Attention restoration theory: a systematic review of the attention restoration potential of exposure to natural environments.
Journal of Toxicology and Environmental Health, Part B
Taylor & Francis
This is the author accepted manuscript. This is an open access article. The final version is available from Taylor & Francis via the DOI in this record.
Attention Restoration Theory (ART) suggests the ability to concentrate may be restored by exposure to natural environments. Although widely cited, it is unclear as to the quantity of empirical evidence that supports this. A systematic review regarding the impact of exposure to natural environments on attention was conducted. Seven electronic databases were searched. Studies were included if (1) they were natural experiments, randomized studies, or recorded ‘before and after’ measurements; (2) compared natural and non-natural/other settings; and (3) used objective measures of attention. Screening of articles for inclusion, data extraction and quality appraisal were performed by one reviewer and checked by another. Where possible, random effects meta-analysis was used to pool effect sizes. Thirty-one studies were included. Meta-analyses provided some support for ART, with significant positive effects of exposure to natural environments for three measures (Digit Span Forward, Digit Span Backward and Trail Making Test B). The remaining 10 meta-analyses did not show marked beneficial effects. Meta-analysis was limited by small numbers of studies, small samples, heterogeneity in reporting of study quality indicators and heterogeneity of outcomes. This review highlights the diversity of evidence around ART in terms of populations, study design and outcomes. There is uncertainty regarding which aspects of attention may be affected by exposure to natural environments.
The European Centre for Environment and Human Health (part of the University of Exeter Medical School) is part financed by the European Regional Development Fund Programme 2007 to 2013 and European Social Fund Convergence Programme for Cornwall and the Isles of Scilly. Ruth Garside is partially supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula (PenCLAHRC).
Published online: 26 Sep 2016