GReen And Healthy Schools

Study Overview
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Brief Summary
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This project aims to investigate the health effects of making schools greener and more biodiverse. We will mainly focus on cognitive effects, well-being, and BMI. The research hypothesis is that greening schools positively influences the health of children through more exercise and cleaner air.

Detailed Description
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Spending time in nature has been associated with improved physical and mental health and well-being. Developing nature-based health-promoting interventions such as providing more nature in schools to improve children's well-being will lead to benefits for society in our rapidly urbanizing world. Although the benefits of exposure to nature have been demonstrated, knowledge of integrating exposure to nature into public health guidelines is scarce. The latter requires an interdisciplinary approach that integrates the impact of nature-based interventions both on health and on the cost-effectiveness of interventions. Little is known about the health effect of greening and, in particular, increasing biodiversity in schools and we want to investigate further with this study. This project, therefore, aims to investigate the health effects of greening primary schools and increasing biodiversity and will mainly focus on the effects on cognition, well-being, and BMI. For this, all children from 4th to 6th grade in the participating schools will be invited to participate in this study (Belgium). This study comprises control schools and intervention schools, the schools are examined before the greening and after the greening. When the informed consent form is signed by the parents, they complete a questionnaire that assesses the child's diet, physical activity, and general questions. A urine sample will be taken for the determination of black carbon particles. The child will also perform computer tests measuring different aspects of cognition. During these tests, we will also look at the eye movements that play an important role in the cognitive ability of the child. To get an idea of a possible effect on BMI, height and weight will be measured. The child fills in a welfare questionnaire and a questionnaire about the perception of nature itself.

Official Title
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The Effect of Greening the School Environment on the Health of Children

Conditions
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Cognitive Function 1, Social, Cognitive Change, Emotions, Weight, Body, Pollution; Exposure

Intervention / Treatment
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* Other: greening of the school environment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being in 4th, 5th, or 6th grade Signed informed consent form by a legal representative Exclusion Criteria: No knowledge of dutch

Ages Eligible for Study
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Minimum Age: 9 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: We have 2 groups: an intervention group that includes children from school that will have more nature in its environment and a control school
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Green school<br>The children from schools that are being greened will be investigated and compared to the control school. We will measure cognitive function, BMI, black carbon levels and emotional wellbeing. | Other: greening of the school environment<br>* The school will be greened and biodiversity will be increased. This will be done on the playground and area around the school. Special needs corners for playing, relaxing or gardening will be installed.<br>|
| No Intervention: control school<br>The children from schools that are not being greened will be investigated and used as a control group. We will measure cognitive function, BMI, black carbon levels and emotional wellbeing | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cognitive function | We measure the cognitive function of children by means of a battery of tests including: stroop test, Continuous Performance, digit span, digit signal and digit selection. We combine the computer tests with eye tracking to provide information about saccadic gain during the tests. The computer tests provide data on how much time per reaction (msec) was needed or how many digits could be remembered. | At the baseline, after 6 months and through study completion, an average of 1 year | 
| Change in wellbeing | We measure the emotional wellbeing by means of the Kids screen test that builds a score of 27 points. | at the baseline, after 6 months and through study completion, an average of 1 year | 
| Change in anthropometry | We measure BMI and waist/hip circumference. They are expressed as kg/m2 and cm. | at the baseline, after 6 months and through study completion, an average of 1 year | 
| Change in black carbon levels | We measure urinary black carbon levels. They are expressed as particles per mm2. | at the baseline, after 6 months and through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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greening of schools, biodiversity, cognition, BMI