Youth Engagement in Environmental Health Research and Initiatives: A Scoping Review of Co-Creation Practices in Europe and MENA Regions with Regional Comparisons

Children and youth face unprecedented environmental health challenges. Despite their heightened vulnerability, they are essential to shaping sustainable futures. Yet youth engagement in environmental health is uneven globally, reflecting broader environmental inequities. Indeed, the Middle East and North Africa (MENA) offer limited opportunities for youth participation. In contrast, Europe has fostered visible youth leadership. Comparing youth co-creation approaches across Europe and the MENA region offers an opportunity to examine how environmental health initiatives are shaped by differing contextual conditions. Thus, this scoping review aims to (1) map and classify youth co-creation approaches in environmental health initiatives across Europe and the MENA region and (2) analyze lessons from both regions, highlighting effective strategies, challenges, and opportunities for cross-regional learning to strengthen youth engagement in environmental health initiatives. We conducted a comprehensive search across three databases, grey literature, and organizational websites. In total, 18 studies met the inclusion criteria; 15 studies were conducted in Europe, while 3 studies were situated in the MENA region. Four key themes emerged: (1) creating space for youth collaboration, dialogue and engagement, which underscores the importance of providing learning opportunities for children and youth; (2) no one-size-fits-all approach to co-creation, which underscores the need for diverse approaches, including innovative methods to engage with children and youth; (3) recruitment and retention challenges and contextual barriers to co-creation, which include social norms that may present additional barriers for girls to participate in co-creation initiatives; and (4) outcomes (such as environmental knowledge, behavioural change, skill development, and participation in decision-making) in co-creation. Several research, policy, and practice recommendations were outlined.