Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis

Abstract Despite increasing interest in nature-based interventions (NBIs) for mental health, no or very few prior reviews have quantitatively synthesised their effects on children’s resilience, a key developmental outcome. This study systematically reviews and meta-analyses available evidence follow...

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Main Authors: Myrian Sze Nga Fan, William Ho Cheung Li, Laurie Long Kwan Ho, Kai Chow Choi, Lophina Phiri, Sara Pacchiani, Brigitta Antal, Clement Shek Kei Cheung, Daoud Kamal Abu Khaleel
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Mental Health
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Online Access:https://doi.org/10.1007/s44192-025-00258-7
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author Myrian Sze Nga Fan
William Ho Cheung Li
Laurie Long Kwan Ho
Kai Chow Choi
Lophina Phiri
Sara Pacchiani
Brigitta Antal
Clement Shek Kei Cheung
Daoud Kamal Abu Khaleel
author_facet Myrian Sze Nga Fan
William Ho Cheung Li
Laurie Long Kwan Ho
Kai Chow Choi
Lophina Phiri
Sara Pacchiani
Brigitta Antal
Clement Shek Kei Cheung
Daoud Kamal Abu Khaleel
author_sort Myrian Sze Nga Fan
collection DOAJ
description Abstract Despite increasing interest in nature-based interventions (NBIs) for mental health, no or very few prior reviews have quantitatively synthesised their effects on children’s resilience, a key developmental outcome. This study systematically reviews and meta-analyses available evidence following PRISMA guideline. The Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, Education Resources Information Center, Medline, APA PsycArticles, SPORTDiscus, and Web of Science were searched from inception to November 28, 2024. For additional studies, Google Scholar and references from included studies were searched. The review included randomised clinical trials, controlled trials, and single-group pre-post studies reporting resilience. Findings not synthesised quantitatively were summarised narratively. A total of 13 articles involved 15 studies with 2,571 participants (mean age 15.57 years; range 13 to 17 years; 1315 [53%] female). Random-effect meta-analysis indicated significant moderate-to-large short-term effects of NBIs on children’s resilience (standardised mean difference, 0.64; 95% confidence level, 0.36 to 0.91; p <.001). Substantial heterogeneity of intervention effects was observed (I2 = 98%). This review provides preliminary evidence that NBIs may be associated with short-term improvements in resilience among children, though results should be interpreted cautiously due to study limitations. This early evidence highlights a community-based approach that may support resilience development through nature. Sailing showed some promise as an early observation noted in subgroup analysis and narrative synthesis emphasising nature-human kinship. High-quality trials are needed to evaluate the effects of sailing on resilience and address gaps: the long-term effect of NBIs and their impact on children outside the 13–17 age range. Trail registration: PROSPERO database (CRD42025634371).
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spelling doaj-art-bc9d6a45d1884e06bc7d96a8374818102025-08-20T03:42:48ZengSpringerDiscover Mental Health2731-43832025-07-015111610.1007/s44192-025-00258-7Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysisMyrian Sze Nga Fan0William Ho Cheung Li1Laurie Long Kwan Ho2Kai Chow Choi3Lophina Phiri4Sara Pacchiani5Brigitta Antal6Clement Shek Kei Cheung7Daoud Kamal Abu Khaleel8The Chinese University of Hong KongThe Chinese University of Hong KongThe Chinese University of Hong KongThe Chinese University of Hong KongThe Chinese University of Hong KongUniversita Degli Studi Di Milano-BicoccaKároli Gáspár University of the Reformed Church in HungaryUniversity of New South WalesHong Kong Institute of Vocational EducationAbstract Despite increasing interest in nature-based interventions (NBIs) for mental health, no or very few prior reviews have quantitatively synthesised their effects on children’s resilience, a key developmental outcome. This study systematically reviews and meta-analyses available evidence following PRISMA guideline. The Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, Education Resources Information Center, Medline, APA PsycArticles, SPORTDiscus, and Web of Science were searched from inception to November 28, 2024. For additional studies, Google Scholar and references from included studies were searched. The review included randomised clinical trials, controlled trials, and single-group pre-post studies reporting resilience. Findings not synthesised quantitatively were summarised narratively. A total of 13 articles involved 15 studies with 2,571 participants (mean age 15.57 years; range 13 to 17 years; 1315 [53%] female). Random-effect meta-analysis indicated significant moderate-to-large short-term effects of NBIs on children’s resilience (standardised mean difference, 0.64; 95% confidence level, 0.36 to 0.91; p <.001). Substantial heterogeneity of intervention effects was observed (I2 = 98%). This review provides preliminary evidence that NBIs may be associated with short-term improvements in resilience among children, though results should be interpreted cautiously due to study limitations. This early evidence highlights a community-based approach that may support resilience development through nature. Sailing showed some promise as an early observation noted in subgroup analysis and narrative synthesis emphasising nature-human kinship. High-quality trials are needed to evaluate the effects of sailing on resilience and address gaps: the long-term effect of NBIs and their impact on children outside the 13–17 age range. Trail registration: PROSPERO database (CRD42025634371).https://doi.org/10.1007/s44192-025-00258-7ChildrenMental healthResilienceNature-based interventions
spellingShingle Myrian Sze Nga Fan
William Ho Cheung Li
Laurie Long Kwan Ho
Kai Chow Choi
Lophina Phiri
Sara Pacchiani
Brigitta Antal
Clement Shek Kei Cheung
Daoud Kamal Abu Khaleel
Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis
Discover Mental Health
Children
Mental health
Resilience
Nature-based interventions
title Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis
title_full Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis
title_fullStr Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis
title_full_unstemmed Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis
title_short Nature-based interventions for enhancing resilience in children: a systematic review and meta-analysis
title_sort nature based interventions for enhancing resilience in children a systematic review and meta analysis
topic Children
Mental health
Resilience
Nature-based interventions
url https://doi.org/10.1007/s44192-025-00258-7
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