Nature Exposure for Mental Health

Recruiting at 8 trial locations

Overseen By Angela M Resseguie, EdD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Michigan State University

Disqualifiers: Not undergraduate, Age, Distance

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

1500 Participants Needed

Trial Summary

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}

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.

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

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

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

Who Is Running the Clinical Trial?

Michigan State University

Lead Sponsor

Trials

202

Recruited

687,000+

University of Virginia

Collaborator

Trials

802

Recruited

1,342,000+

Cleveland State University

Collaborator

Trials

14

Recruited

3,500+

University of Maryland

Collaborator

Trials

171

Recruited

325,000+

Clemson University

Collaborator

Trials

38

Recruited

8,200+

University of Maryland Eastern Shore

Collaborator

Trials

2

Recruited

1,500+

Morgan State University

Collaborator

Trials

7

Recruited

5,600+

University of New Mexico

Collaborator

Trials

393

Recruited

3,526,000+

North Carolina Agricultural and Technical University

Collaborator

Trials

1

Recruited

1,500+

REI Cooperative Action Fund

Collaborator

Trials

2

Recruited

1,600+

Findings from Research

Nature-based interventions (NBIs), such as gardening and green exercise, significantly improve mental health outcomes in adults, including reducing depressive mood and anxiety, based on a systematic review of 50 studies involving various formats and durations.

The most effective NBIs were conducted over 8 to 12 weeks, with sessions lasting between 20 to 90 minutes, indicating a structured approach is key to maximizing their benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. Coventry, PA., Brown, JE., Pervin, J., et al.[2021]

Green social prescribing, which involves nature-based activities, has been shown to improve biopsychosocial wellbeing in community-living adults with mental illness, based on a review of 6 studies involving 334 participants.

Despite the variability in study designs and participant demographics, all studies indicated positive outcomes, suggesting that nature therapy could be a valuable intervention for mental health, warranting further research and standardized practices.

NCBI (Pubmed)

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. Thomas, T., Aggar, C., Baker, J., et al.[2023]

Engaging with natural environments can significantly enhance health and well-being, suggesting a potential benefit for mental healthcare practices.

Targeted nature-based interventions, known as green care, could be tailored to meet individual recovery needs, paving the way for further research to identify the most effective strategies for different populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Green care in psychiatry. Cuthbert, S., Kellas, A., Page, LA.[2021]

A brief 6-minute exposure to a virtual woodland nature video significantly improved mental wellbeing in adolescents, enhancing self-reported outcomes like stress reduction, relaxation, and mood compared to a busy train journey.

The study suggests that virtual nature interventions are feasible and acceptable, making them a promising option for mental health support, especially for those with limited access to real nature or time constraints.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of brief exposure to virtual nature on mental wellbeing in adolescents. Owens, M., Bunce, H.[2023]

A nine-month study using semi-structured surveys revealed that nature-based therapy groups in a psychiatric inpatient setting enhanced patients' sensory experiences, social interactions, and self-care practices.

Patients reported various benefits from engaging with nature, leading to a deeper understanding of how these activities positively impact mental health, which supports the development of a theoretical model for nature-based programming in mental health care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nature-based Group Therapy Reflections: A Grounded Theory Study. Carlson, K., Kingsley, J., Strimaitis, C., et al.[2021]

Nature-based interventions for mental health are gaining popularity in the UK, with increasing evidence supporting their effectiveness.

The 'A Dose of Nature' project highlights key factors that contribute to the success of these interventions, suggesting a structured approach can enhance their impact on mental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What makes nature-based interventions for mental health successful? Bloomfield, D.[2020]

A study involving 11 mental health service users and a survey of 1791 participants found that spending time in green and blue spaces significantly improves mental wellbeing, especially for those with mental health issues.

Barriers such as safety concerns, social anxiety, and lack of motivation hinder outdoor access for individuals with mental health problems, highlighting the need for public mental health interventions that address these challenges.

NCBI (Pubmed)

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. McCartan, C., Davidson, G., Bradley, L., et al.[2023]

References

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

Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. [2021]

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]

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

Green care in psychiatry. [2021]

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

The effect of brief exposure to virtual nature on mental wellbeing in adolescents. [2023]

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

Nature-based Group Therapy Reflections: A Grounded Theory Study. [2021]

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

What makes nature-based interventions for mental health successful? [2020]

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]