Mengren Deng

Physical activity during recess can provide an important opportunity for secondary school students to accumulate health-enhancing movement within the school day. However, in high-density urban schools, limited campus land and uneven spatial conditions may constrain students’ physical activity during recess. Although previous studies examined the role of the school environment in shaping students’ physical activity, little is known about how different types of campus public spaces and students’ perception of such spaces are associated with recess physical activity. In this study, such associations are examined in three high-density urban schools in Guangzhou, China among 900 students in grades 10–12. The students’ moderate-to-vigorous physical activity (MVPA) during recess is measured by using Huawei Band 8 wearable devices, and their primary activity spaces and perception of their spatial environment are determined by using a structured questionnaire. The campus public spaces are classified as sports field, courtyard, plaza, undercroft space and corridors, and the students’ perception of their environment is assessed across four dimensions: usability, accessibility, safety and comfort. Descriptive statistics, Pearson correlation analysis and multiple linear regression are used for the data analysis. Results show differences in recess MVPA levels across the three schools, with high activity levels observed in the school with superior spatial resources and public space conditions, as well as the use of and MVPA behaviour in the different public spaces. Sports fields were generally associated with high use and higher MVPA levels, whereas corridors mainly supported students’ movement between destinations and brief resting and were associated with relatively low MVPA levels. Courtyards, plazas and undercroft spaces show varied patterns, in which activity is related to specific spatial conditions, such as the scale, openness, paving and shading conditions and facility availability. The perception analysis indicates that usability, comfort, accessibility and safety are significantly and positively associated with recess MVPA, with usability showing the strongest association. The regression model can explain 54.7% of the variance in recess MVPA levels. The findings suggest that in similar high-density urban secondary school contexts, spatial support for recess physical activity depends on not only the amount of available space but also the activity-supportive characteristics and perceived environmental quality of the campus public spaces. Improvement of the usability, comfort and accessibility of campus public spaces may provide favourable spatial conditions for students’ physical activity during recess.

With accelerating urbanization and a global emphasis on quality of life, the effects of the built environment on individual physiological and psychological well-being have become a critical research focus. However, existing studies remain fragmented in terms of theoretical perspectives, spatial scales, and methodological approaches, and a comprehensive synthesis of the physiological and psychological effects of the built environment is still lacking. This review adopts an interdisciplinary approach, integrating architecture, urban planning, landscape architecture, geography, and psychology to systematically review the literature on the health impacts of the built environment. Its findings indicate that the scope of the built environment has expanded from natural settings to residential areas, streets, and public spaces. Research scales have progressed from macro-level districts to streets and public spaces and further to micro-level physical environments. The impacts have extended from emotional responses to broader health and well-being outcomes, with increasing attention being given to specific population groups. Technological advances have shifted research paradigms from traditional surveys to approaches incorporating big data, machine learning, virtual reality, and physiological monitoring, enabling more precise analyses of links between spatial perception and emotional responses. This review identifies gaps in interdisciplinary integration, long-term monitoring, and the consideration of individual differences, highlighting the need for future studies to integrate multimodal data with theory-informed practice to support more human-centered, health-promoting built environments.

Against the background of traffic conflicts arising due to the highly concentrated population in high-density cities, this study aims to systematically identify the core transport needs of patients awaiting medical treatment; based on the theory of the Kano model, we construct a measurement system relating to patient transport needs when awaiting medical treatment that encompasses multiple levels. Taking 10 large general hospitals in Guangzhou as samples, this study collected data through questionnaires and auxiliary interviews, using the importance–sensitivity analysis method to accurately measure the degree of patient needs for each influencing factor of the transport environment for medical treatment. The study found that, among the primary needs (core basic needs), the perfection of public transport (which directly affects the convenience of medical care) is the core need with the highest degree of demand. Among the second-level needs (refined categorised demand levels), specifically relating to important attributes (essential needs), priority attention should be given to patient diversion, hospital–city connection, and corridor settings. As concerns the high value-added one-dimensional attributes (desired needs), focus should be placed on controlling health and safety distances and guiding the flow of medical treatment, while for high glamour attributes (glamour needs), primary consideration should be given to crowd distribution, stopping and resting, and direct access to the ground floor. The group difference analysis (grouped by emotional state, transport mode, and group type) showed that the first-level demand sensitivity ranking was highly consistent, and the second-level demand for urban connectivity, convenient transfer, and direct underground access were also common priorities. This study is the first to introduce the Kano model into the analysis of high-density urban healthcare transport systems, providing a clear basis for the grading of demand for the design of the transport environment for patients’ medical care. This is of great practical value for alleviating congestion and improving the resilience of emergency response in mega-cities in relation to medical care.