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Built Environments, Food Environments, and Public Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (15 November 2018) | Viewed by 75260

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Dr. Rebecca A. Seguin

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Division of Nutritional Sciences, Cornell University, 412 Savage Hall, Ithaca, NY 14850, USA
Interests: theory-informed, community-based nutrition and physical activity interventions and dissemination research for chronic disease prevention (e.g., cardiovascular disease, type 2 diabetes), focusing on women, older adults, low-income families, and rural and other underserved populations; health disparities and health equity; food and physical activity environment factors related to behavior change and maintenance; and community capacity building for health promotion

Mr. Brian K. Lo

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Affiliation: Division of Nutritional Sciences, Cornell University, 417 Savage Hall, Ithaca, NY 14850, USA
Interests: determinants of healthy eating and physical activity; diet and physical activity measurements; the behavioral epidemiology of weight control; planning and evaluation of health promotion and public health interventions; and community-engaged research

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on “Built Environments, Food Environments, and Public Health” in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

Over the past decade, there has been growing interest in understanding the role of built environments, food environments, and their related health behaviors and outcomes such as physical activity and diet quality. Improved understanding of these contextual factors is key to identifying innovative policies and programs to promote active living and healthy eating. However, more research is needed to advance the field. First, although both physical activity and food environments have become the target of many interventions and much research, there is a lack of sensitive and specific tools to assess environmental changes, limiting the ability to demonstrate the mediating role of an enhanced environment contributing to the changes in the health outcomes of interest. Second, much of the evidence supporting policy and environmental strategies to encourage healthy living comes from research in urban settings. There is an urgent need to better understand this topic among other underserved populations such as rural and military populations and others. Third, more longitudinal designs and analyses are need to discern causality in the relationship between built environments and health behaviors and outcomes.

In this Special Issue of the journal, we aim to feature articles that highlight: 1) innovative approaches in measuring the built environments, particularly tools shown to be sensitive to change/intervention; 2) findings from underserved populations, broadly defined; and 3) outcomes of cohort and intervention studies that are related to built environments, food environments, and health behaviors and outcomes. Collectively, these articles will advance knowledge that aim to advance measurement tools and methodologies, inform policy, and build a strong evidence base on the effectiveness of built environment interventions.

Dr. Rebecca A. Seguin
Mr. Brian K. Lo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

sedentary behavior
physical activity
diet
interventions
health promotion
measurement
public health
built environment
food environment
underserved populations

Published Papers (11 papers)

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Research

16 pages, 661 KiB

Open AccessArticle

Examining the Associations between Walk Score, Perceived Built Environment, and Physical Activity Behaviors among Women Participating in a Community-Randomized Lifestyle Change Intervention Trial: Strong Hearts, Healthy Communities

by Brian K. Lo, Meredith L. Graham, Sara C. Folta, Lynn C. Paul, David Strogatz, Miriam E. Nelson, Stephen A. Parry, Michelle E. Carfagno, David Wing, Michael Higgins and Rebecca A. Seguin

Int. J. Environ. Res. Public Health 2019, 16(5), 849; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16050849 - 08 Mar 2019

Cited by 20 | Viewed by 4878

Abstract

Little is known about the relationship between perceived and objective measures of the built environment and physical activity behavior among rural populations. Within the context of a lifestyle-change intervention trial for rural women, Strong Hearts, Healthy Communities (SHHC), we examined: (1) if Walk Score (WS), an objective built environment measure, was associated with perceived built environment (PBE); (2) if WS and PBE were associated with moderate-to-vigorous physical activity (MVPA); and (3) if MVPA changes were modified by WS and/or PBE. Accelerometers and questionnaires were used to collect MVPA and PBE. Bivariate analyses and linear mixed models were used for statistical analyses. We found that WS was positively associated with perceived proximity to destinations (p < 0.001) and street shoulder availability (p = 0.001). MVPA was generally not associated with WS or PBE. Compared to controls, intervention group participants increased MVPA if they lived in communities with the lowest WS (WS = 0), fewer perceived walkable destinations, or extremely safe perceived traffic (all p < 0.05). Findings suggest that WS appears to be a relevant indicator of walkable amenities in rural towns; results also suggest that the SHHC intervention likely helped rural women with the greatest dearth of built environment assets to improve MVPA. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

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12 pages, 283 KiB

Open AccessArticle

Adaptation and Validation of the Chinese Version of the Nutrition Environment Measurement Tool for Stores

by Yang Liu, Shenzhi Song, Joel Gittelsohn, Nan Jiang, Jiajin Hu, Yanan Ma and Deliang Wen

Int. J. Environ. Res. Public Health 2019, 16(5), 782; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16050782 - 04 Mar 2019

Cited by 10 | Viewed by 3194

Abstract

Changes in lifestyle and food environment have created a heavy burden of obesity and chronic disease in China. However, measurements of the food environment have been rarely reported in China or other countries with similar food cultures; this measurement shortage is partially due to the lack of valid and reliable measurement tools. The aim of the present study was to adapt and validate a Chinese version of the Nutritional Environment Measurement Survey for Stores (C-NEMS-S). Categories and items of the NEMS-S were culturally adapted to fit the Chinese population and included grains, dry beans, starchy tubers, vegetables, fruits, seafood, meat and poultry, dietary oils, milk, bread, instant noodles, and beverages. A scoring sheet for each food category was created to measure availability, quality, and pricing. Then, the C-NEMS-S was validated in 10 large-sized supermarkets and 10 convenience stores in Shenyang, China. Two trained raters performed their evaluations separately at the same store. The intra-class correlation coefficient (ICC) of the availability composite score was 0.98. All food measures had a moderate or good ICC (0.41 to 1.00). The kappa for each food measure ranged from 0.52 to 1.00. C-NEMS-S was able to show the difference in healthy food availability between large-sized supermarkets and convenience stores, as well as the price differences between healthier options and regular options. Large-sized supermarkets had a significantly higher total score (p < 0.001) and healthier option availability for all food measures (all items were statistically significant (p < 0.05), except sugar-free beverages). Healthier options cost more than regular options for grains, milk, bread, and instant noodles (from 4% to 153%). The adapted C-NEMS-S can be used to measure the consumer food environment in stores in China. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

15 pages, 335 KiB

Open AccessArticle

Development and Validation of the Vending Evaluation for Nutrient-Density (VEND)ing Audit

by Tanya M. Horacek, Elif Dede Yildirim, Melissa Matthews Schreiber, Carol Byrd-Bredbenner, Sarah Colby, Adrienne A. White, Karla P. Shelnutt, Melissa D. Olfert, Anne E. Mathews, Kristin Riggsbee, Lisa Franzen-Castle, Jesse Stabile Morrell and Kendra Kattelmann

Int. J. Environ. Res. Public Health 2019, 16(3), 514; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16030514 - 12 Feb 2019

Cited by 9 | Viewed by 4827

Abstract

Background: This paper describes the development and validation of the Vending Evaluation for Nutrient-Density (VEND)ing audit to comprehensively evaluate vended products based upon healthfulness, price and promotion, and machine accessibility. Methods: A novel vending nutrient-density score was created to determine the healthfulness of vended snack/beverage products. Field tested in United States colleges, VENDing audit (∑nutrient-density + 10 × % healthy products) and Support sub-scores (price + promotion + accessibility) were calculated for snack/beverage machines. Higher scores indicate more healthful vending options and supports for choosing healthfully. Nutrition Environment Measures Survey-Vending (NEMS-V) was used to validate the nutrient-density score for a sub-sample of machines. Sensitivity and specificity were computed by comparing the number of healthy snacks/beverages determined by NEMS-V and the VENDing nutrient-density scores. Results: Researchers conducted the VENDing audit on 228 snack/beverage vending machines at 9 universities within the United States and used both VENDing and NEMS-V on 33 snack and 52 beverage vending machines. Mean VENDing audit scores were 4.5 ± 2.0 (2.6, 3.4) and 2.6 ± 2.0 (0, 12) for snack/beverage machines, respectively. The number of products considered healthy assessed with both the VENDing nutrient-density scores and the NEMS-V were positively correlated for beverages (r = 0.687, p < 0.001) and snacks (r = 0.366, p < 0.05). The sensitivity was excellent for beverages (0.83) and moderate for snacks (0.69); while the specificity was moderate for both beverages (0.66) and snacks (0.50). Conclusions: The VENDing audit uses unique, valid, and reliable nutrient-density scoring to evaluate snacks/beverages along a continuum of healthful criteria and comprehensively evaluates the full vending environment. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

16 pages, 2602 KiB

Open AccessArticle

Obesogenic Environment Case Study from a Food and Nutrition Security Perspective: Hermosillo City

by Ana Contreras Navarro and María-Isabel Ortega Vélez

Int. J. Environ. Res. Public Health 2019, 16(3), 407; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16030407 - 31 Jan 2019

Cited by 6 | Viewed by 6071

Abstract

Obesity and certain nutritional deficiencies are global health problems that emerge in systems of interdependent individual biological and historical factors and social environmental determinants of health. Nutrition security is a framework that assumes stable access to sufficient innocuous and nutritious food (i.e., food security), health care, and sanitation, and information that in conjunction allows self-care-oriented behavior for health protection. To understand the social environment of nutrition insecurity, the object of study was the food distribution and consumption system of a marginalized community in Hermosillo, Mexico. We assessed the distribution of food establishments by social marginalization level in basic geo-statistical areas and the nutrition security status of women in underserved neighborhoods. We found that in Hermosillo >90% of food establishments included for analysis (grocery stores, supermarkets, convenience stores, and beer deposits) were distributed outside of areas with high levels of social marginalization. The nutrition security assessment suggests that low intakes of fruit and vegetables and high intakes of fat and sugar may be associated with food accessibility and acceptability factors in individual decision-making processes. Future research should take into account the variability of food system environments and address the particular needs of communities in terms of food and nutrition security. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

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13 pages, 297 KiB

Open AccessArticle

Improving Physical Activity among Residents of Affordable Housing: Is Active Design Enough?

by Candace Tannis, Araliya Senerat, Malika Garg, Dominique Peters, Sritha Rajupet and Elizabeth Garland

Int. J. Environ. Res. Public Health 2019, 16(1), 151; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16010151 - 08 Jan 2019

Cited by 7 | Viewed by 4079

Abstract

Physical inactivity increases risk of chronic disease. Few studies examine how built environment interventions increase physical activity (PA). Active design (AD) utilizes strategies in affordable housing to improve resident health. We assessed how AD housing affects PA among low-income families in Brooklyn, New York. Participants were recruited at lease signings in 2016 from a new AD apartment complex and two recently renovated comparison buildings without AD features. Eligibility included age ≥18 years with no contraindications to exercise. Anthropometric data were collected. PA was self-reported using the Recent and Global Physical Activity Questionnaires. Smartphone users shared their tracked step. Data collection was repeated one year after move-in. All data were analyzed using SPSS. Eighty-eight eligible participants completed the initial questionnaire (36 AD and 52 from 2 comparison buildings) at baseline (T0). There were no differences between AD and comparison cohorts in: stair use, PA, sitting time or, mean waist-to-hip ratio (WHR) at T0. However, the AD cohort had a lower baseline BMI (27.6 vs. 31.0, p = 0.019). At one-year follow-up (T1), 75 participants completed our survey including a 64% retention rate among those who previously completed the T0 questionnaire. Among T0 questionnaire respondents, mean daily steps increased at T1 among AD participants who moved from an elevator building (∆6782, p = 0.051) and in the comparison group (∆2960, p = 0.023). Aggregate moderate work-related activity was higher at T1 in the AD building (746 vs. 401, p = 0.031). AD building women reported more work-related PA overall but AD men engaged in more moderate recreational PA. Living in an AD building can enhance low-income residents’ PA. More research with objective measures is needed to identify strategies to sustain higher PA levels and overall health. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

14 pages, 686 KiB

Open AccessArticle

The Impact of a City-Level Minimum Wage Policy on Supermarket Food Prices by Food Quality Metrics: A Two-Year Follow Up Study

by James Buszkiewicz, Cathy House, Anju Aggarwal, Mark Long, Adam Drewnowski and Jennifer J. Otten

Int. J. Environ. Res. Public Health 2019, 16(1), 102; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16010102 - 01 Jan 2019

Cited by 6 | Viewed by 25058

Abstract

Objective: To examine the effects of increasing minimum wage on supermarket food prices in Seattle over 2 years of policy implementation, overall and differentially across food quality metrics. Methods: Prices for the UW Center for Public Health Nutrition (CPHN) market basket of 106 foods were obtained for 6 large supermarket chain stores in Seattle (“intervention”) and for the same chain stores in King County (“control”) at four time points: 1-month pre- (March 2015), 1-month post- (May 2015), 1-year post- (May 2016), and 2-years post-policy implementation (May 2017). Prices for all food items were standardized and converted to price per 100 kcal. Food quality metrics were used to explore potential differential price increases by (a) food groups, as defined by US Department of Agriculture; (b) NOVA food processing categories, and (c) nutrient density quartiles, based on the Nutrient Rich Foods Index 9.3. Separate difference-in-differences linear regression models with robust standard errors, examined price differences per 100 kcal overall, clustered by store chain, and stratified by each food quality metric. Results: There were no overall market basket price changes attributable to Seattle’s minimum wage policy. Moreover, no minimum wage effect was detected by USDA food group, food processing, or nutrient density categories. Conclusions: Local area supermarket food prices were not impacted by Seattle’s minimum wage policy 2 years into policy implementation and after the first increase to $15/h overall or by sub-classification. Low-income workers may be able to afford higher quality diets if wages increase yet supermarket prices stay the same. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

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13 pages, 307 KiB

Open AccessArticle

B’more Healthy Corner Stores for Moms and Kids: Identifying Optimal Behavioral Economic Strategies to Increase WIC Redemptions in Small Urban Corner Stores

by Caroline R. Wensel, Angela C.B. Trude, Lisa Poirier, Riyad Alghamdi, Antonio Trujillo, Elizabeth Anderson Steeves, David Paige and Joel Gittelsohn

Int. J. Environ. Res. Public Health 2019, 16(1), 64; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16010064 - 27 Dec 2018

Cited by 17 | Viewed by 4526

Abstract

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) redemption rates have been declining in many low-income urban settings, potentially related to aspects of the food environment. B’more Healthy Corner Stores for Moms and Kids was a feasibility trial in Baltimore City that aimed to test multiple behavioral economic (BE) strategies in 10 corner stores (intervention = eight stores, comparison = two stores), to evaluate their influence on the stocking and redemptions of WIC foods. Tested strategies included in-person storeowner training, point of purchase promotion, product placement, and grouping of products in a display. All four strategies were feasible and implemented with high reach, dose delivered, and fidelity. Additionally, text messaging was found to be an acceptable form of intervention reinforcement for storeowners. Analyses to assess change in stocking of WIC foods, total sales of WIC foods, and sales of WIC foods to WIC clients, revealed consistent positive changes after implementation of the store owner training strategy, while changes after the implementation of other strategies were mixed. Furthermore, WIC food sales to WIC clients significantly increased after the simultaneous implementation of two strategies, compared to one (p > 0.05). Results suggest that store owner training was the most influential strategy and that the implementation of more BE strategies does not necessarily lead to proportional increases in stocking and sales. Selected BE strategies appear to be an effective way of increasing stocking and sales of WIC foods in small urban food stores. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

14 pages, 933 KiB

Open AccessArticle

Challenges and Lessons Learned from Multi-Level Multi-Component Interventions to Prevent and Reduce Childhood Obesity

by Joel Gittelsohn, Rachel Novotny, Angela Cristina Bizzotto Trude, Jean Butel and Bent Egberg Mikkelsen

Int. J. Environ. Res. Public Health 2019, 16(1), 30; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16010030 - 24 Dec 2018

Cited by 17 | Viewed by 6928

Abstract

Multi-level multi-component (MLMC) strategies have been recommended to prevent and reduce childhood obesity, but results of such trials have been mixed. The present work discusses lessons learned from three recently completed MLMC interventions to inform future research and policy addressing childhood obesity. B’more Healthy Communities for Kids (BHCK), Children’s Healthy Living (CHL), and Health and Local Community (SoL) trials had distinct cultural contexts, global regions, and study designs, but intervened at multiple levels of the socioecological model with strategies that address multiple components of complex food and physical activity environments to prevent childhood obesity. We discuss four common themes: (i) How to engage with community partners and involve them in development of intervention and study design; (ii) build and maintain intervention intensity by creating mutual promotion and reinforcement of the intervention activities across the multiple levels and components; (iii) conduct process evaluation for monitoring, midcourse corrections, and to engage stakeholder groups; and (iv) sustaining MLMC interventions and its effect by developing enduring and systems focused collaborations. The paper expands on each of these themes with specific lessons learned and presents future directions for MLMC trials. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

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10 pages, 835 KiB

Open AccessArticle

Healthy Food Options at Dollar Discount Stores Are Equivalent in Quality and Lower in Price Compared to Grocery Stores: An Examination in Las Vegas, NV

by Courtney Coughenour, Timothy J. Bungum and M. Nikki Regalado

Int. J. Environ. Res. Public Health 2018, 15(12), 2773; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15122773 - 07 Dec 2018

Cited by 7 | Viewed by 3898

Abstract

Food deserts indicate limited access to and affordability of healthy foods. One potential mediator is the availability of healthy food in non-traditional outlets such as dollar-discount stores, stores selling produce at the fixed $1 price. The purpose of this study was to compare availability, quality, price differences in ‘healthier’ versus ‘regular’ food choices, price per each food item, and summary score in dollar-discount stores to grocery stores in Las Vegas using the NEMS-S; a protocol consisting of three subscores—availability, quality, price of healthier versus regular food, and a summary score. A 25% sample of grocery stores (n = 40) and all dollar-discount stores (n = 14) were evaluated. t-tests showed that dollar-discount stores were less likely to price healthy options lower than their unhealthy alternatives (mean (M) = 1.0 vs. M = 2.5; p < 0.001) and had reduced availability (M = 20.50 vs. M = 23.80; p < 0.001) compared to grocery stores. The quality of produce did not differ (M = 5.93 vs. M = 6.00; p = 0.34). Price comparisons revealed that 84.2% of produce and 89.5% of other food items were significantly less expensive at the dollar-discount stores, with only two items being more expensive. While dollar-discount stores did have lower availability, they provided quality fresh and healthy foods which were usually less expensive. Findings indicate that dollar discount stores may be an existing community asset, and considering them as such may aid in efforts to strengthen the overall food system. Practitioners should consider dollar discount stores when assessing the community food environment and designing and implementing outreach programs, as they may bridge some disparities in access. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

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10 pages, 407 KiB

Open AccessFeature PaperArticle

One-Year Follow-Up Examination of the Impact of the North Carolina Healthy Food Small Retailer Program on Healthy Food Availability, Purchases, and Consumption

by Stephanie B. Jilcott Pitts, Qiang Wu, Kimberly P. Truesdale, Lindsey Haynes-Maslow, Jared T. McGuirt, Alice Ammerman, Ronny Bell and Melissa N. Laska

Int. J. Environ. Res. Public Health 2018, 15(12), 2681; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15122681 - 28 Nov 2018

Cited by 23 | Viewed by 4029

Abstract

We examined the short-term impact of the North Carolina Healthy Food Small Retailer Program (HFSRP), a legislatively appropriated bill providing funding up to $25,000 to small food retailers for equipment to stock and promote healthier foods, on store-level availability and purchase of healthy foods and beverages, as well as customer dietary patterns, one year post-policy implementation. We evaluated healthy food availability using a validated audit tool, purchases using customer bag-checks, and diet using self-reported questionnaires and skin carotenoid levels, assessed via Veggie Meter™, a non-invasive tool to objectively measure fruit and vegetable consumption. Difference-in-difference analyses were used to examine changes in HFSRP stores versus control stores after 1 year. There were statistically significant improvements in healthy food supply scores (availability), with the Healthy Food Supply HFS score being −0.44 points lower in control stores and 3.13 points higher in HFSRP stores pre/post HFSRP (p = 0.04). However, there were no statistically significant changes in purchases or self-reported consumption or skin carotenoids among customers in HFSRP versus control stores. Additional time or other supports for retailers (e.g., marketing and promotional materials) may be needed for HFSRP implementation to influence purchase and consumption. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

12 pages, 321 KiB

Open AccessArticle

Physical Activity and Fundamental Motor Skill Performance of 5–10 Year Old Children in Three Different Playgrounds

by Jessie Adams, Jenny Veitch and Lisa Barnett

Int. J. Environ. Res. Public Health 2018, 15(9), 1896; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15091896 - 31 Aug 2018

Cited by 36 | Viewed by 6792

Abstract

Playgrounds provide opportunities for children to engage in physical activity and develop their fundamental motor skills. The aim of this descriptive pilot study was to examine whether playground design facilitated different levels of physical activity and fundamental motor skills. Children aged 5 to 10 (n = 57) were recruited from three independent playgrounds located in Melbourne (Australia). Whilst playing, children wore accelerometers which measured time spent in physical activity and direct observations recorded fundamental motor skills and play equipment use. A general linear model with playground type as the predictor and adjusting for monitor wear-time identified whether mean time in physical activity was different for the three playgrounds. Frequencies and a one-way ANOVA assessed whether the observed mean number of fundamental motor skills varied between playgrounds. On average, 38.1% of time (12.0 min) was spent in moderate- vigorous-intensity physical activity. Children in the traditional playground (n = 16) engaged in more moderate-intensity physical activity (9.4 min) than children in the adventure playground (n = 21), (5.6 min) (p = 0.027). There were no significant associations with vigorous-intensity physical activity or fundamental motor skills between playgrounds. Children performed few fundamental motor skills but used a wider variety of equipment in the contemporary and adventure playgrounds. Playgrounds need to maximise opportunities for children to engage in physical activity and develop fundamental motor skills. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

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