School-Based Interventions to Support Healthy Indoor and Outdoor Environments for Children: A Systematic Review

Amanda Fernandes (), Mònica Ubalde-López, Tiffany C. Yang, Rosemary R. C. McEachan, Rukhsana Rashid, Léa Maitre, Mark J. Nieuwenhuijsen and Martine Vrijheid
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Amanda Fernandes: ISGlobal, Barcelona Institute for Global Health, 08003 Barcelona, Spain
Mònica Ubalde-López: ISGlobal, Barcelona Institute for Global Health, 08003 Barcelona, Spain
Tiffany C. Yang: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford BD9 6RJ, UK
Rosemary R. C. McEachan: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford BD9 6RJ, UK
Rukhsana Rashid: Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford BD9 6RJ, UK
Léa Maitre: ISGlobal, Barcelona Institute for Global Health, 08003 Barcelona, Spain
Mark J. Nieuwenhuijsen: ISGlobal, Barcelona Institute for Global Health, 08003 Barcelona, Spain
Martine Vrijheid: ISGlobal, Barcelona Institute for Global Health, 08003 Barcelona, Spain

IJERPH, 2023, vol. 20, issue 3, 1-24

Abstract: Environmental exposures are associated with children’s health. Schools are often urban exposure ‘hotspots’ for pollution, noise, lack of green space and un-walkable built environments. The aim of this systematic review was to explore the impact of school-based interventions on the modification of indoor and outdoor stressors related to the built and natural environment on children’s exposure and health. A systematic review of seven databases was performed. We included quantitative studies on children aged 5–12, which reported intervention delivered within school settings aimed at addressing key environmental exposures including air pollution, green spaces, traffic noise or active travel; and reported physical and mental health, physical activity or active travel behavior. The quality of studies was assessed and interventions were described using a standardized framework. A narrative synthesis approach was used to describe the findings. Thirty-nine papers were included on three main intervention types: improve indoor air quality by the increase of ventilation rates in classrooms; increase children’s green time or greening schools, and multicomponent interventions to increase active travel to school by changes in pedestrian facilities. No eligible intervention to reduce traffic noise at school was found. Increasing ventilation rates improved short-term indoor air quality in classrooms, but the effect on cognitive performance was inconsistent. Greening schools and increasing children’s green time have consistent positive effects on cognition and physical activity, but not in behavior. Multi-component interventions can increase walking and cycling after three years. Overall, the studies were rated as having poor quality owing to weak study designs. We found modest evidence that school-based built and natural environment interventions can improve children’s exposure and health.

Keywords: air pollution; road-traffic noise; urban green space; active travel; systematic review; school children (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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