Greening Schoolyards to Improve Child Health: A Quasi-Experimental Study Protocol in Belgian and Dutch Primary...

Childhood obesity and mental health problems are major public health concerns worldwide. Early-life exposure to green spaces has been shown to promote physical activity, reduce obesity risk, and improve cognitive and emotional development. Schoolyards offer a unique opportunity to promote health, as children spend a large proportion of their time at school.

This quasi-experimental protocol study investigates the effects of transforming gray schoolyards into biodiverse green spaces on children's health and well-being. Four primary schools in Limburg (Belgium and The Netherlands) were recruited: two intervention schools and two control schools. Children aged 7-12 years were enrolled, with baseline data collected in November 2021 and follow-up measurements scheduled every six months until November 2023. Outcomes include body mass index (BMI) z-score (primary outcome), waist circumference, diet, cognitive performance, psychological well-being, biodiversity knowledge, and physical activity. Data will be analyzed using linear mixed models, and cost-effectiveness analyses will be performed.

Improvements in BMI z-scores, cognitive functioning, dietary behavior, and psychological well-being are expected among children in green schoolyards compared to those in control schools. Increased biodiversity awareness and reduced exposure to black carbon are also anticipated.

This study is designed to provide evidence on the health impacts of greener schoolyards and contribute to strategies for promoting child development through environmental interventions.