Special Issue "Nature-Based Therapies and Human Health"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (24 February 2020).

Special Issue Editors

Prof. Dr. Patrik Grahn
Website
Guest Editor
Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Box 88, 23053 Alnarp, Sweden
Interests: Landscape Architecture; Health Design; Public Health; Rehabilitation; Therapeutic Use of Natural Environments; Coping Resources
Prof. Lena Lidfors
Website
Co-Guest Editor
Department of Animal Environment and Health, Swedish University of Agricultural Sciences, P.O Box 234, SE-532 23 Skara, Sweden
Interests: Animal-Assisted Therapy; Anthrozoology; Therapy dogs; Cats in homes for elderly; Green Care farms; Equine Assisted Therapy
Dr. Anna Maria Palsdottir
Website
Co-Guest Editor
Department of Work Science, Business Economics and Environmental Psychology, P.O. Box 88, SE-230 53 Alnarp, Sweden
Interests: Nature-based interventions including different kind of landscape such as forest, gardens, parks, agriculturla landscape, lakes/sea shores; Landscape Planning and Architecutre; Evidence Based Health Design; Public Health and Nature; Environmental Pscyhology; Urban Agriculture; Nature-based Integration and social interactions
Assoc. Prof. Ann Dolling
Website
Co-Guest Editor
Department of Forest Ecology and Management, Forest and Health, SE-901 83 Umeå, Sweden
Interests: Wilderness Therapy and Forest Therapy; Forest Bathing; Forest planning; Human health; Nature Based Integration

Special Issue Information

Dear Colleagues,

Interventions aimed at strengthening human health have been used in natural environments since ancient time. From the beginning of the 20th century, they have included more and more varieties, such as horticultural therapy, nature therapy, garden therapy, wilderness therapy, ecotherapy, forest therapy, green care and animal assisted therapy. At the same time, these nature-based therapies (NBT) target more and more types of disability, ill health and diseases. As non-communicable diseases, such as psychiatric diagnoses, burnout, cardiovascular disease; and chronic diseases, such as dementia, ASD, asthma, body aches, COPD, etc. are increasing worldwide, interest in NBT are also increasing. This is because NBT appear to have a positive impact on these often hard-to-treat diseases, and without any serious side effects.

NBT contain many parts, such as choice of location, choice of team, choice of activities, etc. It is important for the continued development in the field that all these parts are carefully described. As interest increases, the demands for evidence-based development in the area increase. In this special issue, we invite researchers in health promoting interventions (e.g., public health, psychology, sociology, psychiatry, occupational therapy and physiotherapy), as well as experts in "nature" (e.g., biology, agriculture, veterinary medicine, ethology, horticulture, forestry, and landscape architecture) to deepen the research topic of NBT:

1)    Evidence. More well-designed studies are needed to prove that NBT work; and furthermore, for what types of diseases/ill health may NBT be the best choice.

2)    Theory. Theoretical explanatory models regarding how NBT can improve human health.

3)    Content. Description of the studied interventions: qualities of the site; team knowledge and education; selected activities; participants’ time in intervention.

4)    Best matching, between selected intervention and participants needs. This include: composition of team, choice of location, choice of activities, and length of intervention.

Prof. Dr. Patrik Grahn
Prof. Lena Lidfors
Dr. Anna Maria Palsdottir
Assoc. Prof. Ann Dolling
Guest Editors

Manuscript Submission Information

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Keywords

  • Health promotion
  • Rehabilitation
  • Natural Environment
  • Nature Therapy
  • Horticultural Therapy
  • Green Care
  • Animal Assisted Therapy

Published Papers (19 papers)

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Open AccessArticle
Embodying Experiences with Nature in Everyday Life Recovery for Persons with Eating Disorders
Int. J. Environ. Res. Public Health 2020, 17(8), 2784; https://doi.org/10.3390/ijerph17082784 - 17 Apr 2020
Cited by 2
Abstract
Eating disorders can be understood as attempts to manage a problematic relationship with one’s own body. The objective of this qualitative study was to explore and discuss perspectives of embodying “experiences with nature” related to recovery in everyday life for persons experiencing eating [...] Read more.
Eating disorders can be understood as attempts to manage a problematic relationship with one’s own body. The objective of this qualitative study was to explore and discuss perspectives of embodying “experiences with nature” related to recovery in everyday life for persons experiencing eating disorders. The study was carried out in the context of a hermeneutic phenomenological approach. Eight participants with an interest in nature and friluftsliv (outdoor pursuits), and with experiences with bulimia nervosa and/or binge-eating disorders, were interviewed twice. Interviews took place in nature, in combination with a “going together” method. The results reveal how the participants highlighted experiences with nature as accentuating feelings of calmness and an engagement of the senses. Participants described nature as a non-judgmental environment that also provided room for self-care. This article explores the implications of everyday life perspectives on nature in recovery, as well as of an integrated focus on body and mind in experiences with eating disorders. The article concludes with an emphasis on how participant’s embodying experiences with nature enabled a (re)connection with one’s own body. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
Open AccessArticle
Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study
Int. J. Environ. Res. Public Health 2020, 17(7), 2515; https://doi.org/10.3390/ijerph17072515 - 07 Apr 2020
Cited by 2
Abstract
Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) [...] Read more.
Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) incorporating activity trackers and use of a holistic health and wellbeing measure, the Self-sasessment of Change (SAC) scale. A mixed methods design explored participant recruitment and retention, programme delivery, and measures of physical activity and health and wellbeing. Walker data included: pre-post questionnaires, daily step counts, and interviews. Programme delivery information included: weekly checklists, staff reflections, stakeholder meeting minutes, and a report. Thirteen adults (age 63–81, 76% female) joined and completed the activity tracker GOHW. Activity trackers motivated walkers to join and be more active but complicated programme delivery. Activity trackers allowed the quantification of physical activity and the SAC health and wellbeing measure was easy to use. By week 12, all participants met national physical activity guidelines. Clinically relevant changes on the SAC scale included: sleeping well, experiencing vibrant senses, and feeling energised, focused, joyful, calm and whole. Results illustrate the feasibility of using activity trackers to motivate engagement in and provide a measure of physical activity from GOHWs. The SAC scale offers a promising measure for nature–health research. A conceptual model is provided for the development of future large-scale studies of NBIs, such as group outdoor health walks. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Equine-Assisted Intervention to Improve Perceived Value of Everyday Occupations and Quality of Life in People with Lifelong Neurological Disorders: A Prospective Controlled Study
Int. J. Environ. Res. Public Health 2020, 17(7), 2431; https://doi.org/10.3390/ijerph17072431 - 03 Apr 2020
Abstract
People with neurological disorders suffer from poor mobility, poor balance, fatigue, isolation and monotonous everyday activities. Studies show that equine-assisted interventions can improve their mobility and balance, but could these kinds of interventions also increase participants’ activity repertoire and self-assessed health, and reduce [...] Read more.
People with neurological disorders suffer from poor mobility, poor balance, fatigue, isolation and monotonous everyday activities. Studies show that equine-assisted interventions can improve their mobility and balance, but could these kinds of interventions also increase participants’ activity repertoire and self-assessed health, and reduce their fatigue? The study was conducted as a prospective, controlled study with three cohorts followed for one year: intervention group (n = 14), control group Passive (n = 29), and control group Active (n = 147). Participants in the study were affected by neurological disease or injury that limited their opportunities for an active everyday life. The intervention group lacked regular activities outside the home before the intervention, which consisted of riding once a week, led by a certified therapist. Control group Passive lacked regular activities outside the home, while control group Active had several activities outside the home per week. Primary outcome measures were activity repertoire measured with Occupational Value Assessment questionnaire. Secondary outcome measures were global self-assessed health measured with EuroQol-VAS and fatigue measured with Shirom-Melamed Burnout Questionnaire. The intervention group’s activity repertoire and self-assessed health increased significantly compared to both baseline and the control groups. Equine-assisted interventions could help to improve the perceived value of everyday occupations and quality of life, as well as break isolation and increase the activity repertoire of people with neurological disorders. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Investigating the Qualities of a Recreational Forest: Findings from the Cross-Sectional Hallerwald Case Study
Int. J. Environ. Res. Public Health 2020, 17(5), 1676; https://doi.org/10.3390/ijerph17051676 - 04 Mar 2020
Cited by 3
Abstract
Prior research shows that forests contribute to human health and well-being. In this sense, this cross-sectional case study, adopting the principles of citizen science, assessed the restorative potential of places in the Hallerwald, an Austrian community forest. A convenience sample of adult forest [...] Read more.
Prior research shows that forests contribute to human health and well-being. In this sense, this cross-sectional case study, adopting the principles of citizen science, assessed the restorative potential of places in the Hallerwald, an Austrian community forest. A convenience sample of adult forest visitors (n = 99, 64% females) completed a survey during a guided 2.5 h forest tour. The German questionnaire assessed the qualities of defined places in the forest. We also investigated changes in mood states, perceived stress, restoration, connectedness, and mindfulness before and after visiting the forest. In cooperation with a local working group, we developed the new Widen One’s Mind (WOM) scale, which showed good scale characteristics. All places received high scores in their potential to increase restoration and vitality and to widen one’s mind. Positive affect, restoration, connectedness with nature and the forest, and mindfulness increased pre- versus post-visits, whereas negative affect and perceived stress decreased. The findings of this study suggest that in recreational forests, visitors experience beneficial mental effects such as stress reduction in addition to physical exercise. To facilitate regional development goals, we recommend evaluating places in forests regarding the potential effects on the health and well-being as well as citizen participation before initiating extensive remodeling. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Six-Step Model of Nature-Based Therapy Process
Int. J. Environ. Res. Public Health 2020, 17(3), 685; https://doi.org/10.3390/ijerph17030685 - 21 Jan 2020
Cited by 2
Abstract
Several studies have confirmed that the natural environment has psychophysiological healing effects. However, few studies have investigated the healing process involved in the effect of the natural environment. To date, no theoretical model on the nature-based therapy process has been clearly established. Thus, [...] Read more.
Several studies have confirmed that the natural environment has psychophysiological healing effects. However, few studies have investigated the healing process involved in the effect of the natural environment. To date, no theoretical model on the nature-based therapy process has been clearly established. Thus, the aim of this study was to develop a theoretical model of the nature-based therapy process by analyzing individual empirical data. Research materials were 180 self-reported essays on “Forest Therapy Experiences” submitted to the Korea Forest Service. This study was conducted based on grounded theory. Data were analyzed through open coding. A total of 82 concepts, 21 subcategories, and six categories were derived. Results revealed that the nature-based therapy process contained six categories: Stimulation, acceptance, purification, insight, recharging, and change. When in the natural environment, participants first experienced positive emotional change, followed by cognitive and behavioral changes. Based on these results, a nature-based therapy process model was derived. This study revealed that the nature-based therapy process did not consist of just a single element or step, but involved an integrated way of healing with emotional and cognitive changes. This study is significant in that it derives a theoretical model of the nature-based therapy process with comprehensive mechanisms. Further research is needed to establish more systematic theoretical model. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Effect of Faint Road Traffic Noise Mixed in Birdsong on the Perceived Restorativeness and Listeners’ Physiological Response: An Exploratory Study
Int. J. Environ. Res. Public Health 2019, 16(24), 4985; https://doi.org/10.3390/ijerph16244985 - 07 Dec 2019
Abstract
Many studies have reported that natural sounds (e.g., birdsong) are more restorative than urban noise. These studies have used physiological and psychological indicators, such as the skin conductance level (SCL) and the Perceived Restorativeness Scale (PRS), to evaluate the restorative effect of natural [...] Read more.
Many studies have reported that natural sounds (e.g., birdsong) are more restorative than urban noise. These studies have used physiological and psychological indicators, such as the skin conductance level (SCL) and the Perceived Restorativeness Scale (PRS), to evaluate the restorative effect of natural sounds. However, the effect of faint background noise mixed with birdsong on the restorativeness of birdsong has not been described yet. In the current experiment, we examined whether traffic noise affects the perceived restorativeness and the physiological restorativeness of birdsong in a low-stress condition using the SCL and the PRS. The scores of the PRS showed that birdsong significantly increased the perceived restorativeness of the place regardless of the car noise, but no significant difference was found between these two birdsongs. In contrast, physiologically, the birdsong without car noise decreased the participants’ SCL significantly more than the birdsong with car noise did. These results indicate that the SCL would be useful to detect the effect of background noise on natural sound when the noise is too low to affect the perceived restorativeness. This study highlights the importance of measuring the SCL besides assessing perceived restorativeness to describe the characteristics of restorative natural sound in future research. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Improved Wellbeing for Both Caretakers and Users from A Zoo-Related Nature Based Intervention—A Study at Nordens Ark Zoo, Sweden
Int. J. Environ. Res. Public Health 2019, 16(24), 4929; https://doi.org/10.3390/ijerph16244929 - 05 Dec 2019
Cited by 1
Abstract
Nature-based interventions have been proposed to promote physical and mental health and give stress reduction. Little attention has been given to the potential of zoos for human health and wellbeing. A disadvantaged group in Sweden regarding access to nature are individuals with disabilities [...] Read more.
Nature-based interventions have been proposed to promote physical and mental health and give stress reduction. Little attention has been given to the potential of zoos for human health and wellbeing. A disadvantaged group in Sweden regarding access to nature are individuals with disabilities who consequently do not have the same access to these health benefits as other groups. To increase awareness and knowledge regarding spending time in nature and with animals, courses directed at caretakers for persons with disabilities and their users were held at Nordens Ark, a zoo in Sweden. To explore if the courses had led to increased nature activities, and if participating in the courses had affected caretakers’ and their users’ health and wellbeing, questionnaires and interviews for evaluating the courses were used. The results showed improved quality in nature visits because of course participation as well as positive effects for the wellbeing, sustainability for the caregivers and users in their working lives, and relationships were positively affected. The conclusion from this study is that nature and animal-based education should be more frequent to provide opportunities for a disadvantaged group to have the positive effects of nature of which most other groups have obvious access to. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessFeature PaperArticle
Vitality from Experiences in Nature and Contact with Animals—A Way to Develop Joint Attention and Social Engagement in Children with Autism?
Int. J. Environ. Res. Public Health 2019, 16(23), 4673; https://doi.org/10.3390/ijerph16234673 - 23 Nov 2019
Cited by 2
Abstract
Animals are increasingly included in treatment for children with autism, and research has shown positive effects, such as increased social initiatives, decreased typical autistic behaviors, and decreased stress. However, there are still knowledge gaps, for example, on underlying mechanisms and effects from longer [...] Read more.
Animals are increasingly included in treatment for children with autism, and research has shown positive effects, such as increased social initiatives, decreased typical autistic behaviors, and decreased stress. However, there are still knowledge gaps, for example, on underlying mechanisms and effects from longer treatment duration. The purpose of this study is to contribute to these gaps and ask questions about the ways in which animals and nature can improve conditions for psychological development through support from therapists. The method is based on grounded theory. Data comes from a treatment model (duration 1½ years, a total of nine children), from environmental psychology and developmental psychology, both typical and atypical as in autism. The results consist of three key categories; reduce stress and instill calm, arouse curiosity and interest, and attract attention spontaneously. These three key categories are related to an underlying core variable, vitality forms, which was described by Daniel Stern and, according to him, is important in forming overall experiences. The starting point is the brain’s way of encoding many internal and external events based on movement perception. Here it is argued that the vitality forms from nature and animals are particularly favorable for effecting development-promoting interactions with a therapist. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Wetlands for Wellbeing: Piloting a Nature-Based Health Intervention for the Management of Anxiety and Depression
Int. J. Environ. Res. Public Health 2019, 16(22), 4413; https://doi.org/10.3390/ijerph16224413 - 11 Nov 2019
Cited by 3
Abstract
Nature-based health interventions (NBIs) for the treatment of poor mental health are becoming increasingly common, yet evidence to support their effectiveness is lacking. We conduct a pilot study of a six-week intervention, aiming to engage individuals with wetland nature for the treatment of [...] Read more.
Nature-based health interventions (NBIs) for the treatment of poor mental health are becoming increasingly common, yet evidence to support their effectiveness is lacking. We conduct a pilot study of a six-week intervention, aiming to engage individuals with wetland nature for the treatment of anxiety and/or depression. We employed a mixed methods design, using questionnaires, focus groups and semi-structured interviews to evaluate the intervention from the perspective of participants (n = 16) and healthcare professionals (n = 2). Results demonstrate significant improvements in mental health across a range of indicators, including mental wellbeing (Warwick and Edinburgh Mental Wellbeing Scale), anxiety (Generalised Anxiety Disorder-7), stress (Perceived Stress Scale) and emotional wellbeing (Positive and Negative Affect Schedule). Participants and healthcare professionals cited additional outcomes including improved physical health and reduced social isolation. The wetland site provided a sense of escape from participants’ everyday environments, facilitating relaxation and reductions in stress. Wetland staff knowledge of the natural world, transportation and group organisation also played a considerable role in the intervention’s success. These aspects should be considered in future and existing NBIs to maximise benefits to participants. We propose NBIs based in wetlands are an effective therapy option for individuals diagnosed with anxiety and/or depression. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Traditional Korean Medicine-Based Forest Therapy Programs Providing Electrophysiological Benefits for Elderly Individuals
Int. J. Environ. Res. Public Health 2019, 16(22), 4325; https://doi.org/10.3390/ijerph16224325 - 06 Nov 2019
Cited by 4
Abstract
We aimed to develop forest therapy programs (FTPs) to prevent dementia and related health problems in the elderly population, with the assumption that health benefits are FTP-type specific and depend on the participant’s psychophysiological traits. For this purpose, we developed two distinct FTPs, [...] Read more.
We aimed to develop forest therapy programs (FTPs) to prevent dementia and related health problems in the elderly population, with the assumption that health benefits are FTP-type specific and depend on the participant’s psychophysiological traits. For this purpose, we developed two distinct FTPs, namely, a guided-breathing meditation program (BP) and a walking program (WP); we adopted the approach of Sasang constitutional (SC) medicine, which categorizes individuals into one of three SC types (SC1, SC2, or SC3) for medical care. The FTPs ran 11 sessions over 11 weeks. We recruited 29/31/28 participants who were 65 years of age or older for the BP/WP/control groups, respectively; obtained electrophysiological measurements via electroencephalogram (EEG), heart rate variability (HRV), and bioimpedance; and analyzed the intervention effects with analysis of covariance. Compared with the control, the BP and WP resulted in benefits for neural activity and parasympathetic nervous activity (PNA), respectively, and both FTPs yielded distinct beneficial effects on bioimpedance. Constitution-specific effects were also present. The SC1- and SC2-type participants gained positive effects in neural activity from the BP and WP, respectively. The SC3-type participants showed improvements in PNA from the WP. In conclusion, for older individuals, both programs conferred health benefits that would help prevent dementia, and the benefits were program-specific and constitution-specific. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Organised Physical Activity in the Forests of the Warsaw and Tricity Agglomerations, Poland
Int. J. Environ. Res. Public Health 2019, 16(20), 3961; https://doi.org/10.3390/ijerph16203961 - 17 Oct 2019
Cited by 3
Abstract
Research Highlights: The achieved results indicate that in the period of 2010–2016, the number of sporting events (running, cycling and walking) as well as the number of participants has increased many times. Methods: A geostatistical method, i.e., kriging, was used to check the [...] Read more.
Research Highlights: The achieved results indicate that in the period of 2010–2016, the number of sporting events (running, cycling and walking) as well as the number of participants has increased many times. Methods: A geostatistical method, i.e., kriging, was used to check the distance-based relationship between agglomerations proximity and sporting events. The questionnaire surveys were used to determine the reasons for physical activity in the forest. Results: The analysis of the impact of the scope of the urban agglomerations on the number of organised physical activities proved that, in both cases (Warsaw and Tricity), most events take place in forests located close to these cities. The larger the distance to Warsaw or Tricity, the lower the number of sporting events and the lower the number of participants. The reasons why people take up physical activity are mainly to improve their health and physical condition, reduce stress and improve wellbeing. Conclusions: The conducted research indicates a significant increase in the importance of non-productive functions of forests located in the vicinity of urban agglomerations, as well as the need for continuous monitoring of actions taken by foresters to promote active lifestyles. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
The Influence of Forest Resting Environments on Stress Using Virtual Reality
Int. J. Environ. Res. Public Health 2019, 16(18), 3263; https://doi.org/10.3390/ijerph16183263 - 05 Sep 2019
Cited by 8
Abstract
To explore the effects of different types of forest environments for forest therapy, this study focused on forest resting environments. Seven representative forest resting environments found in field research in Beijing were used as independent variables and were shown to subjects by a [...] Read more.
To explore the effects of different types of forest environments for forest therapy, this study focused on forest resting environments. Seven representative forest resting environments found in field research in Beijing were used as independent variables and were shown to subjects by a virtual reality (VR) video. Stress level was used as the dependent variable, and blood pressure, heart rate, salivary amylase, and the Brief Profile of Mood States (BPOMS) were used as physiological and psychological indicators. A between-subjects design was used in the experiment. A total of 96 subjects were randomly assigned to each environment type, and only one type of forest resting environment was observed. Through the relevant sample t-test and one-way analysis of variance, the pre- and post-test data of the indicators were analyzed. This study found that all the seven different types of forest resting environments can produce stress relief effects to some extent. Different types of forest resting environments have different effects on relieving stress. The most natural environment does not have the most significant effect on stress relief. A water landscape has a positive effect on the relief of stress. The conclusions of this study are conducive to the better use of the forest environment for forest therapy services. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
A Systematic Review and Meta-Analysis of Nature-Based Mindfulness: Effects of Moving Mindfulness Training into an Outdoor Natural Setting
Int. J. Environ. Res. Public Health 2019, 16(17), 3202; https://doi.org/10.3390/ijerph16173202 - 02 Sep 2019
Cited by 2
Abstract
Research has proven that both mindfulness training and exposure to nature have positive health effects. The purpose of this study was to systematically review quantitative studies of mindfulness interventions conducted in nature (nature-based mindfulness), and to analyze the effects through meta-analyses. Electronic searches [...] Read more.
Research has proven that both mindfulness training and exposure to nature have positive health effects. The purpose of this study was to systematically review quantitative studies of mindfulness interventions conducted in nature (nature-based mindfulness), and to analyze the effects through meta-analyses. Electronic searches revealed a total of 25 studies to be included, examining 2990 participants. Three analyses were conducted: Nature-based mindfulness interventions evaluated as open trials (k = 13), nature-based mindfulness compared with groups in non-active control conditions (k = 5), and nature-based mindfulness compared with similar interventions but without contact with nature (k = 7). The overall combined psychological, physiological, and interpersonal effects from pre- to post-intervention were statistically significant and of medium size (g = 0.54, p < 0.001). Moderation analyses showed that natural environments characterized as forests/wild nature obtained larger numerical effects than environments characterized as gardens/parks, as did informal mindfulness compared with formal mindfulness. The small number of studies included, as well as the heterogeneity and generally low quality of the studies, must be taken into consideration when the results are interpreted. PROSPERO registration number: CRD42017065639. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Experiences of the Urban Green Local Environment as a Factor for Well-Being among Adults: An Exploratory Qualitative Study in Southern Sweden
Int. J. Environ. Res. Public Health 2019, 16(14), 2464; https://doi.org/10.3390/ijerph16142464 - 11 Jul 2019
Cited by 3
Abstract
The amount and quality of greenness in the local outdoor environment has repeatedly been linked to human well-being. Different types of green areas are likely required in order to meet the various needs of people throughout the course of their lives and with [...] Read more.
The amount and quality of greenness in the local outdoor environment has repeatedly been linked to human well-being. Different types of green areas are likely required in order to meet the various needs of people throughout the course of their lives and with regard to individual social and economic living conditions. The aim of the present study was to increase the understanding of different pathways between green environments, well-being and health. We conducted 16 interviews to explore perceptions and experiences among adults residing in a semi-urban to urban area and derived categories and subcategories from the data using content analysis. We identified six categories; promoting activities, supporting social contacts, stimulating sensory impressions, providing a retreat, offering ways to influence and creating a sense of coherence, and we recognized that the availability to, and contrasts between and maintenance of the environment were experienced as prerequisites for health-promoting properties of the green local environment. The results illustrate a rich variety in potential pathways through which the green local environment may promote well-being. The study highlights the need to plan the local environment from multiple perspectives, as well as carefully considering prerequisites of various kinds in order for the green environment to support health across the life-course. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
Open AccessArticle
Growing Resilience through Interaction with Nature: Can Group Walks in Nature Buffer the Effects of Stressful Life Events on Mental Health?
Int. J. Environ. Res. Public Health 2019, 16(6), 986; https://doi.org/10.3390/ijerph16060986 - 19 Mar 2019
Cited by 7
Abstract
Nature-based activities have been used as therapeutic interventions for those experiencing stress and mental ill health. This study investigates whether group walks could be a nature-based intervention to foster resilience, by buffering the effects of recent stressful life events on mental health. An [...] Read more.
Nature-based activities have been used as therapeutic interventions for those experiencing stress and mental ill health. This study investigates whether group walks could be a nature-based intervention to foster resilience, by buffering the effects of recent stressful life events on mental health. An observational research design with propensity score-matched samples compared the mental health of individuals who did (Nature Group Walkers, n = 1081) or did not (Non-Group Walkers, n = 435) attend nature group walks. A sub-sample of Frequent Nature Group Walkers (at least once per week, n = 631) was also investigated. Data were analyzed using multiple regression with an interaction term. All analyses were controlled for age, gender, and recent physical activity. Results showed that neither nature group walking, nor doing this frequently, moderated the effects of stressful life events on mental health. Using a main effects model, the positive associations of group walks in nature were at a greater magnitude than the negative associations of stressful life events on depression, positive affect, and mental well-being, suggesting an ‘undoing’ effect of nature group walks. Group walking schemes in natural environments may be an important public health promotion intervention for mental health. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessArticle
Benefits of Gardening Activities for Cognitive Function According to Measurement of Brain Nerve Growth Factor Levels
Int. J. Environ. Res. Public Health 2019, 16(5), 760; https://doi.org/10.3390/ijerph16050760 - 02 Mar 2019
Cited by 5
Abstract
The objective of this study was to determine the effects of gardening activities in senior individuals on brain nerve growth factors related to cognitive function. Forty-one senior individuals (age 76.6 ± 6.0 years) were recruited from the local community in Gwangjin-gu, Seoul, South [...] Read more.
The objective of this study was to determine the effects of gardening activities in senior individuals on brain nerve growth factors related to cognitive function. Forty-one senior individuals (age 76.6 ± 6.0 years) were recruited from the local community in Gwangjin-gu, Seoul, South Korea. A 20-min low-to-moderate intensity gardening activity intervention, making a vegetable garden, was performed by the subjects in a garden plot located on the Konkuk University (Seoul, South Korea) campus. The gardening involved six activities including cleaning a garden plot, digging, fertilizing, raking, planting/transplanting, and watering. To determine the effects of the gardening activities on brain nerve growth factors related to memory, blood samples were drawn twice from each subject before and after the gardening activity by professional nurses. The levels of brain nerve growth factors, including brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF), were analyzed. Levels of BDNF and PDGF were significantly increased after the gardening activity. This study revealed a potential benefit of gardening activities for cognitive function in senior individuals. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
Open AccessArticle
The Tree Is My Anchor: A Pilot Study on the Treatment of BED through Nature-Based Therapy
Int. J. Environ. Res. Public Health 2018, 15(11), 2486; https://doi.org/10.3390/ijerph15112486 - 08 Nov 2018
Cited by 2
Abstract
Binge eating disorder (BED), characterized by recurrent episodes of binge eating with a subjective experience of lack of control, is the world’s most common eating disorder. The aim of the present pilot study was to examine the feasibility of implementing nature-based therapy (NBT) [...] Read more.
Binge eating disorder (BED), characterized by recurrent episodes of binge eating with a subjective experience of lack of control, is the world’s most common eating disorder. The aim of the present pilot study was to examine the feasibility of implementing nature-based therapy (NBT) in the treatment of BED. The NBT intervention was compared to Support Group Meetings (SGMs), which are the only publicly available form of support for people diagnosed with BED in Denmark. Twenty participants with a BED diagnosis were included in the study, which had a mixed-methods design including Eating Disorder Examination interviews, semi-structured interviews, and questionnaires measuring well-being (The Psychological General Well-Being Index) and self-esteem (Rosenberg’s Self-Esteem Scale). Both the NBT and the SGMs showed positive results on all outcome measures (decreases in binge eating episodes and increases in general psychological well-being and self-esteem). The interviews indicated that the NBT context made the psychotherapeutic content more accessible to the participants and further helped them transfer the therapeutic gains to daily life after completing treatment. However, these results should be interpreted with caution due to the small sample size—ideally, they would need to be tested on a larger, randomized sample. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)

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Open AccessReview
Psycho-Physiological Stress Recovery in Outdoor Nature-Based Interventions: A Systematic Review of the Past Eight Years of Research
Int. J. Environ. Res. Public Health 2019, 16(10), 1711; https://doi.org/10.3390/ijerph16101711 - 16 May 2019
Cited by 10
Abstract
Background: In modern, urban daily life, natural environments are increasingly recognized as an important resource for stress recovery and general well-being. Aim: the present review aims to provide an overview and synthesis of the past eight years’ research into the psycho-physiological effects of [...] Read more.
Background: In modern, urban daily life, natural environments are increasingly recognized as an important resource for stress recovery and general well-being. Aim: the present review aims to provide an overview and synthesis of the past eight years’ research into the psycho-physiological effects of outdoor nature-based interventions, related to stress recovery. Method: a structured search was performed in seven databases, returning 5618 articles. Removal of duplicates and initial screening gave a total of 95 studies. After full text reading, 36 studies were included in the assessment. Results: most of the psychological outcomes were related to different emotional measures. The synthesis of the results points towards outdoor, nature-based exposure having a positive effect on different emotional parameters, related to stress relief. The studies into physiological measures showed more equivocal results. Conclusion: the research, conducted over the past eight years, into outdoor, nature-based exposure has now attained a sound evidence base for psychological and especially emotional effects, but the evidence base for physiological effects within this timeframe shows a great degree of heterogeneity. Limitations: interpretation of the results is limited by the review only covering the past eight years’ research on the subject. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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Open AccessProtocol
The Wildman Programme. A Nature-Based Rehabilitation Programme Enhancing Quality of Life for Men on Long-Term Sick Leave: Study Protocol for a Matched Controlled Study In Denmark
Int. J. Environ. Res. Public Health 2020, 17(10), 3368; https://doi.org/10.3390/ijerph17103368 - 12 May 2020
Abstract
Many men have poor mental health and need help to recover. However, designing a rehabilitation intervention that appeals to men is challenging. This study protocol aims to describe the ‘Wildman Programme’, which will be a nature-based rehabilitation programme for men on long-term sick [...] Read more.
Many men have poor mental health and need help to recover. However, designing a rehabilitation intervention that appeals to men is challenging. This study protocol aims to describe the ‘Wildman Programme’, which will be a nature-based rehabilitation programme for men on long-term sick leave due to health problems such as stress, anxiety, depression, post-cancer and chronic cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, or diabetes type II. The programme will be a nature-based rehabilitation initiative combining nature experiences, attention training, body awareness training, and supporting community spirit. The aim of the study will be to examine whether the ‘Wildman Programme’ can help to increase quality of life and reduce stress among men with health problems compared to treatment as usual. The study will be a matched control study where an intervention group (number of respondents, N = 52) participating in a 12-week nature-based intervention will be compared to a control group (N = 52) receiving treatment as usual. Outcomes are measured at baseline (T1), post-treatment (T2), and at follow up 6 months post-intervention (T3). The results of this study will be important to state whether the method in the ‘Wildman Programme’ can be implemented as a rehabilitation offer in the Danish Healthcare System to help men with different health problems. Full article
(This article belongs to the Special Issue Nature-Based Therapies and Human Health)
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