Associations between nature exposure, screen use, and parent–child relations: a scoping review protocol

This mixed-methods systematic scoping review will be conducted following Arksey and O’Malley’s framework [21] with methodological enhancements from Levac and associates [22] and further recommendations from the Joanna Briggs Institute’s methodological guidance for conducting scoping reviews [23]. This framework proposes five sequential stages to developing a scoping review: (a) identifying the research question, (b) identifying relevant literature, (c) selecting studies, (d) mapping the data, and (e) summarising, synthesising, and reporting the results. This protocol is registered with the Open Science Framework (registration ID: https://doi.org/10.17605/OSF.IO/TFZDV) and has followed reporting recommendations from the preferred reporting items for systematic review and meta-analysis protocols [23] (see Additional file 2). The Preferred Reporting for Systematic Reviews Checklist [24] will be adhered to when final review output is reported. All data will be saved on a password protected secure Deakin University server.

Step 1: Identifying the research question

The review will be guided by the following research question: What is the scope of existing literature, including construct definitions, major findings, limitations, and areas for future research, that explores nature exposure, screen use and parent–child relations across childhood? For the purpose of this review, ‘nature exposure’ will be conceptualised as exposure to any outdoor space that is characterised by elements of the natural environment (see Table 1 for key definitions). This definition precludes time outdoors where features of natural environments are not specified (e.g. outdoor basketball court).

Table 1 Population-concept-context frameworkStep 2: Identifying relevant literature

The Population-Concept-Context framework (see Table 1) was used to guide the conceptualisation of key review questions, eligibility criteria for study inclusion, and the study selection process [23]. Preliminary searches were conducted in PsycINFO (EBSCO) using key variable terms in varying combinations to develop a targeted scope for eligibility criteria and search terms. Article subject headings and titles were scanned for alternative/additional definitions for key concepts. Where search results generated voluminous or non-specific articles, specific search terms were removed from the search strategy. For example, freestanding search terms such as ‘technology’ and ‘nature’ were either removed altogether or adjoined with other terms using Boolean operators for a more targeted search output. Inclusion criteria will be (a) peer reviewed studies published in English from 2012 onwards with either quantitative, qualitative, or mixed-methods design and (b) studies whose participants are children aged 0–12 years and/or primary caregivers (parents or carers) to children aged 0–12 years. A range of study methodologies (including randomised control trial, cross-sectional, and longitudinal) will be considered due to the explorative nature of the current review, novelty of the conceptual field, and heterogeneity of study designs. Exclusion criteria will be a) reviews b) unpublished data and c) grey literature. The screening and selection process will be represented by the Preferred Reporting Items for Systematic Reviews and Meta-analyses Flowchart Extension for Scoping Reviews [24]. Prior to implementation, the search strategy quality will be independently reviewed by two liaison-librarians, using The Peer Review of Electronic Search Strategies Evidence-Based Checklist [25]. The review search will be run through five electronic interdisciplinary and discipline-specific databases covering the conceptually related fields of health and medicine, psychology, and education. The following databases will be searched (from August 2022 onwards): PsycINFO (EBSCO), MEDLINE complete (EBSCO), ERIC (EBSCO), EMBASE and the Cochrane library. A structured step-by-step search strategy using keywords and subject terms will be used for each database (an additional file shows this in more detail (see Additional file 1)). Boolean operators and truncations will be used in various combinations for search parsimony. Only articles related to the constructs of nature exposure and screen-use and/or parenting will be considered in the context of early to late childhood (up to 12 years old). Additional studies will be obtained through snowballing of all publications identified for inclusion. The retrieved articles will be collated and managed through Covidence, and duplicates will be removed.

Step 3: Selecting studies

Two reviewers will independently screen titles, abstracts, and selected full-text articles. Screening of abstracts will be an iterative process; study selection will be discussed by the review team at the start, middle, and end of the abstract review process, and refinements to the inclusion/exclusion criteria will be made if needed [22]. Discrepancies between reviewer decisions will be handled by a third reviewer. Articles that do not meet eligibility criteria will be removed and exclusion reasons will be documented along with the document source. Due to the nature and purpose of this scoping review, a formal risk of bias assessment was not deemed necessary [21].

Step 4: Mapping the data

A customised data charting form (see Table 2) has been adapted from the template data extraction instrument for scoping reviews in the Joanna Briggs Institute Manual for Evidence Synthesis [23]. This charting tool will be collaboratively developed through an iterative process by the research team to determine which data needs to be extracted from articles to answer the research questions and will be updated throughout the extraction process. Following recommendations from Levac and associates [22], the research team will meet following data extraction for five studies, to establish whether the extraction process is capturing information aligned with the review aims and research questions.

Table 2 Initial data extraction charting templateStep 5: Summarising, synthesising, and reporting the results

Evidence will be collated and described following Arksey and O’Malley’s methods [21], with recommendations from Levac and associates [22]. First, a numerical summary of information obtained from the data extraction charting template will be provided in tabular form, describing key characteristics of included studies (e.g. study design, intervention, population and outcome measures). A textual summary of the data will be analysed and described using qualitative thematic analysis. Information within the populated data charting tool will be hand coded and then further developed by identification of overarching themes. Relationships and connections between themes will be mapped using mind-mapping software and critically discussed by all authors throughout an iterative mapping process. Discussion of results will reflect the final thematic categories. Results will be reported in alignment with the review objectives and research questions and interpreted in view of future research direction and implications on recommendations, policies, and practices within the conceptual field.

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