GIS-derived measures of the built environment determinants of mental health and activity participation in childhood and adolescence: A systematic review

Studies increasingly use geographic information systems (GISs) to assess the impact of built environments on health in childhood. The extensive range of GIS measures and operational definitions of the built environment determinants, as well as definitions of the geographic areas of exposure, entail methodological challenges that need to be addressed. We aimed to identify, systematize and evaluate (1) operational definitions of GIS-derived built environment measures and (2) the geographic areas of exposure applied in studies examining the impact of built environments on mental health and activity participation among children and adolescents. A systematic literature review was conducted. We searched for peer-reviewed articles using Web of Science, PubMed, Medline, PsychINFO and SweMed+. The material was systematized using descriptive statistics and a synthesis approach. Numerous operational definitions were identified, which we grouped into the following categories of measures: population, built form, land-use, road/street environment, facility and amenity, neighborhood green and open space and composite measures. There was a large variability in the measures applied, and some studies lacked precise operational definitions. Most studies used ego-centered definitions, based on circular and/or network buffers with distances that ranged from 50 to 8050 m, to define the areas of exposure. This review elucidated that consistency in operational definitions is urgently needed. We suggest that the identified categories of measures represent an initial step towards establishing consensus about which determinants are important to measure. This could provide a basis for refining operational definitions, which eventually can ensure targeted use and consistency in measures applied across future studies.