Use of green spaces, self-satisfaction and social contacts in adolescents: A population-based CASPIAN-V study

Background. A growing body of evidence has associated contact with green spaces with improved mental health and wellbeing in adults. Social contacts has been postulated as a potential mechanism underlying such effects. However, the available evidence on the association between green spaces and self-satisfaction and also the mediatory role of social contacts in health benefits of green spaces in adolescents is still very scarce. We aimed to evaluate the association of time spent in different types of green spaces with self-satisfaction and social contacts in adolescents. We also investigated the mediatory role of social contacts in the association of green space use and self-satisfaction. Methods: This cross-sectional study was based on a population-representative sample of 10,856 adolescents (10-18 years old) living in urban and rural districts across 30 provinces of Iran (2015). Data on the time spent in green spaces (separately for parks, forests and private gardens), self-satisfaction, social contacts (number of friends and time spent with friends), and socio-demographic characteristics were obtained through questionnaires from parents and children. Logistic mixed effects models with recruitment centre as the random effect were developed to estimate associations adjusted for relevant covariates. Results: More time spent in green spaces was associated with improved self-satisfaction and social contacts. While for the self-satisfaction, there was no indication for effect modification by sex, socioeconomic status (SES), and urbanity, we observed stronger associations for older adolescents (> 14 years old). For social contacts, we found indications for stronger associations for boys, older adolescents, those residing in rural areas, and those from lowest and highest SES groups. Social contacts could explain more than half of the association between green spaces use and self-satisfaction. Conclusions: Our observed enhanced self-satisfaction and social contacts associated with more time spent in green spaces could provide policymakers with measures to improve mental wellbeing of adolescents. Further studies are required to replicate our findings in other populations with different climates, cultures and lifestyles.