A systematic review of geographically informed ecological momentary assessment studies on the place-based correlates of mental health, substance use and wellbeing

Place characteristics are associated with mental health and wellbeing, yet mechanisms and pathways are not well understood. Geographically explicit ecological momentary assessment (GEMA) is a real-time data collection method that captures individuals’ experiences and behaviours in their natural environments, minimising recall bias and enhancing ecological validity. Previous reviews have underscored the feasibility of GEMA studies to deliver important insights on relationships between mental health and wellbeing and place. This systematic review provides a narrative synthesis of the existing GEMA literature on place-based correlates of mental health and wellbeing in daily life. We searched PubMed, PsycINFO and Embase, using a systematic search strategy to identify relevant English-language studies that used EMA and geographical information to assess place and mental health, wellbeing and/or substance use and their relationship. Studies were included if either the exposure (place) or outcome (mental health, substance use or wellbeing) was assessed in the moment. We identified 33 eligible studies. Eleven focused on nature exposure, 19 on built environment characteristics, and three studies on ambient characteristics. Place-based factors were assessed through various objective and subjective indicators (e.g. Global Positioning System signal, descriptions of nature sounds or noise levels). Regardless of study methodology, exposure to nature was consistently associated with better mental health and higher wellbeing, with small to moderate effect sizes. Specific urban characteristics were linked to poorer mental health and increased substance use. Despite much heterogeneity in study methodologies, our results suggest that EMA in conjunction with geographical information can advance the understanding of the place-mental health and wellbeing nexus. Although these findings reinforce well-established associations, relatively few GEMA studies have examined how place-based exposures influence mental health over time, limiting the ability to infer causal mechanisms. We discuss implications for urban planning, policy making and mental health and wellbeing support through place-based interventions.