Impact of outdoor and nature-based interventions on self-efficacy among adolescents and young adults: a three-level meta-analysis

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Introduction: Self-efficacy plays a critical role in motivation, emotional regulation, and adaptive functioning, particularly during adolescence and young adulthood. Outdoor and nature-based interventions have been proposed as a promising approach to enhance self-efficacy. However, prior meta-analyses have been limited by the assumption of independent effect sizes, which may not adequately account for multiple outcomes reported within the same study. This study aimed to systematically evaluate the effects of outdoor and nature-based interventions on self-efficacy among adolescents and young adults using a three-level meta-analytic approach. Methods: A systematic literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, SPORTDiscus, and PsycArticles for studies published up to December 8, 2025. Standardized mean differences (Cohen's d) were calculated using post-intervention means and standard deviations from the intervention and comparison groups. A three-level random-effects meta-analysis was performed to account for statistical dependence among multiple effect sizes. Meta-regression analyses were conducted to examine the potential moderating effects of intervention duration and population type. Results: Six independent studies comprising 10 effect sizes were included, involving 1,356 participants aged 12-24 years. The three-level meta-analysis demonstrated a significant positive effect of outdoor and nature-based interventions on self-efficacy (d = 0.80, 95% CI 0.31 to 1.30, p = 0.005). Meta-regression analyses indicated no significant moderating effects of intervention duration or population type. Conclusion: Outdoor and nature-based interventions were associated with improvements in self-efficacy among adolescents and young adults. No significant moderating effects were observed for age group or intervention duration. These findings suggest that outdoor and nature-based interventions may represent a promising approach for supporting self-efficacy during critical developmental periods. However, the findings should be interpreted cautiously given the small number of available studies and indications of potential small-study effects. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420261293707.

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