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Background
Promotion of healthy lifestyles in children focuses predominantly on proper nutrition and physical activity, elements now widely recognised as essential for a healthy life. Systematic reviews have shown that nature-related activities also enhance general well-being as reflected in increased physical activity, a healthier diet, reduced st...
Context in source publication
Context 1
... objectives of the proposed project will be achieved in two stages over a 30-month period (Fig. 2) in Hong Kong. Firstly, to create a valid measurement tool for the novel Connectedness to nature intervention element, a Nature Relatedness Scale (NRS) will be validated and tested for reliability (Stage 1). To measure the effective- ness of the early-intervention Play & Grow programme, a RCT will be conducted (Stage 2). In order to ...
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Objective
To classify a rural community sample by their modifiable health behaviours and identify the prevalence of chronic conditions, poor self-rated health, obesity and hospital use.
Method
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Citations
... As a result, study results were reported and discussed by infants (cognitive assessments conducted at 1 year old and younger), pre-school children (>1 to <5 years old) and school-aged children (5 to <12 years old). Three studies explored associations between gut metagenomes and cognitive outcomes (Sobko et al., 2016;Flannery et al., 2020;Kelsey et al., 2021). One study explored relationships of cognitive outcomes with the microbiome metabolites, volatile fatty acids (VFAs) (Loughman et al., 2020). ...
Evidence from animal models or children with neurodevelopmental disorders has implicated the gut microbiome (GM) in neurocognitive development. However, even subclinical impairement of cognition can have negative consequences, as cognition serves as the foundation for skills necessary to succeed in school, vocation and socially. The present study aims to identify gut microbiome characteristics or changes in gut microbiome characteristics that consistently associate with cognitive outcomes in healthy, neurotypical infants and children. Of the 1,520 articles identified in the search, 23 were included in qualitative synthesis after applying exclusion criteria. Most studies were cross-sectional and focused on behavior or motor and language skills. Bifidobacterium, Bacteroides, Clostridia, Prevotella, and Roseburia were related to these aspects of cognition across several studies. While these results support the role of GM in cognitive development, higher quality studies focused on more complex cognition are needed to understand the extent to which the GM contributes to cognitive development.
... Advocating for healthy nutrition and physical activity in children at a young age is essential to establish a strong foundation for a long-term healthy lifestyle. Research has shown that although feeding and physical activity behaviours that have been developed in early childhood can be modified [7], it is imperative to encourage healthy behaviours as early as possible before they become ingrained [8,9]. Once a child matures into adulthood, behaviour changes required to shift to a healthier lifestyle are more challenging [10]. ...
Background:
Instilling healthy dietary habits and active play in early childhood is an important public health focus. Interventions supporting the establishment of nutrition and active play behaviours in the first years of life have shown positive outcomes and long-term cost-effectiveness, however, most are research trials, with limited evidence regarding real-world application. Implementation science theories, models and frameworks (TMFs) can guide the process of research translation from trial to real-world intervention. The application of TMFs within nutrition and active play intervention studies in early childhood (< 5 years) is currently unknown. This systematic review identified the use of TMFs and barriers/ enablers associated with intervention adoption, implementation, and sustainability in early childhood nutrition and active play interventions implemented under real-world conditions.
Methods:
Six databases were searched for peer-reviewed publications between 2000-2021. Studies were included if primary outcomes reported improvement in diet, physical activity or sedentary behaviours amongst children aged < 5 years and interventions were delivered under real-world conditions within a community and/or healthcare setting. Two reviewers extracted and evaluated studies, cross checked by a third and verified by all authors. Quality assessment of included studies was completed by two authors using the Mixed Methods Appraisal Tool (MMAT).
Results:
Eleven studies comprising eleven unique interventions were included. Studies represented low, middle and high-income countries, and were conducted across a range of settings. Five TMFs were identified representing four of Nilsen's implementation model categories, predominantly 'evaluation models'. Ninety-nine barriers/facilitators were extracted across the three intervention phases-Implementation (n = 33 barriers; 33 facilitators), Sustainability (n = 19 barriers; n = 9 facilitators), Adoption (n = 2 barriers; n = 3 facilitators). Identified barriers/facilitators were mapped to the five domains of the Durlak and DuPre framework, with 'funding', 'compatibility' and 'integration of new programming' common across the three intervention phases.
Conclusions:
Findings demonstrate that there is no systematic application of TMFs in the planning, implementation and/or evaluation of early childhood nutrition and active play interventions in real-world settings, and selective and sporadic application of TMFs occurs across the intervention lifespan. This apparent limited uptake of TMFs is a missed opportunity to enhance real-world implementation success.
Trial registration:
PROSPERO (CRD42021243841).
... There are also longer, more intensive nature-based programs in much younger children which demonstrate healthy changes in both health behaviours and environmental attitudes. One good example of this is the Nature Play and Grow program in Hong Kong, which also developed validated NR scales for very young children [107,108]. This randomized, controlled trial allocated 241 pre-schoolers and their families to either a control group or a 10 week program of outdoor play and nature discovery, age-appropriate, short health and environmental discussions, and food play activities. ...
The vast and growing challenges for human health and all life on Earth require urgent and deep structural changes to the way in which we live. Broken relationships with nature are at the core of both the modern health crisis and the erosion of planetary health. A declining connection to nature has been implicated in the exploitative attitudes that underpin the degradation of both physical and social environments and almost all aspects of personal physical, mental, and spiritual health. It is increasingly clear that the entwined challenges of biodiversity loss, climate change, and human health cannot be addressed without addressing selfishness, greed, apathy, and the value systems that created these global problems. Calls for a spiritual and cultural transformation recognize that “inner” development is important and necessary for meaningful “outward” transitions with a shared purpose for wiser, more sustainable societies. Many of these emotional and spiritual assets appear to be facilitated by a connection to nature, which is also strongly associated with community cohesion, prosocial attitudes, and pro-environmental actions. Restoring the human connection to nature may therefore provide a critical common pathway to promote the physical and spiritual wellbeing of individuals and communities as well as personal and social environmental responsibility. In this paper, we summarize and reflect on the discussions of the Nova Network planetary health community with respect to nature-based solutions as pathways to promote both personal and planetary health with a more mutualistic mindset. These discussions spanned biological to psychological interactions with nature—including the critical relationships with environmental microbes that influence the physical, emotional, and behavioral aspects of health. We consider the ways in which stronger relationships with nature promote “inner assets” to support “outward actions” for personal and planetary health.
... Therefore, the introduction of techniques that are based on poetry and fairy tales into the practice of physical education with kids will help to reveal hidden, still unknown talents in children and give a powerful impetus to their development [18][19][20][21][22]. Physical activity is the basis and "foundation" of a person who is developing. In combination with poems and fairy tales, it is an excellent means of harmonious development [23][24][25][26] In addition, exercises that are displayed in vivid natural images are the most accessible for children due to the prevailing development of imaginative thinking. That is why we propose in the practice of physical education with children 1-5 years old the use of exercises performed to the verses [1,3,27,28]. ...
... Develops friendliness and sense of humor. 25. A mouse is sitting in a hole. ...
Purpose of this work is to highlight the features of the author's systems of integral development of preschool children. Material and Methods. A system of lessons with newborns and infants with the help of dynamic exercises has been developed, as well as an author's system of lessons with children from 1 to 7 years old. The exercises are performed with verses about nature. Results. The use of dynamic gymnastics for newborns and infants "Miracle of Nature" helps to strengthen the musculoskeletal system and all body systems; development of strength, flexibility, agility, endurance, and later - speed; prevention or reduction of child injuries during the subsequent development of walking, running, jumping, etc.; increasing resistance to adverse environmental influences; formation of a base for the tolerance of intellectual workloads associated with studies; creating a solid foundation for subsequent practice of any sport. Conclusions. It is shown that performing exercises not counting, but under poetic images, which is most acceptable for children from 1 year old, promotes integral development, reduces the feeling of fatigue, saturates emotionally classes, making gymnastics very attractive for children and adults.
... Based on the above information, a prior analysis was conducted, which indicates that a minimum sample size of 99 (33 per group) is required to detect a small effect size f of 0.15 with a power of 0.90 under the conditions of an alpha level of 0.05, three arms (PA + SB group, PA + SB + sleep group, wait-list control group), and four repeated measures assuming a correlation between repeated measures at 0.50. Considering a potential attrition rate of 20% (25,26), 119 children are needed. Therefore, using an over-sampling procedure, 150 parent-child dyads will be recruited and screened. ...
Background
Interventions targeting single behaviors of preschool-aged children have been mainstream for some time, but integrated interventions targeting all three 24-h movement behaviors (physical activity [PA], sedentary behavior [SB], and sleep hygiene) are less studied. The aims of this study will be to test the feasibility, acceptability, and effectiveness of a parent-focused intervention for preschool-aged children targeting multiple 24-h movement behaviors.
Methods
This three-arm randomized controlled trial will comprise a 12-week intervention and a 12-week follow-up. A total of 150 parent-child dyads will be recruited and randomly allocated to one of three arms: (1) a PA + SB group (dyadic approach), (2) a PA + SB + sleep group (integrated approach), and (3) a wait-list control group. The theory of planned behavior and behavioral change techniques will guide the development of the intervention via workshops, education materials, interactive questionnaires, and reminders. The intervention strategies for the integrated group will be the same as for the dyadic approach except that the intervention will also target sleep hygiene in addition to PA and SB. The primary outcomes will be preschoolers' 24-h movement behaviors (e.g., activity sleep index, compositional data of PA, SB, screen time, and sleep duration). The secondary outcomes will be preschoolers' sleep quality, weight status, cognitive function, and parents' movement behaviors. The feasibility and acceptability of the intervention will also be evaluated.
Discussion
The proposed study will be a theory-based, parent-focused intervention designed to improve all three 24-h movement behaviors among preschoolers. The trial is expected to improve preschoolers' movement behaviors and health outcomes, as well as their parents' movement behaviors. Given the urgent need to promote active lifestyles, our findings will help to determine best practices for movement behavior change among young children.
Trial Registration
The study is prospectively registered at the Chinese Clinical Trial Registry (ChiCTR2200055958).
... Nature "homework" was also encouraged, such as taking care of own gardens, or growing own plants to maximize the frequency of contact with nature. A detailed description of the intervention structure and content has been published in a separate publication (Sobko et al., 2016). ...
Background
The time that children and young people spend in nature and outdoor spaces has decreased significantly over the past 30 years. This was exacerbated with a further 60% decline post-COVID-19. Research demonstrating that natural environments have a positive impact on health and wellbeing has led to prescription of nature-based health interventions and green prescribing, although evidence for its use is predominantly limited to adults. Growing evidence also shows the impact of arts on all aspects of health and wellbeing. However, what has received scant attention in literature is the interconnection between the two: arts and nature.
Aims
This review synthesizes the literature surrounding the interconnectedness between arts and nature, and their impact on the health and wellbeing of children and young people.
Methods
Eight major electronic databases were systematically searched, while hand-searching included 20 journals, six books, and contact with experts. The review was conducted using the Cochrane handbook for systematic reviews, PRISMA guidelines and TIDieR template. All stages were conducted independently by two researchers and the protocol was published on PROSPERO (Registration no.: CRD42021286574).
Results
Although 9,314 records were identified, only 11 records were included as most studies focused either on arts or nature, but not both. Studies were conducted in United Kingdom, United States, Ireland, Australia, and Hong Kong, in a range of spaces such as forests, woodlands, beaches, parks, fields, gardens, and school playgrounds. The review encompasses data from 602 participants in total.
Discussion
Arts-in-nature offered an inclusive medium to engage all children and young people, especially those who might otherwise remain disinterested about environmental issues and disengaged with educational programs. Further, arts-in-nature provided stimuli to increase nature connectivity, understand environmental issues and explore ways to prevent environmental disasters. This led to higher environmental awareness and pro-environmental behaviors, and potential decrease in eco-anxiety.
Conclusion
Although the quality of qualitative studies was high, the quality of quantitative studies was low or unclear, thus quantitative evidence is still at its infancy. Implications for research, policy, and practice are discussed, such as methods and activities to strengthen future interventions. Scaling-up existing interventions may lead to wider recognition and inclusion of arts-in-nature in future health guidelines, including green prescribing.
... Nature 'homework' was also encouraged, such as taking care of own gardens, or growing own plants to maximise the frequency of contact with nature. A detailed description of the intervention structure and content has been published in a separate publication (Sobko, Tse & Kaplan, 2016). ...
Published version: https://doi.org/10.3389/fpsyg.2022.858781
Background: The time that children and young people spend in nature and outdoor spaces has decreased significantly over the past 30 years. This was exacerbated with a further 60% decline post-Covid-19 (Natural England, 2020). Research demonstrating that natural environments have a positive impact on health and wellbeing has led to prescription of nature-based health interventions and green prescribing, although evidence for its use is predominantly limited to adults. Growing evidence also shows the impact of arts on all aspects of health and wellbeing. However, what has received scant attention in literature is the interconnection between the two: arts and nature.
Aims: This review synthesises the literature surrounding the interconnectedness between arts and nature, and their impact on the health and wellbeing of children and young people.
Methods: Eight major electronic databases were systematically searched, while hand-searching included 20 journals, five books, and contact with experts. The review was conducted using the Cochrane handbook for systematic reviews, PRISMA guidelines and TIDieR template. All stages were conducted independently by two researchers and the protocol was published on PROSPERO (Registration no.:CRD42021286574).
Results: Although 9,314 records were identified, only 11 records were included as most studies focused either on arts or nature, but not both. Studies were conducted in UK, USA, Ireland, Australia, and Hong Kong, in a range of spaces such as forests, woodlands, beaches, parks, fields, gardens, and school playgrounds. The review encompasses data from 602 participants in total.
Discussion: Arts-in-nature offered an inclusive medium to engage all children and young people, especially those who might otherwise remain disinterested about environmental issues and disengaged with educational programs. Further, arts-in-nature provided stimuli to increase nature connectivity, understand environmental issues and explore ways to prevent environmental disasters. This led to higher environmental awareness and pro-environmental behaviours, and potential decrease in eco-anxiety.
Conclusion: Although the quality of qualitative studies was high, the quality of quantitative studies was low or unclear, thus quantitative evidence is still at its infancy. Implications for research, policy, and practice are discussed, such as methods and activities to strengthen future interventions. Scaling-up existing interventions may lead to wider recognition and inclusion of arts-in-nature in future health guidelines, including green prescribing.
... Already, there are encouraging early results from simple experiential interventions improving health behaviours in preschool children, specifically with interventions to promote nature relatedness. 79 A randomised controlled study examining the merits of a 10 week environmental intervention programme in Hong Kong pre-schoolers (with outdoor play and nature discovery, age-appropriate short health and environment discussions and food play activities) was shown to improve dietary habits and exercise among parents and children in the same household. Specifically, after the trial, those in the intervention group were more connected to nature (sense of environmental responsibility) and more active, and had improved eating habits, improved quality of life and physical functioning. ...
The ecology of the early environment – including microbial diversity, nutrition, nature, social interactions and the totality of exposures in the wider “exposome” – have life‐long implications for all aspects of health and resilience. In particular, the emergence of “microbiome science” provides new evidence for vital relationships between biodiversity and health at every level. New perspectives of ecological interdependence connect personal and planetary health; the human health crisis cannot be separated from the social, political and economic “ecosystems” otherwise driving dysbiosis (from its etymological root, “life in distress”) at every level. Adverse changes in macroscale ecology – of food systems, lifestyle behaviours, socioeconomic disadvantage and environmental degradation – all impact the microbial systems sitting at the foundations of all ecosystems. In particular, changes in the function and composition of the human‐associated microbiome have been implicated in the mounting global burden of noncommunicable diseases (NCDs), exacerbating inflammation and metabolic dysregulation through multiple pathways across the lifespan. This “dysbiotic drift” (adverse shifts in ecology at all scales) underscores the need for ecological approaches aimed at restoring symbiosis, balance and mutualism. While there is promise with supplement‐based strategies (e.g. probiotics, prebiotics), it is essential to focus on upstream factors implicated in dysbiosis, including the health of wider environments, lifestyle, nature relatedness, and the social policies and practices which can facilitate or inhibit dysbiotic drift. This also calls for ambitious integrative approaches which not only define these interconnections, but also capitalize on them to create novel, collaborative and mutualistic solutions to our vast interdependent global challenges.
... The Play&Grow early environmental education program, with its unique Connectedness to Nature component, is designed to increase biophilia and positive health outcomes for preschoolers. This intervention allows interaction with the natural outdoor world and has proven to be effective in encouraging healthy lifestyle behaviors in families with preschoolers in prior experiments [16][17][18]. The main objective of this sub-study was to investigate a potential association between the CN and the psychological well-being of two-to-five-year-old children following the Play&Grow intervention, reflected in emotional and behavioral problems before and after the intervention. ...
Urbanized children today have fewer opportunities to interact with nature which may lead to a greater risk of mental health problems. The objective of this randomized controlled trial was to investigate which particular changes in connectedness to nature (CN) would improve psychological well-being (PW) in young children. Six hundred and thirty-nine preschoolers (52.0% boys, age 34.9 ± 9.5 months) participated in Play&Grow, an early environmental education intervention. Children’s CN and PW were evaluated by parents before and after the program with validated measures; the CNI-PPC (four factors) and the SDQ, Strength and Difficulties questionnaire (five factors), respectively. The effectiveness of the intervention on the primary outcomes (CN, PW) as well as the relationship between them was analyzed in a repeated measures path model with intervention status as a causal predictor. Specific CN factors consistently increased ProSocial behavior and reduced Hyperactivity and Emotional problems. In summary, this study showed that the previously reported impact shifted from the total CN score to the specific CN factors. The Play&Grow intervention positively increased children’s CN and improved some aspects of psychological well-being in children which is a preliminary evidence of developmental benefits of connecting young children with nature. Our results indicate promising direction of action for the improvement of families’ psychological health.
... Intervention design. A two-arm, randomized controlled trial (RCT) with masked outcome assessment-"Play&Grow"-was developed as a family-oriented, early environmental education programme for families with preschool children at the University of Hong Kong 29,30 . Primarily, the "Play&Grow" programme aims to reconnect preschoolers to nature and induce changes in health behaviours and outcomes by having outdoor activities that promote exposure to nature. ...
... The intervention was held once per week for ten consecutive weeks, from June 2018, in public parks throughout the Hong Kong SAR. Topics and elements of the programme were developed prior to the start of the intervention and were discussed in detail 29 . Each session, led by a pair of research assistants, included a guided nature activity that promoted "hands-on" experiences with materials found in nature. ...
Due to rapid urbanization, children today have fewer opportunities to interact with nature and this may result in a greater risk for developing stress and depression. Outdoor nature-related activities can enhance general well-being. However, the underlying mechanisms are not fully delineated. Here we recruited 54 preschool children to participate in a 10-week structured nature-related “Play&Grow” program. Following the intervention, children were assessed for connectedness to nature and perceived stress levels using validated questionnaires. Moreover, fecal serotonin level and gut microbiota profiles were measured by ELISA and 16S rDNA amplicon sequencing, respectively. Children were significantly more connected to nature after the intervention. Their gut microbiota altered, especially by modulating the abundance of Roseburia and the fecal-serotonin level. Moreover, we also observed a reduction in the overall perceived stress, particularly in the frequency of anger among these children. This study is the first to demonstrate the impact of nature-related activities on gut microbiota, fecal serotonin and psychosocial behaviour of preschool children. However, further mechanistic studies are needed to confirm the functional role of gut microbiota in the association between connectedness to nature and improved psychosocial behavior.
