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Promoting activity participation and well-being among children and adolescents: a systematic review of neighborhood built-environment determinants.

OBJECTIVE: The objective of this review was to identify, evaluate, and synthesize the findings on built-environment determinants and their relation to participation in different domains of activities, including physical activity, recreational and social activities, and well-being in childhood and adolescence.

INTRODUCTION: Creating supportive environments for children and adolescents is a priority in society. To ensure informed decision making and policy changes, initiatives need to rely on systematic development and the use of evidence-based knowledge. Thus, it is necessary to critically review the current evidence on the relationship between features of the built environment and health in a more specific and detailed manner to better understand the health-promoting potential of neighborhood built environments.

INCLUSION CRITERIA: This review included studies on children and adolescents between five and 18 years of age, which examined relationships between one or several neighborhood built-environment determinants and participation in activities and/or well-being. The studies had to report test statistics for associations between built-environment determinants and the outcomes, which means that descriptive cross-sectional studies were not eligible for inclusion.

METHODS: A four-step search strategy was utilized to identify peer-reviewed studies within six databases. The search was limited to English articles published since January 2010. A data extraction form was developed and used to mine the descriptive details of each included study. The included studies were further assessed for methodological quality by three reviewer pairs independently, using the standard critical appraisal tools from JBI. Due to the methodological heterogeneity of the included studies, a narrative summary of the quantitative findings was conducted.

RESULTS: The 127 studies included in the review were mainly cross-sectional (87.4%). The built environment was most extensively studied in relation to the outcomes active travel (n = 54) and unspecified physical activity (n = 46). The evidence suggests that a composite determinant of facilities and amenities is related to more unspecified physical activity. Furthermore, less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability supported active travel behavior. Fewer studies (n = 11) examined the built-environment determinants of organized sports and well-being, and limited, as well as contradictory, evidence existed for the relationship between the built environment and well-being.

CONCLUSION: The following determinants potentially support active travel behavior: less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability. A high facility and amenity index might promote unspecified physical activity. Policies and planning processes should consider these determinants to strengthen children's and adolescents' health and well-being. However, there are remaining research gaps and important avenues for future research that need to be addressed before more specific and robust conclusions can be drawn.

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