Journal of Healthy Eating and Active Living

Landscape Architecture and Health: An Umbrella Review

Raul D. Gierbolini-Rivera — 2026-10-07

Landscape architecture influences environmental conditions related to health, but evidence on how design features impact health is scattered across disciplines. The review aims to assess the evidence, identify pathways to health, and guide collaboration between landscape architects and public health professionals. Following PRISMA and JBI Umbrella Review guidelines, systematic searches were conducted in PubMed, Web of Science, Academic Search Complete, and GreenFILE. Exposures included landscape design features, while outcomes captured pathways such as instoration, restoration, mitigation, adaptation, and direct health effects. The review is registered with PROSPERO (CRD420251058826). Fifty-six systematic reviews and meta-analyses were included, covering 2,654 studies, most published from 2021 to 2025. Frequently, landscape types included parks, forests, recreational spaces, streetscapes, health gardens, and educational landscapes. Instoration pathways consistently increased physical activity and active transportation. Restoration pathways improved social inclusion, particularly in hospital gardens and green schoolyards. Mitigation pathways demonstrated reductions in heat and noise and improved thermal comfort. Adaptation pathways such as green roofs and other green infrastructure reduced heat stress and supported outdoor use. Reported health outcomes included improved psychological well-being, some cardiometabolic benefits, and reduced behavioral symptoms in clinical contexts; however, the quality of the evidence remains limited. Findings indicate that landscape architecture practice can improve health by encouraging physical activity and social cohesion, but climate mitigation and adaptation have been less studied. Despite standards that promote active living and climate resilience, systematic evaluation of health-focused landscape projects remains lacking. Collaboration between health and design is necessary to create evidence-based landscapes that enhance health and environmental quality.

Cognitive Interview-Based Validation and Reliability of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in Nigeria

Godsway Otchere — 2026-10-07

Physical inactivity among children and adolescents is a growing public health concern in low- and middle-income countries (LMICs) in Africa, where culturally appropriate physical activity (PA) surveillance tools remain scarce. The Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) was developed to assess PA across multiple domains in diverse settings. This study evaluated the GAC-PAQ's cultural relevance, feasibility, and inter-rater reliability among children and caregivers in Nigeria. In Phase 1, we conducted cognitive interviews with 10 child–caregiver pairs from urban (n= 5) and rural (n= 5) settings, using think-aloud techniques and targeted probing to assess comprehension of the GAC-PAQ and its cultural appropriateness. Findings informed linguistic and contextual revisions prior to pilot testing. In Phase 2, the revised GAC-PAQ was pilot-tested with 45 youth–caregiver pairs (youth aged 8–17 years) from primary and secondary schools in Osogbo and Ede, Osun State, Nigeria. Inter-rater reliability between child and caregiver reports was assessed using Cohen's kappa (κ), and we examined associations between PA duration, age, sex, and residence using proportional-odds regression models. Cognitive interviews identified key cultural adaptations and post-revision app satisfaction was high (caregivers: 100%; youth: 95%). Inter-rater reliability ranged from fair to almost perfect across domains, with the strongest agreement for transportation mode (κ= 0.81) and the weakest for recess duration (κ = 0.26). Age, sex, and residence were each significantly associated with PA duration across selected domains. These findings provide preliminary evidence supporting the cultural appropriateness, content validity, and inter-rater reliability of the GAC-PAQ among children and adolescents in Nigeria.

Rust and Ruin: How Deindustrialization’s Ghosts Shape Urban Health and Landscapes

Hannah Hardy — 2026-10-07

The closure of steel mills along the Monongahela River in the late 20th century dramatically reshaped communities in Allegheny County, Pennsylvania. This case study examines the enduring impacts of deindustrialization on McKeesport, Pennsylvania, one of those river towns and once at the epicenter of the Pittsburgh region's industrial revolution. McKeesport, like many former industrial hubs, has long grappled with the impacts of deindustrialization, including population loss, economic decline, and striking health disparities. The physical landscape bears witness to this transformation, with high rates of blight, vacant land, and abandoned properties. Through the lens of neoliberal capitalism, this research explores how deindustrialization fundamentally altered the community’s fabric and health outcomes. The question guiding this research is how do the long-term outcomes of deindustrialization impacting the built environment contribute to health experiences of the people who live in McKeesport, PA? The study identifies strategies for mitigating these impacts of deindustrialization, particularly by addressing the legacy that vacant land and abandoned property have on health policy implications. Ultimately, this project contributes to the broader discourse on reducing health disparities in deindustrialized communities, offering insights that may inform policy and revitalization efforts in similar post-industrial landscapes across the United States considering persistent neoliberal trends.

Family Physical Activity and Employment Background as a Model for Child Physical Activity in Mexican-heritage Families

Haley Delgado — 2026-10-07

The purpose of this study was to examine the relationship between family-engaged physical activity (PA), parental employment background, and children’s PA among Mexican-heritage families residing in rural areas of the south-Texas Mexico border. Promotoras (community health workers trained in research methods) administered surveys to mothers (n=346) about family and child characteristics. Survey questions included frequency of participation in family-engaged PA, weekday and weekend maternal-reported hours of active play outside as reported by mothers, and parental employment background. Logistic regression analyses were used to examine the relationship between family-engaged PA frequency, parental employment, and maternal-reported hours of active play outside during weekdays and weekends. Mothers (n=346) were, on average, 36 years old (SD=10.0), married (65.3%), and born in Mexico (81.5%). Children (n=346) were either 8 (n=117), 9 (n=110), or 10 (n=119) years old. Maternal employment was suggestively inversely associated with maternal-reported hours of active play outside during weekdays and weekends (OR=0.47; 90% CI=0.24, 0.90; p=0.05). Frequent family PA was suggestively positively associated with weekday PA for children, even after adjusting for paternal job status (OR=1.84; 90% CI=1.06, 3.32; p=0.08). Children from families that participated in family PA more frequently (more than 3 times per week) showed higher weekday PA, even after adjusting for paternal days worked (OR=1.86; 90% CI=1.06, 3.34; p=0.07). Understanding the relationship between family PA and maternal-reported hours of active play may facilitate maintained engagement in PA programs. More work is needed to understand the impact, feasibility, and sustainability of family-focused PA interventions within diverse cultural and socioeconomic contexts.