Green and blue physical activity for quality of life: A systematic review and meta-analysis of randomized control trials

Physical activity in green and blue spaces provide physical and mental health benefits in populations of all ages. In this study, we explored the effectiveness of longer-term green and blue physical activity of improving the quality of life. Medline, Pubmed, Embase, and Web of Science databases were searched in September 2020. A systematic review and meta-analysis were conducted using a random-effects model. Moderator analyses were performed to investigate differences in effect sizes. In total, eight randomized controlled trials (RCTs) were selected for a qualitative and quantitative synthesis of quality of life outcomes. Results showed significant increased effects of green and blue physical activity interventions on physical and mental health compared to a control group, but an insignificant effect on the general quality of life. A moderator analysis and meta-regression indicated that the mean age of the experimental group had a significant effect on mental health. This first meta-analysis of RCTs found multiple instances of green and blue physical activity being beneficial to physical and mental health. Engaging in physical activity in green and blue spaces is advocated to improve the quality of life of individuals, health practitioners, urban planning, and policymakers.