Nature Exposure for Mental Health

Recruiting in Palo Alto (17 mi)

+8 other locations

Age: 18 - 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Michigan State University

Disqualifiers: Not undergraduate, Age, Distance

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

This project will first examine nature opportunities, belonging and benefits with a multi-state nature-based intervention with a focus on students of color. In light of the syndemic, 'nature deficit disorder' and poor mental health, the investigators anticipate several far-reaching impacts that will (a) test a nationally useful standardized way to quantify exposure; (b) invest in nature resources and accessibility on campuses; and (c) promote the mental health and therapeutic benefits of nature among young adults. These will lead to understanding the nature exposure and mental health interplay and techniques for quantifying and encouraging nature exposure to treat the on-going youth mental health crisis. Including HBCUs and an hispanic-serving institution is expected to result in heightened visibility of underlying disparities, including structural racism and land-based violence and discrimination, that have contributed to current-day nature gaps and dismantled nature relationships for students of color.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Increasing time in nature, Nature-based interventions, Green space therapy, Outdoor activities for mental health?

Research shows that spending time in nature can help improve mental health by reducing feelings of depression and anxiety, and increasing positive emotions. Nature-based activities, like gardening and green exercise, have been found to be effective for adults, including those with existing mental health issues. ^{1 2 3 4 5}

Is nature exposure safe for mental health treatment?

Research on nature-based interventions for mental health shows they are generally safe and can improve mental well-being, with no significant safety concerns reported in the studies reviewed. ^{1 2 3 4 6}

How is the nature exposure treatment different from other mental health treatments?

Nature exposure treatment is unique because it involves spending structured time in natural environments, like parks or gardens, to improve mental health, rather than using medication or traditional therapy. This approach leverages the calming and restorative effects of nature, offering a non-invasive and accessible option for mental health improvement. ^{1 3 4 6 7}

Eligibility Criteria

The Nature IDEAS Study is for students of color who are experiencing mental health issues. It aims to explore the therapeutic benefits of spending more time in nature, particularly on college campuses. The study will include participants from historically black colleges and universities (HBCUs) and a Hispanic-serving institution.

Inclusion Criteria

I am an 18-24 year old undergrad at one of the specified universities, living within 30 miles of campus.

Exclusion Criteria

Not an undergraduate student in one of the included universities

Live further than 30 miles from the university campus

I am either younger than 18 or older than 24 years old.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete baseline surveys on nature connectedness, belongingness, mental health, and demographics. NatureDose™ app data is collected over a 2-week baseline period.

2 weeks

1 visit (in-person) for baseline surveys

Intervention

Participants are randomized to receive either standard health information or additional incentives to increase time outdoors. App data continues to be collected.

2 weeks

1 visit (virtual) for follow-up surveys

Follow-up

Participants are monitored for changes in nature connectedness, belongingness, and mental health through final surveys.

4 weeks

1 visit (virtual) for final surveys

Treatment Details

Interventions

• Increasing time in nature (Behavioural Intervention)

Trial Overview This trial is testing whether increasing exposure to natural environments can improve mental health among young adults, especially students of color. It involves a multi-state intervention that seeks to quantify nature exposure and assess its impact on well-being during the current youth mental health crisis.

Participant Groups

Group I: Control group receiving standard health information Active Control 1 Intervention

This group will receive information about health benefits in nature.

Group II: Intervention Group receiving standard health information + incentives to increase time outdoors Active Control 1 Intervention

This group will receive information on the health benefits of time outdoors, a request to increase their time outdoors, eligibility to receive a prize, and information on peer performance.

Increasing time in nature is already approved in United States, European Union, Canada for the following indications:

🇺🇸 Approved in United States as Nature-based interventions for:

• Mental health improvement
• Anxiety reduction
• Depression management

🇪🇺 Approved in European Union as Green space therapy for:

• Stress reduction
• Emotional wellbeing
• Social isolation prevention

🇨🇦 Approved in Canada as Outdoor activities for mental health for:

• Improved mood
• Reduced symptoms of ADHD
• Enhanced cognitive function

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

Morgan State University Baltimore, MD

University of Maryland Eastern Shore Salisbury, MD

Michigan State University East Lansing, MI

University of Maryland College Park, MD

More Trial Locations

Who Is Running the Clinical Trial?

Michigan State University Lead Sponsor

University of Virginia Collaborator

Cleveland State University Collaborator

University of Maryland Collaborator

Clemson University Collaborator

University of Maryland Eastern Shore Collaborator

Morgan State University Collaborator

University of New Mexico Collaborator

North Carolina Agricultural and Technical University Collaborator

REI Cooperative Action Fund Collaborator

References

1. England pubmed.ncbi.nlm.nih.gov

Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. [2021] Mental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for community based adults. However, it is unclear which NBIs are most effective, or what format and dose is most efficacious. We systematically reviewed the controlled and uncontrolled evidence for outdoor NBIs. The protocol was registered at PROSPERO (CRD42020163103). Studies that included adults (aged ≥18 years) in community-based settings with or without mental and/or physical health problems were eligible for inclusion. Eligible interventions were structured outdoor activities in green and/or blue space for health and wellbeing. We searched ASSIA, CENTRAL, Embase, Greenfile, MEDLINE, PsycINFO, and Web of Science in October 2019; the search was updated in September 2020. We screened 14,321 records and included 50 studies. Sixteen studies were randomised controlled trials (RCTs); 18 were controlled studies; and 16 were uncontrolled before and after studies. Risk of bias for RCTs was low to moderate; and moderate to high for controlled and uncontrolled studies. Random effects meta-analysis of RCTs showed that NBIs were effective for improving depressive mood -0.64 (95% CI: 1.05 to -0.23), reducing anxiety -0.94 (95% CI: 0.94 to -0.01), improving positive affect 0.95 (95% CI: 0.59 to 1.31), and reducing negative affect -0.52 (95% CI: 0.77 to -0.26). Results from controlled and uncontrolled studies largely reflected findings from RCTs. There was less evidence that NBIs improved physical health. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. NBIs, specifically gardening, green exercise and nature-based therapy, are effective for improving mental health outcomes in adults, including those with pre-existing mental health problems.

2. Switzerland pubmed.ncbi.nlm.nih.gov

Social prescribing of nature therapy for adults with mental illness living in the community: A scoping review of peer-reviewed international evidence. [2023] Social prescribing of nature therapy "green social prescribing" facilitates access to local nature-based activities that improve biopsychosocial wellbeing outcomes, are affordable, accessible, and can be adapted to context. These are becoming increasingly popular and gray literature is emerging, however, peer-reviewed scientific evidence is exiguous. This scoping review aimed to identify and critique peer-reviewed evidence for green social prescribing interventions and develop recommendations for research and clinical practice. Included studies were published in peer-reviewed journals in English on/after 1 January 2000. Participants were community-living adults with mental illness; Intervention was any green social prescribing program; Comparator was not restricted/required; Outcomes were any biopsychosocial measures; and any/all Study Designs were included. Twelve databases were searched on 15 October 2022; these were Academic Search Premier, APA PsycArticles, APA PsycINFO, CINAHL, Cochrane Library, Google Scholar, JSTOR, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Mixed Methods Appraisal Tool was used to assess quality. Seven publications describing 6 unique studies (5 UK, 1 Australia) were identified including 3 mixed-methods, 2 qualitative, and 1 RCT. Participants included 334 adults (45% female, aged 35-70 years); sample sizes ranged from 9 to 164. All studies showed improvements in biopsychosocial wellbeing, and participants from most studies (n = 5) reported increased connection to the earth and intention to further access nature. Participant demographics and diagnoses were poorly reported, and intervention activities and assessments varied considerably. However, MMAT scores were good overall suggesting these studies may reliably demonstrate intervention outcomes. We conclude that socially prescribed nature therapy can improve biopsychosocial wellbeing and is a potentially important intervention for mental illness. Recommendations for research and clinical practice are provided.

3. England pubmed.ncbi.nlm.nih.gov

Green care in psychiatry. [2021] Engagement with natural environments is associated with improved health and well-being in the general population. This has implications for mental healthcare. Implementation of targeted nature-based interventions (green care) meets recovery needs and would enable research to develop, clarifying what works best for whom.

4. England pubmed.ncbi.nlm.nih.gov

The effect of brief exposure to virtual nature on mental wellbeing in adolescents. [2023] Adolescence is a time of multiple transitions and a vulnerability period for mental health difficulties. There are many barriers to the treatment of mental health conditions which is one reason for developing alternatives to help improve efficacy in treatment and prevention. One approach is to use nature-based interventions (NBIs) to improve mental wellbeing. In this experimental proof-of-principle intervention study, we randomly allocated a sample of adolescents to brief exposure (6 min) to either a virtual woodland nature video or a busy train journey and tested the effect on mental wellbeing. Results showed beneficial effects in the nature condition on several self-reported outcomes including stress, relaxation, affect, mood, attention, nature connection and nature spirituality. The intervention was mainly acceptable and feasible to do suggesting that overall brief virtual nature interventions may have utility in a range of mental health contexts for adolescents including as self-help universal or targeted prevention strategies, adjunct to psychological therapy and as preparation for more intensive NBIs. Additionally, brief virtual nature interventions support accessibility for those who may be limited on time, unable to access real-life nature or who may be more biophobic.

5. United States pubmed.ncbi.nlm.nih.gov

Nature-based Group Therapy Reflections: A Grounded Theory Study. [2021] Nature-based therapies have a long history in mental health care. Beneficial effects have been documented for nature-based therapies in a variety of other health care settings. The aims of this grounded theory study were to understand the processes of maintaining nature-based therapeutic groups and the value of the activities to patients in a psychiatric inpatient setting. Over a nine-month period, semi-structured surveys of patient responses to nature-based activities were administered to patients in a pilot therapy group assessing the feasibility of a nature-based group program. Findings indicated that the group promoted use of the senses, social interaction, and care of self/others. Perceptions of benefits led to a nuanced understanding of the effects of being in contact with nature. Based on our findings we offer a preliminary theoretical model for patient engagement with nature-based programming in inpatient mental health care.

6. England pubmed.ncbi.nlm.nih.gov

What makes nature-based interventions for mental health successful? [2020] Nature-based interventions for mental health are beginning to become more common in the UK. The evidence for their usefulness is building. Taking the 'A Dose of Nature' project in the south-west as an example, factors for making such interventions a success are described.

7. England pubmed.ncbi.nlm.nih.gov

'Lifts your spirits, lifts your mind': A co-produced mixed-methods exploration of the benefits of green and blue spaces for mental wellbeing. [2023] Mental health problems are a considerable public health issue and spending time in nature has been promoted as a way to access a range of psychological benefits leading to the development of nature-based interventions for people with severe and enduring mental health problems. Less, however, is understood about the potential benefits and efficacy of day-to-day routine access to outdoor green and blue spaces for mental health service users.