., sensory-based) has not been well documented compared to indirect contact (e.g., distance, percentage, region-based). Although encouraging, the available body of evidence is limited and lacks consistency. Future research is needed to provide complementary evidence between outdoor blue spaces and elderly health.

Urban green, blue spaces and their joint effect are associated with lower risk of emotional and behavior problem in children and adolescents, a large population-based study in Guangzhou, China

Extensive research has been conducted on the impact of urban Green and blue spaces (GBS) on mental health. However, there is a dearth of studies examining the potential influence of GBS on Emotion and behavior problems (EBP) in youth populations. This study seeks to address this research gap by examining the association between GBS exposure and EBP in youths, utilizing a large population-based survey. Exposure indicators were derived for each participant, taking into account the 1-m resolution land coverage percentage measurements at their residential and school locations, with buffer sizes of 500m and 800m. The study employed the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a measurement to EBP. To investigate this relationship, a Poisson linear mixed-effects model with comprehensive adjustment was utilized. Stratified analyses were conducted, taking into account demographic variables, while sensitivity analyses were performed to evaluate the reliability of the findings. The primary analysis encompassed a sample of 172,490 individuals, with an average age of 10.2 (standard deviation = 2.99), of whom 55.8% were male. Among young individuals residing within a 500-m radius of residential green spaces (GS), those in the second and third tertiles experienced a 5.0% and 7.6% decrease in the risk of developing total difficulties respectively, compared to those in the first tertile. Exposure to blue spaces (BS) around the residence yielded comparable results, with an AOR of 0.896 (95% CI: 0.866, 0.928) for the second tertile and an AOR of 0.991 (95% CI: 0.879, 0.943) for the third tertile, compared to the first tertile. The decrease in EBPs may also be linked to the joint effect of GS and BS. Young individuals were exposed to GS or BS, as well as the higher level of GS in conjunction with comparable BS, exhibited an inverse correlation with self-reported EBPs.

Nature-based interventions to support mental health and well-being of young women in pregnancy: exploratory work for future feasibility RCT

Background

The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16-24 years) in a future study.

Methods

This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women's panel (Research Influencers Group). Networking and stakeholder engagement to support future research.

Results

The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women's focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial.

Conclusion

This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout.

Limitations

This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey.

Future work

Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women.

Funding

This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167.

Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health

Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.

Shaping the healthy subject in gentrified spaces: Two case studies in Barcelona (Spain)

Several studies have analysed the impact of gentrification on health. However, a more in-depth examination of the constitutive role of health discourses in shaping spaces is required. This article explores the links between the gentrification process and the subjectification of healthy subjects through a critical discourse analysis of 35 walking interviews and a visual semiotic analysis of 140 shopfronts. Health is put forth as a super value to justify market interference in the configuration of urban space and class privilege based on the health products and healthy practices that have undergone a process of elitisation.

Nature contact and general health: Testing multiple serial mediation pathways with data from adults in 18 countries

The role of neighbourhood nature in promoting good health is increasingly recognised in policy and practice, but consistent evidence for the underlying mechanisms is lacking. Heterogeneity in exposure methods, outcome measures, and population characteristics, little exploration of recreational use or the role of different types of green or blue space, and multiple separate mediation models in previous studies have limited our ability to synthesise findings and draw clear conclusions. We examined multiple pathways linking different types of neighbourhood nature with general health using a harmonised international sample of adults. Using cross-sectional survey data from 18 countries (n = 15,917), we developed a multigroup path model to test theorised pathways, controlling for sociodemographic variables. We tested the possibility that neighbourhood nature (e.g. greenspace, inland bluespace, and coastal bluespace) would be associated with general health through lower air pollution exposure, greater physical activity attainment, more social contact, and higher subjective well-being. However, our central prediction was that associations between different types of neighbourhood nature and general health would largely be serially mediated by recent visit frequency to corresponding environment types, and, subsequently, physical activity, social contact, and subjective well-being associated with these frequencies. Several subsidiary analyses assessed the robustness of the results to alternative model specifications as well as effect modification by sociodemographics. Consistent with this prediction, there was statistical support for eight of nine potential serial mediation pathways via visit frequency which held for a range of alternative model specifications. Effect modification by financial strain, sex, age, and urbanicity altered some associations but did not necessarily support the idea that nature reduced health inequalities. The results demonstrate that across countries, theorised nature-health linkages operate primarily through recreational contact with natural environments. This provides arguments for greater efforts to support use of local green/blue spaces for health promotion and disease prevention.

Public holiday and long weekend mortality risk in Australia: A behaviour and usage risk analysis for coastal drowning and other fatalities

OBJECTIVE

This article aims to determine the impact of public holidays and long weekends on the risk of drowning and non-drowning deaths on the Australian coast.

METHODS

A retrospective case-control study using relative risk ratios and Z-scores to compare all unintentional fatalities on the Australian coast between 2004 and 2021 to a longitudinal representative survey sample of the Australian public and their coastal usage.

RESULTS

Overall, the coastal mortality risk increased by 2.03 times for public holidays (95%CI = 1.77-2.33, p<0.0001) and 2.14 times by long weekends (95%CI = 1.85-2.48, p<0.0001). Children <16 years had the highest increased risk of death on public holidays (RR = 3.53, 95%CI = 1.98-6.31, p = 0.0005) and long weekends (RR = 2.90, 95%CI = 1.43-5.89, p = 0.011), while residents who were born overseas had a higher risk of death compared to those born in Australia. For public holidays, the greatest increase in risk was for swimming/wading and bystander rescues, while for long weekends, it was for scuba diving and snorkelling.

CONCLUSIONS

Public holidays and long weekends increase the risk of both drowning and non-drowning deaths on the Australian coast, which differed by demographics and activities.

IMPLICATIONS FOR PUBLIC HEALTH

These results highlight periods of risk when targeted coastal safety messaging to high-risk demographics (particularly children and overseas-born residents), and provision of surf lifesaving resources can be increased.

Tides of Change-Barriers and Facilitators to Beach Accessibility for Older People and People with Disability: An Australian Community Survey

The beach is Australia's most popular recreational destination with participation in beach-based activities associated with a wide range of health and wellbeing benefits. Unfortunately, access to beach environments is not possible for many older people and people with a disability. The purpose of this study was to investigate the barriers and facilitators of beach accessibility using a framework that recognises the complex interconnections between blue space, accessibility, physical activity, and health and wellbeing. A 39-item anonymous online cross-sectional survey was developed and administered to explore the perspectives of older people and people with a disability regarding beach accessibility. In total, 350 people completed the survey (69% female, age range 2-90 years (mean = 52)). Disability was reported by 88% of respondents, with 77% requiring a community mobility aid. Two-thirds (68%) of respondents were unable to visit the beach as often as they wanted, with 45% unable to visit at all. The most frequently reported barriers to beach access included difficulty moving on soft sand (87%), no specialised mobility equipment (75%), and inaccessible lead-up pathways (81%). If beach access was improved, respondents reported they would visit the beach more often (85%), for longer (83%), and have an improved experience (91%). The most frequently reported facilitators to beach access were the presence of accessible lead-up pathways (90%), sand walkways (89%), and parking (87%). Older people and people with disability have limited beach access, primarily due to a lack of accessible equipment, excluding them from the wide range of health benefits associated with visiting the beach.

Applying an ecosystem services framework on nature and mental health to recreational blue space visits across 18 countries

The effects of 'nature' on mental health and subjective well-being have yet to be consistently integrated into ecosystem service models and frameworks. To address this gap, we used data on subjective mental well-being from an 18-country survey to test a conceptual model integrating mental health with ecosystem services, initially proposed by Bratman et al. We analysed a range of individual and contextual factors in the context of 14,998 recreational visits to blue spaces, outdoor environments which prominently feature water. Consistent with the conceptual model, subjective mental well-being outcomes were dependent upon on a complex interplay of environmental type and quality, visit characteristics, and individual factors. These results have implications for public health and environmental management, as they may help identify the bluespace locations, environmental features, and key activities, that are most likely to impact well-being, but also potentially affect recreational demand on fragile aquatic ecosystems.

"That Was the Happiest Time of My Life": Understanding Childhood Eco-Connections in Appalachian Communities

The goal of this study was to explore facets of childhood eco-connections, using retrospective qualitative data from adults. One hundred and forty-five adults from predominantly rural and small-town communities in southern Appalachia (71.7% female), average age 36.23 years (SD = 12.08) participated in semi-structured qualitative interviews on key life experiences and the places they grew up. Mentions about place-related childhood memories or interactions were grouped into four themes based on exploratory thematic content analysis: nature nostalgia (positive reminiscences about nature experiences); nature immersion (extensive contact with the natural world during childhood); formative experiences with nature (nature interactions that taught a skill or life lesson); and rhythms of nature (appreciation of seasonal or cyclical patterns). Childhood eco-connections are multifaceted and often emerge from early impactful or intense experiences. Pro-environmentalism messages to youth may benefit from more references to childhood eco-connections.

Relationship between "Blue Space" Proximity and Children's Weight Status, Health Behaviors, and Health-Related Quality of Life among a Sample of Regional Victorian Primary School Children

Background: Access to green space (e.g., parks and gardens) has been associated with child health and wellbeing, whereas blue space (e.g., coasts, lakes, and rivers) is understudied. Our aim was to determine whether proximity to the coast was associated with primary school children's weight status, modifiable health-related behaviors, and health-related quality of life (HRQoL). Methods: Exploratory cross-sectional analysis of baseline data from the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHOSTOPS) study, to estimate gender-specific differences in weight and behaviors across four bands of distance from the coast (<5 km, 5 to <25 km, 25 to <50 km, ≥50 km). Linear and logistic models, with robust standard errors, adjusted for school year level, area-level socioeconomic position and rurality, and allowing for distance by gender interaction were fitted on data from 1216 children (aged 8.5-13 years). Main outcomes were weight status (categorical), physical activity (PA) (categorical), and global HRQoL score (continuous). Results: Compared with girls living in towns ≥50 km from the coast, those living within 5 km had lower odds for overweight/obesity [odds ratio (OR) = 0.50; 95% confidence interval (CI): 0.37-0.67] and higher mean moderate-to-vigorous PA minutes (accelerometry) (β = 8.7; 95% CI: 2.0-15.5) and global HRQoL (β = 3.2; 95% CI: 1.4-5.0). Compared with boys living ≥50 km from the coast, those living within 5 km had higher odds of meeting self-reported PA guidelines (≥60 minutes/day) for ≥5 days (OR = 2.33; 95% CI: 1.75-3.10), and higher mean global HRQoL scores (β = 5.6; 95% CI: 1.9-9.3). Conclusions: Living close to the coast was associated with some favorable health outcomes and behaviors, which differed between girls and boys.

The mental health benefits of visiting canals and rivers: An ecological momentary assessment study

Existing evidence shows positive effects of being in nature on wellbeing, but we know little about the mental health benefits of spending time near canals and rivers specifically. This study investigates the association between visits to canals and rivers and mental wellbeing. We addressed the following questions: Are visits to canals and rivers associated with higher levels of mental wellbeing? Does this association depend on age and gender? Does this association vary between people with and without a diagnosis on mental illness? We used Urban Mind, a flexible smartphone application for examining the impact of different aspects of the built and social environment on mental wellbeing, a strong predictor of mental health. Participants were invited to complete an ecological momentary assessment three times a day for fourteen days. Each assessment included questions about their surrounding environment and mental wellbeing. A total of 7,975 assessments were completed by 299 participants including 87 with a diagnosis of mental illness. Multilevel regression models were used to analyse the data. We found positive associations between visits to canals and rivers and mental wellbeing (p < .05) when compared to being anywhere else and when compared to being in green spaces. Increases in mental wellbeing were still evident after the visit had taken place. These effects remained significant after adjusting for age, gender, ethnicity and education, and were consistent in people with and without a diagnosis of mental illness. Spending time near canals and rivers is associated with better mental wellbeing. These findings have potential implications for mental health as well as urban planning and policy. Visits to canals and rivers could become part of social prescribing schemes, playing a role in preventing mental health difficulties and complementing more traditional interventions.

A Qualitative Study on Emotions Experienced at the Coast and Their Influence on Well-Being

Coastal environments are increasingly shown to have a positive effect on our health and well-being. Various mechanisms have been suggested to explain this effect. However, so far little focus has been devoted to emotions that might be relevant in this context, especially for people who are directly or indirectly exposed to the coast on a daily basis. Our preregistered qualitative study explored how coastal residents experience the emotions they feel at the coast and how they interpret the effect these emotions have on them. We conducted semi-structured interviews with a purposive sample of eight Belgian coastal residents aged 21–25 years old. The interviews were analyzed with the approach of interpretative phenomenological analysis. Five superordinate themes were identified and indicate that, for our participants, the coast represents a safe haven (1) in which they can experience emotional restoration (2), awe (3), and nostalgia (4). These emotional states are accompanied with adaptive emotion regulating strategies (5), such as reflection and positive reappraisal, that may facilitate coping with difficult thoughts and feelings. Our study demonstrates the importance of investigating specific emotions and related processes triggered at the coast and how these could contribute to the therapeutic value of the coast.

Social Workers’ Choice Making in Supporting Nature Activities by Parents and Children in Shelters

Visiting a natural environment such as a garden or park helps people to recover from stressful circumstances. Women’s shelters and homeless shelters have started to integrate nature in their work, especially for families who seek temporary refuge, with the aim to support parents’ functioning and resilience. For professionals who want to facilitate engagement with nature among their clients, it may be helpful to learn how other professionals choose nature activities for the support of parents. The current study was aimed to uncover how social workers choose a nature activity for the support of parents, resulting in a model that can be used as a reflective tool among shelter professionals. The model is based on an analysis of actions of professionals, captured in case descriptions written by shelter professionals about parenting supportive nature activities that they facilitated for families under their care. The model shows that social workers promoted a back-and-forth between children’s exploration away from the parent and being with the parent. In facilitating these interactions, social workers used nature as an environment with stress reducing and strengthening capacities for parents and as an environment with supportive qualities for children’s play. A dimensional framework was extracted that described how professionals may choose activities.

Coupling Coordination Evaluation of Lakefront Landscape Spatial Quality and Public Sentiment

The comprehensive quality evaluation of the lakefront landscape relies on a combination of subjective and objective methods. This study aims to evaluate the coupling coordination between spatial quality and public sentiment in Wuhan’s lakefront area, and explore the distribution of various coupling coordination types through machine learning of street view images and sentiment analysis of microblog texts. Results show that: (1) The hot and cold spots of spatial quality are distributed in a contiguous pattern, whereas the public sentiments are distributed in multiple clusters. (2) A strong coupling coordination and correlation exists between spatial quality and public sentiment. High green visibility, high sky visibility, and natural revetment have remarkable positive effects on public sentiment. In comparison, high water visibility has a negative effect on public sentiment, which may be related to the negative impact of traffic-oriented streets on the lakefront landscape. (3) Lakefront areas close to urban centers generally show a low spatial quality–high public sentiment distribution, which may be related to factors such as rapid urbanization. This study can help planners identify critical areas to be optimized through coupling coordination relationship evaluation, and provides a practical basis for the future development of urban lakefront areas.

Children's Voices in Physical Activity Research: A Qualitative Review and Synthesis of UK Children's Perspectives

BACKGROUND

Physical activity during childhood is associated with multiple short- and long-term health benefits. Physical activity levels decline throughout primary school emphasising a need for effective strategies to promote more activity in children. Children have rarely been involved in the intervention development process. This gap is an important omission and there is much to be learnt from existing qualitative studies with children, which could serve as a starting point for specific projects. This systematic review aimed to synthesise qualitative studies with primary school children in the United Kingdom to identify children's perspectives on why physical activity is important, the factors that influence their physical activity and what they like when it comes to physical activity.

METHODS

A search of seven databases (conducted in October 2019) identified 26 papers for inclusion. Data extraction and synthesis were conducted using qualitative thematic synthesis. The quality of papers was assessed using the Critical Appraisal Skills Programme checklist for qualitative research.

RESULTS

Across the diverse range of studies, several key themes were identified in relation to the three research questions. Children have a comprehensive understanding of the various benefits of physical activity, including benefits for health, fitness and skills development. A range of social agents and practical issues influence children's physical activity, with friend and peer influences being particularly salient. Most children like to have choice over the activities they undertake and the opportunities for creative physical play such as making up active games.

CONCLUSIONS

The findings suggest that future interventions should utilize peer relationships, ensure a variety of activities are offered to cater to a broad range of children's physical activity preferences and incorporate child-led activities where possible. The included studies also highlight a need for more diversity in qualitative research in this area, particularly in terms of ethnicity and age, and combining traditional qualitative methods with creative methods, such as photography, may provide richer insights than when using a single mode of data collection. We also highlight several methodological challenges, and in particular, the need for greater acknowledgement of the role of the researcher in qualitative work with children.

Geographies of Dirty Water: Landscape-Scale Inequities in Coastal Access in Rhode Island

Across the United States, development, gentrification, and water quality degradation have altered our access to the coasts, redistributing the benefits from those spaces. Building on prior coastal and green space access research, we examined different populations' relative travel distances to all public coastal access and to public marine swimming beaches across the state of Rhode Island, by race, ethnicity, and socioeconomics. Next, we assessed relative travel distances to high quality public coastal amenities, i.e., sites with no history of water quality impairment. We used three state-level policy attributes to identify sites with the best water quality: Clean Water Act Section 303(d) impaired waters, shellfishing restrictions, and bacterial beach closure histories. Our analysis revealed statewide disparities in access to Rhode Island's public coastal amenities. With robust socioeconomic and geographic controls, race and ethnicity remained strongly correlated to travel distance. Higher proportions of Black and Latinx populations in census block groups were associated with longer travel distances to public access, in particular to public coastal sites with better water quality and to public swimming beaches. This translates to added costs on each trip for areas with higher Black and Latinx populations.

Associations between Parent-Child Nature Visits and Sleep, Physical Activity and Weight Status among Finnish 3-6-Year-Olds

Nature visits and nature exposure have been shown to be favorably associated with children’s health and development, but the research regarding their associations with children’s lifestyle habits is limited. The current study aimed to investigate the associations between the frequency of parent–child nature visits and sleep, moderate-to-vigorous physical activity (MVPA) and weight status among three- to six-year-old Finnish preschoolers. Parents and their children (n = 864) participated in a cross-sectional DAGIS (increased health and wellbeing in preschools) study, which was conducted between 2015 and 2016 in Finland. In total, 798 parents answered a questionnaire on the frequency of parent–child nature visits, which also included questions on sociodemographic factors and their children’s sleep habits. Parents also reported children’s bedtimes and wake-up times and children wore an accelerometer for seven days. Trained researchers measured children’s weight and height. Linear and logistic regression analyses were conducted. More frequent parent–child nature visits were associated with children’s longer sleep duration at night, higher amounts of MVPA outside preschool time and, among girls, good sleep consistency. The frequency of parent–child nature visits was not significantly associated with whether children were overweight or obese or not. Promoting parent–child nature visits could be a cost-effective way to increase young children’s MVPA and enhance night-time sleep.

The Role of Blue and Green Exercise in Planetary Health and Well-Being

The World Health Organization (WHO) recognizes that health and well-being are essential to achieving the United Nations (UN) Development Agenda 2030, which includes the goal of empowering people to adopt active lifestyles while protecting the planet’s health. This article aims at exploring how exercise performed in different natural settings can contribute to improving health and to a more sustainable world. We define “exercise” as a form of physical activity undertaken to increase fitness, health, and well-being, and argue for the importance of “green” and “blue” exercise as forms of physical activity that are associated with the protection and sustainability of natural settings and the promotion of planetary health. Blue and green exercise should become a focus of public policies, especially when outdoor activities are being identified as fundamental for the promotion of mental, physical, social, and spiritual health. The current paper intends to raise the awareness of political decision-makers and professionals in education, environment, and heath sectors for the potential of green and blue exercise as specific exercise practices that are healthy, joyful, and environmentally friendly.

A fragmented sense of home: Reconfiguring therapeutic coastal encounters in Covid-19 times

A growing body of research suggests positive links between coastal proximity, interaction, human health and wellbeing. In 2020, following the onset of the Covid-19 pandemic, many people in the UK could not engage in their usual coastal practices due to a national lockdown and associated restrictions, including government bans in entering the sea. This paper shares findings from an exploratory study examining how these restrictions shaped the recreational coastal practices, perceptions and emotions of residents in the case study region of Devon, South West England. In-depth semi-structured interviews were conducted with a purposive sample of 12 residents, with varying domestic and employment circumstances in the pandemic. We foreground three key themes identified through an inductive thematic analysis of the interviews: feeling 'at home' with the sea, experiencing a fragmented sense of home with Covid-19, and reconfiguring the coast as a therapeutic landscape. While important to understand the links between coastal proximity, health and wellbeing, we highlight the value of gaining more nuanced insights into the emotional, social, material and temporal dynamics that can re-shape the therapeutic potential of coastal encounter in the largely unprecedented situation of a global pandemic.

Effects on general health associated with beach proximity in Barcelona (Spain)

Health benefits of blue spaces have been less studied compared with other urban natural environments. As a type of blue space, beaches are also affected by this lack of evidence, despite their cultural and economic importance in lots of coastal regions all over the world. Based on secondary health data from 3192 participants of the Health Survey of Barcelona 2016, we conducted a logit regression analysis to explore the relationship between people's general health and beach proximity from their dwelling place, controlling for several health determinants. Our main results suggested that having good general health was less likely for a 1-km increase in the linear distance to the closest beach from people's dwelling places (OR: 0.93; 95% CI: 0.87, 1.00). Moreover, the probability of having good general health was 45% higher for people living in the first 2 km from the beach (OR: 1.45; 95% CI: 1.01, 2.09), relative to those living >5-10 km from it. Also, these health effects were stronger for people with a low family income. These findings contribute to grow the currently small body of research related to health benefits of beach spaces. Likewise, they encourage fostering the use of these spaces for health promotion in cities, as well as protecting them and improving their accessibility and safety. Further research should lean towards the underlying causes of these health benefits linked to people's exposure to beach spaces.

Quantified Activity Patterns for Young Children in Beach Environments Relevant for Exposure to Contaminants

In a study to evaluate beach play activities, 120 children were videotaped to observe and quantify factors that could influence their exposure to contaminants in the beach environment. Children aged 1 to 6 years were followed by researchers with video cameras at beaches (two in Miami, Florida and two in Galveston, Texas) for approximately one hour each. Factors evaluated included time spent in various beach locations, various activities engaged in, and various surfaces contacted (including contacts by hand and mouth). Activities recorded in the videos were transcribed to text files to allow for quantitative analyses. Across all sexes, age groups, and beaches, Wading was the most common activity and Seawater was the most common location where children played. The left hand was found to not be in contact with objects most of the time, while the right hand, considered the most dominant hand in most cases, contacted Plastic-Toys the most. Although activity patterns collection through videotaping and videotranslation can be labor-intensive, once collected, they can be widely useful for estimates of exposures to all contaminants in the beach environment (e.g., microorganisms and chemicals) as well as UV exposure, with considerations for whether the contaminants are found in water, sand or both. These activity patterns were collected to potentially look at exposures following the Deepwater Horizon 2010 Spill.

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

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

Y-PATHS: A Conceptual Framework for Classifying the Timing, How, and Setting of Youth Physical Activity

BACKGROUND

Multiple models and frameworks exist for the measurement and classification of physical activity in adults that are applied broadly across populations but have limitations when applied to youth. The authors propose a conceptual framework specifically designed for classifying youth physical activity.

METHODS

The Youth Physical Activity Timing, How, and Setting (Y-PATHS) framework is a conceptualization of the when (timing), how, and where (setting) of children's and adolescents' physical activity patterns. The authors developed Y-PATHS using the design thinking process, which includes 3 stages: inspiration, ideation, and implementation.

RESULTS

The Y-PATHS includes 3 major components (timing, how, and setting) and 13 subcomponents. Timing subcomponents include (1) school days: in-school, (2) school days: out-of-school, and (3) nonschool days. How subcomponents include: (1) functional, (2) transportation, (3) organized, and (4) free play. Setting subcomponents include: (1) natural areas, (2) schools, (3) home, (4) recreational facilities, (5) shops and services, and (6) travel infrastructure.

CONCLUSIONS

The Y-PATHS is a comprehensive classification framework that can help researchers, practitioners, and policymakers to better understand youth physical activity. Specifically, Y-PATHS can help to identify the domains of youth physical activity for surveillance and research and to inform the planning/evaluation of more comprehensive physical activity programming.

How Do Urban Environments Affect Young People's Mental Health? A Novel Conceptual Framework to Bridge Public Health, Planning, and Neurourbanism

Childhood and adolescence are crucial periods for mental and social development. Currently, mental illness among young people is a global epidemic, and rates of disorders such as depression and anxiety are rising. Urban living, compared with rural living, is linked with a higher risk of serious mental illness, which is important because the world is urbanizing faster than ever before. Urban environments and their landscapes, designs, and features influence mental health and well-being. However, no conceptual frameworks to date have detailed the effect of urban environments on young people's mental health, and few studies have considered the growing role of digital and social media in this relationship, leading to calls for the development of holistic approaches to describe this relationship. This article synthesizes existing knowledge on urban places (both built and natural environments) and mental health in the public health and urban planning literature and examines the emerging field of neurourbanism (a multidisciplinary study of the effect of urban environments on mental health and brain activity) to enhance current practice and research. We developed 2 novel conceptual frameworks (1 research-oriented, 1 practice-oriented), adapted from Bronfenbrenner's socioecological model, that focus on the relationship between urban environments and young people's mental health. We added a digital and social media contextual level to the socioecological model, and we applied a multilayer concept to highlight potential cross-field interactions and collaborations. The proposed frameworks can help to guide future practice and research in this area.

Urban Blue Acupuncture: An Experiment on Preferences for Design Options Using Virtual Models

Within the BlueHealth project, funded under the Horizon 2020 European Union research framework, a number of targeted experimental design interventions created in virtual reality (VR) were used to test the effect and impact of planning and design on encouraging people to use various blue spaces. A set of designs in three different coastal landscape types—a cliff/steep slope; a sandy beach and an area of reed beds—located in Tallinn, Estonia, were used as the sites for nine different intervention designs. The designs were based on a combination of the site features and inspirations from solutions found in different locations internationally. Using 3D modelling and a Virtual Reality system, a set of nine videos, one to depict each intervention, was created and shown to a quota sample of 252 Estonian residents. Respondents were asked a set of questions associated with each option. The results were analysed statistically and qualitatively. The results uncovered key preferences for designs and revealed differences among age groups and the levels of personal interconnection with nature. However, there were problems associated with the interpretation and understanding of some of the options by some of the people due to the degree of realism of the VR representations, which may have affected the results. The project shows that VR could be a useful tool for testing design ideas as part of public participation approaches but that care is needed in ensuring that viewers understand what they are assessing.

Blue space, health and well-being: A narrative overview and synthesis of potential benefits

Research into the potential health and well-being benefits from exposure to green spaces such as parks and woodlands has led to the development of several frameworks linking the different strands of evidence. The current paper builds on these to provide a model of how exposure to aquatic environments, or blue spaces such as rivers, lakes and the coast, in particular, may benefit health and well-being. Although green and blue spaces share many commonalities, there are also important differences. Given the breadth of the research, spanning multiple disciplines and research methodologies, a narrative review approach was adopted which aimed to highlight key issues and processes rather than provide a definitive balance of evidence summary. Novel aspects of our framework included the inclusion of outcomes that are only indirectly good for health through being good for the environment, the addition of nature connectedness as both a trait and state, and feedback loops where actions/interventions to increase exposure are implemented. Limitations of the review and areas for future work, including the need to integrate potential benefits with potential risks, are discussed.

Descriptive epidemiology and correlates of children's swimming competence

This study examined the swimming competence of primary school children, and how it was related to swimming activity, non-fatal aquatic events, and demographic factors. Primary school students (N = 4959; female = 2705, male = 2241; age range = 5 to 14 years) across 28 schools in the 15 districts of Hong Kong completed the Swimming Competence Questionnaire, and questions about their swimming experience, non-fatal aquatic events, and demographic variables. Descriptive statistics showed that over 60% of children could swim more than 5m, but less than 50% could swim over 25m. Over 50% of children were able to perform some basic swimming skills (e.g., holding breath underwater, floating, poolside/kickboard kicking, and treading water). Swimming competence was positively predicted by the demographic factors (i.e., age, sex, family income, and parents' highest education level), swimming experience, learning experience, and swimming location. Treading water was the only factor of swimming competence that established asignificant negative association with non-fatal aquatic events. Current results can be used to target key groups to improve children's swimming competence and reduce non-fatal aquatic events; children from lower socio-economic backgrounds and with less swimming experience should be encouraged to participate in more formal learn to swim lessons.

General health and residential proximity to the coast in Belgium: Results from a cross-sectional health survey

The health risks of coastal areas have long been researched, but the potential benefits for health are only recently being explored. The present study compared the general health of Belgian citizens a) according to the EU's definition of coastal (<50 km) vs. inland (>50 km), and b) between eight more refined categories of residential proximity to the coast (<5 km to >250 km). Data was drawn from the Belgian Health Interview Survey (n = 60,939) and investigated using linear regression models and mediation analyses on several hypothesized mechanisms. Results indicated that populations living <5 km of the coast reported better general health than populations living at >50-100 km. Four commonly hypothesized mechanisms were considered but no indirect associations were found: scores for mental health, physical activity levels and social contacts were not higher at 0-5 km from the coast, and air pollution (PM₁₀ concentrations) was lower at 0-5 km from the coast but not statistically associated with better health. Results are controlled for typical variables such as age, sex, income, neighbourhood levels of green and freshwater blue space, etc. The spatial urban-rural-nature mosaic at the Belgian coast and alternative explanations are discussed. The positive associations between the ocean and human health observed in this study encourage policy makers to manage coastal areas sustainably to maintain associated public health benefits into the future.

Wetlands for Wellbeing: Piloting a Nature-Based Health Intervention for the Management of Anxiety and Depression

Nature-based health interventions (NBIs) for the treatment of poor mental health are becoming increasingly common, yet evidence to support their effectiveness is lacking. We conduct a pilot study of a six-week intervention, aiming to engage individuals with wetland nature for the treatment of anxiety and/or depression. We employed a mixed methods design, using questionnaires, focus groups and semi-structured interviews to evaluate the intervention from the perspective of participants (n = 16) and healthcare professionals (n = 2). Results demonstrate significant improvements in mental health across a range of indicators, including mental wellbeing (Warwick and Edinburgh Mental Wellbeing Scale), anxiety (Generalised Anxiety Disorder-7), stress (Perceived Stress Scale) and emotional wellbeing (Positive and Negative Affect Schedule). Participants and healthcare professionals cited additional outcomes including improved physical health and reduced social isolation. The wetland site provided a sense of escape from participants’ everyday environments, facilitating relaxation and reductions in stress. Wetland staff knowledge of the natural world, transportation and group organisation also played a considerable role in the intervention’s success. These aspects should be considered in future and existing NBIs to maximise benefits to participants. We propose NBIs based in wetlands are an effective therapy option for individuals diagnosed with anxiety and/or depression.

Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use

Background: Oil spill chemicals (OSCs) result not only from the crude oil components but also from dispersants used in the clean-up activities, where some may result in adverse health effects under certain exposure and dosage conditions. One of the main populations of concern for exposure to OSCs are children, who are frequent beach users. Activities such as ingestion of and digging in sand can increase dermal and ingestion exposure. Longer times spent at the beach can also increase exposures for all routes. Objectives: The Beach Exposure and Child Health Study (BEaCHeS) was initiated to evaluate the risk of exposure to children from oil contaminants. Reported here are results for surveys collected, as a part of the project, to address exposure-related behavior patterns and risk perception for parents or guardians who visit the beach. Methods: Over 400 parental surveys were collected at four beaches, two in Miami and two in Texas, to evaluate children’s exposure related activities. Surveys consisted of three general sections: demographics, exposure, and risk perception. Surveys were analyzed in REDcap and Stata to evaluate demographic and regional differences on activities related to beach behavior and potential exposures to oil contaminants (e.g., how much time spent on beach, cleaning habits following beach activities). The statistical analysis included the mean and standard errors, along with regressions to evaluate associations between parameters. Results: Overall, the data showed high variability in how children play on the beach, influenced more by age and less by gender. Variations were also seen in certain variables by beach region (e.g., hygiene practices). By race, variations were seen in income, distance of travel to beach, and preferred method of communication for beach warning. Other important findings are reflected in the article. Discussion: The data presented here may prove useful for those evaluating children exposures to a variety of contaminants, chemical, or bacterial in origin. In addition, coastal managers may find the risk perception and general behaviors useful for planning and maintenance of beach areas.

Global ecological, social and economic impacts of marine plastic

This research takes a holistic approach to considering the consequences of marine plastic pollution. A semi-systematic literature review of 1191 data points provides the basis to determine the global ecological, social and economic impacts. An ecosystem impact analysis demonstrates that there is global evidence of impact with medium to high frequency on all subjects, with a medium to high degree of irreversibility. A novel translation of these ecological impacts into ecosystem service impacts provides evidence that all ecosystem services are impacted to some extent by the presence of marine plastic, with a reduction in provision predicted for all except one. This reduction in ecosystem service provision is evidenced to have implications for human health and wellbeing, linked particularly to fisheries, heritage and charismatic species, and recreation.

Tackling challenges for Mediterranean sustainable coastal tourism: An ecosystem service perspective

Coastal tourism is a growing industry sector in the Mediterranean Basin. This and the other human activities occurring along the coastline share space and resources, leading to conflicts for divergent uses. Moreover, the overexploitation of natural resources degrades and depletes coastal habitats, with negative feedback effects for all human activities. Hence, both tourism and the other human activities have to consider their dependence on coastal ecosystem services, and act at technical and policy level to reach a compromise that preserves natural resources in the long term. Here we provide a conceptual framework illustrating the complex relationships and trade-offs among threats from coastal tourism and from other human activities and coastal ecosystem services, with a focus on cultural ones. We discuss the negative feedbacks on tourism development and provide examples of geospatial analysis on cumulative threats generated by other human activities and affecting tourism itself. The proposed conceptual framework and the threat analysis aim at highlighting the negative feedback effects of human driven threats on the development of Mediterranean coastal tourism, through an ecosystem service perspective. Both tools provide valuable insight for supporting decision makers and planners in achieving integrated coastal management, with a focus on sustainable tourism.

Exploratory study on the natural ground electric current that flows through human body as a possible pathway for the therapeutic effects of beach going

This paper explores the electrical nature of sandy beach and proposes a pathway for the therapeutic effects of beach going. The electric potential and current generated on the ground across the human body and resistors were measured. The ground was found to have a non-homogenous electric potential which generated a potential difference between any two points on the ground. A power curve, similar to a battery, in the nanowatt range was obtained. This power appeared to be stable across time but varies across ground location. Standing on the beach with dry feet did not allow any current in the micro-ampere range to conduct. But upon moistening the feet, the body electrical resistance was reduced by 94% and the ground potential difference across the two feet was sufficient to drive a micro-ampere range current through the body. This may be one reason for the therapeutic effects of being on the beach.

Blue and Green Spaces as Therapeutic Landscapes: Health Effects of Urban Water Canal Areas of Isfahan

Blue and green spaces contribute to the quality of cities in various ways—ranging from providing air corridors and visual amenities to positively affecting public psychological health and wellbeing. Urban blue and green spaces had geopolitical and agricultural functions in the past. These functions are still evident in many cities. They also provide ecological qualities for the surrounding (sub)urban neighborhoods. While in recent decades, many studies have explored the features and characteristics of urban blue and green spaces that are associated with positive health benefits, the healthy lifestyle promoting role of artificial water canals has received little attention. This case report investigates the canals in Isfahan from Iran that branch off from the Zayandeh Rood River and provide blue and green corridors to the city. The aim of this case report study is to explore the health aspects of urban water canals in physical, mental, and social dimensions based on the residents’ experiences. The study develops a framework for assessing the quality of therapeutic effect of canals in Isfahan, Iran. The paper employs qualitative content analysis as the methodological approach. In total, 200 people from the residential neighborhoods of the Niasarm Canal participated in semi-structured interviews in early 2018. The results of this research reveal that the canal—with ‘upgrade of active life’, ‘sense of rehabilitation, relaxation and concentration along with the canal’, ‘promotion of social life’, and ‘place identity’ characteristics—plays an important therapeutic role on the physical, psychological, and social health conditions of local residents.

Water Exclosure Treatment System (WETS): An innovative device for minimizing beach closures

A Water Exclosure Treatment System (WETS) is developed and installed to minimize the occurrence of beach closures due to algae and Escherchia coli (E. coli) in an inland lake. WETS consists of an "exclosure" sub-system with a five-sided polypropylene, barrier that excludes offshore lake contaminated water from the swimming area. Inside the exclosure, water is pumped to a portable filtration-ultraviolet treatment sub-system with three components. First, heavy debris like aquatic plants are removed through a strainer. Second, fine particles are removed through a sand filter and backwashing is automated through a program logic controller triggered by pressure sensor readings. Third, pathogens, algae, bacteria, and viruses are inactivated through ultraviolet (UV) disinfection. To determine sizing of sand filters and evaluation of efficiency of UV disinfection and aid in the design of the inlet and outlet locations for the pump system, computational fluid dynamics modeling with a Lagrangian particle-tracking method are employed. Flushing time is determined to range from 0.67 to 1.89days. Residence time maps reveal inlet and outlet locations play an important role in depicting the duration of particles within the swimming area. Comprehensive water quality sampling is conducted and analyzed with ANOVA testing reveal that water quality parameters inside the exclosure are significantly different than those outside. There have been no beach closures issued since deployment of WETS. Overall, WETS, an innovative Water Exclosure Treatment System, provides safe, clean water inside the exclosure for minimizing beach closure.

Significance of beach geomorphology on fecal indicator bacteria levels

Large databases of fecal indicator bacteria (FIB) measurements are available for coastal waters. With the assistance of satellite imagery, we illustrated the power of assessing data for many sites by evaluating beach features such as geomorphology, distance from rivers and canals, presence of piers and causeways, and degree of urbanization coupled with the enterococci FIB database for the state of Florida. We found that beach geomorphology was the primary characteristic associated with enterococci levels that exceeded regulatory guidelines. Beaches in close proximity to marshes or within bays had higher enterococci exceedances in comparison to open coast beaches. For open coast beaches, greater enterococci exceedances were associated with nearby rivers and higher levels of urbanization. Piers and causeways had a minimal contribution, as their effect was often overwhelmed by beach geomorphology. Results can be used to understand the potential causes of elevated enterococci levels and to promote public health.

BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces

INTRODUCTION

Proximity and access to water have long been central to human culture and accordingly deliver countless societal benefits. Over 200 million people live on Europe's coastline, and aquatic environments are the top recreational destination in the region. In terms of public health, interactions with 'blue space' (eg, coasts, rivers, lakes) are often considered solely in terms of risk (eg, drowning, microbial pollution). Exposure to blue space can, however, promote health and well-being and prevent disease, although underlying mechanisms are poorly understood.

AIMS AND METHODS

The BlueHealth project aims to understand the relationships between exposure to blue space and health and well-being, to map and quantify the public health impacts of changes to both natural blue spaces and associated urban infrastructure in Europe, and to provide evidence-based information to policymakers on how to maximise health benefits associated with interventions in and around aquatic environments. To achieve these aims, an evidence base will be created through systematic reviews, analyses of secondary data sets and analyses of new data collected through a bespoke international survey and a wide range of community-level interventions. We will also explore how to deliver the benefits associated with blue spaces to those without direct access through the use of virtual reality. Scenarios will be developed that allow the evaluation of health impacts in plausible future societal contexts and changing environments. BlueHealth will develop key inputs into policymaking and land/water-use planning towards more salutogenic and sustainable uses of blue space, particularly in urban areas.

ETHICS AND DISSEMINATION

Throughout the BlueHealth project, ethics review and approval are obtained for all relevant aspects of the study by the local ethics committees prior to any work being initiated and an ethics expert has been appointed to the project advisory board. So far, ethical approval has been obtained for the BlueHealth International Survey and for community-level interventions taking place in Spain, Italy and the UK. Engagement of stakeholders, including the public, involves citizens in many aspects of the project. Results of all individual studies within the BlueHealth project will be published with open access. After full anonymisation and application of any measures necessary to prevent disclosure, data generated in the project will be deposited into open data repositories of the partner institutions, in line with a formal data management plan. Other knowledge and tools developed in the project will be made available via the project website (www.bluehealth2020.eu). Project results will ultimately provide key inputs to planning and policy relating to blue space, further stimulating the integration of environmental and health considerations into decision-making, such that blue infrastructure is developed across Europe with both public health and the environment in mind.

Can Beach Cleans Do More Than Clean-Up Litter? Comparing Beach Cleans to Other Coastal Activities

Coastal visits not only provide psychological benefits but can also contribute to the accumulation of rubbish. Volunteer beach cleans help address this issue, but may only have limited, local impact. Consequently, it is important to study any broader benefits associated with beach cleans. This article examines the well-being and educational value of beach cleans, as well as their impacts on individuals' behavioral intentions. We conducted an experimental study that allocated students (n = 90) to a beach cleaning, rock pooling, or walking activity. All three coastal activities were associated with positive mood and pro-environmental intentions. Beach cleaning and rock pooling were associated with higher marine awareness. The unique impacts of beach cleaning were that they were rated as most meaningful but linked to lower restorativeness ratings of the environment compared with the other activities. This research highlights the interplay between environment and activities, raising questions for future research on the complexities of person-environment interactions.

Physical activity levels and pattern of use for youth participants at a traditional aquatic venue

In an effort to encourage youth to acquire recommended levels of moderate to vigorous physical activity (MVPA), we need to examine affordances available to enhance opportunities. Included for consideration should be built environments such as swimming pools which can have significant impacts through leisure service delivery to promote active lifestyles. For this study, The System for Observing Play and Recreation in Communities (SOPARC), was employed at a traditional aquatic venue during July and August in the Midwestern region of the U.S. Data was collected on three physical activity postures for youths age 4 to 18 along with variables including: (a) age, (b) gender, (c) physical activity posture, and (d) areas of participation termed target areas. A total of 3780 observations were taken into account during analysis. To detect differences among key variables, One-Way ANOVA and t-tests were performed. Descriptive results indicated that MVPA accounted for 70% of activity in the aquatic venue. Overall, female youths generated more MVPA within target areas compared to males, and youth as a single group consistently scored higher in all target areas as well as overall in MVPA. Significant differences were discovered in relation to several target areas. Findings from the study indicate that the use of a traditional aquatic venue can have positive impacts on youth physical activity and assist in meeting national standards for daily requirements of MVPA. It is also indicated that design features of an aquatic venue can play a role in determining levels of engagement and physical activity.

Measuring Blue Space Visibility and 'Blue Recreation' in the Everyday Lives of Children in a Capital City

Blue spaces (water bodies) may promote positive mental and physical health through opportunities for relaxation, recreation, and social connections. However, we know little about the nature and extent of everyday exposure to blue spaces, particularly in settings outside the home or among children, nor whether exposure varies by individual or household characteristics. Wearable cameras offer a novel, reliable method for blue space exposure measurement. In this study, we used images from cameras worn over two days by 166 children in Wellington, New Zealand, and conducted content and blue space quantification analysis on each image (n = 749,389). Blue space was identified in 24,721 images (3.6%), with a total of 23 blue recreation events. Visual exposure and participation in blue recreation did not differ by ethnicity, weight status, household deprivation, or residential proximity to the coastline. Significant differences in both visual exposure to blue space and participation in blue recreation were observed, whereby children from the most deprived schools had significantly higher rates of blue space exposure than children from low deprivation schools. Schools may be important settings to promote equitable blue space exposures. Childhood exposures to blue space may not follow the expected income inequality trends observed among adults.

Developing the urban blue: Comparative health responses to blue and green urban open spaces in Germany

Recently, new perspectives upon healthy urban open spaces propose that open spaces can be regarded as urban green or blue spaces. However, there has so far been very little research into blue environments and their benefits for mental well-being. Our article focuses on the effects of water in cities, "urban blue" (as compared to "urban green"), on human health and well-being. To assess the mental well-being of visitors, we conducted qualitative semi-standardised interviews (n=113), asking which differences in well-being occur when visiting urban green and blue spaces in high-density areas of the inner city in Dusseldorf and Cologne, Germany. Although we found many similarities, some health-enhancing effects for users turned out to be prominent for urban blue in the four conceptual therapeutic landscape dimensions: experienced, symbolic, social and activity space. These effects include enhanced contemplation, emotional bonding, participation, and physical activity. The results suggest that urban blue as a health-promoting factor needs more detailed and accurate determination and examination of its general and local health-enhancing effects.

Factors That Can Undermine the Psychological Benefits of Coastal Environments: Exploring the Effect of Tidal State, Presence, and Type of Litter

The beneficial effects of blue environments have been well documented; however, we do not know how marine litter might modify these effects. Three studies adopted a picture-rating task to examine the influence of litter on preference, perceived restorative quality, and psychological impacts. Photographs varied the presence of marine litter (Study 1) and the type of litter (Studies 2 and 3). The influence of tide and the role of connectedness were also explored. Using both quantitative and qualitative methods, it was shown that litter can undermine the psychological benefits that the coast ordinarily provides, thus demonstrating that, in addition to environmental costs of marine litter, there are also costs to people. Litter stemming from the public had the most negative impact. This research extends our understanding of the psychological benefits from natural coastal environments and the threats to these benefits from abundant and increasing marine litter.