Self-reported participation in outdoor and nature-based recreation before and during the COVID-19 pandemic supports psychological health and well-being

Nature exposure and mental health during the COVID-19 pandemic: A Navigation Guide systematic review with meta-analysis

Prior reviews have highlighted that nature exposure was a valuable coping strategy enhancing mental health during the COVID-19 pandemic. However, no existing reviews have determined the quality of evidence and risk of bias of the empirical studies supporting this claim. To address this gap, we employed a Navigation Guide systematic review and meta-analysis approach to investigate associations between nature exposure and mental health during the pandemic. Searches in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo retrieved relevant articles published between January 1, 2020, and March 4, 2024. We used the Navigation Guide methodology to assess the risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessments to evaluate the overall quality of evidence. Our search retrieved 113 studies that met the inclusion criteria and reported diverse types of exposure, including nature availability, nature visit frequency, green space accessibility, and green space type, alongside associations with 12 mental health outcomes. Meta-analyses found access to gardens was associated with lower odds of depression [(Pooled odds ratio [OR] = 0.71, 95%CI = 0.61, 0.82), I2 = 0%, n = 3] and anxiety [(Pooled OR = 0.73, 95%CI = 0.63, 0.84), I2 = 0%, n = 3]. Increased time in green spaces was associated with lower level of stress [(Pooled Corr = -0.11, 95%CI = -0.17, -0.05), I2 = 0%, n = 2]. Higher frequency of visits to nature was associated with improved mental well-being [(Pooled standardized beta = 0.10, 95%CI = 0.07, 0.14), I2 = 0%, n = 2] and general mental health [(Pooled standardized beta = 0.11, 95%CI = 0.03-0.38), I2 = 82%, n = 2]. However, the number of pooled studies was small and the overall quality of evidence was "very low" for all outcomes, and high levels of bias were observed (26% of studies had high, 71% probably high). Nonetheless, given the trends in the results, nature-based solutions emphasizing exposure to gardens and green spaces near the home may have promoted psychological resilience during this public health crisis.

Preferences for woodland activities and forest features as predictors of well-being after forest visits: Evidence from a nationally representative survey in Slovakia

The link between subjective well-being (SWB) and forest visits is increasingly driving the development and preservation of restorative forest environments in numerous countries. However, there is limited knowledge regarding the effect of people's preferences for forest patterns and activities on this connection. Here we investigated whether associations exist between the preferences for certain forest features and activities, and the SWB increase and stress reduction in response to forest visits. A nationwide digital survey was administered to a representative sample of the Slovak population. The recollection-based data obtained from one thousand respondents were analysed through agglomerative clustering and ordinal regression. The analyses revealed that improved SWB and stress reduction were associated with preferences for uneven-aged forests, forest smell, as well as recreational, but not provisioning forest activities. The respective interrelationships explained up to 20% of SWB increase and stress reduction after forest visits. The results suggest that recollection-based study findings can be generalized for real-world forests and that forest management can contribute to the well-being of forest visitors by shaping the diversity of woodlands and their sensory experiences.

Green and blue spaces, COVID-19 lockdowns, and mental health: An Australian population-based longitudinal analysis

Australia experienced some of the world's longest and most stringent lockdowns during the COVID-19 pandemic. While lockdown measures had consequences for mental health, investigation is lacking on the potential for green and blue space coverage within people's local environments to ameliorate the impact of lockdowns with varied lengths using longitudinal cohorts. This study examined the impact of lockdown durations on population mental health and tests the effect modification of neighbourhood green and inland and coastal blue space coverage in metropolitan areas. We merged population-based longitudinal data on more than 11,000 individuals collected over a ten-year period from 2012 to 2021 with national land use data describing green and blue space coverage. We used fixed effect models to estimate the relationship between lockdowns (with different durations and staggered introduction) and mental health, controlling for sociodemographic, health, and geographical confounders, and tested the significance of effect modification of green and blue space. Results show that extended lockdowns led to considerably larger decreases in mental health (COVID-y1: -2.66, 95%CI: -3.43, -1.89; COVID-y2: -2.65, 95%CI: -3.33, -1.97) relative to short lockdowns. The mental health effect of lockdowns was smaller where green spaces and inland and coastal blue spaces were available. Effect modification was statistically significant for green space, with smaller negative mental health effects observed where there was sizeable green space coverage, particularly during long lockdowns (COVID-y1: -2.69, 95%CI: -3.63, -1.76 for coverage <5%; -3.27, 95%CI: -4.70, -1.84 for coverage 5%-10%; -0.60, 95%CI: -2.03, 0.83 for coverage ≥30%; COVID-y2: -2.74, 95%CI: -3.62, -1.87 for coverage <5%, -2.95, 95%CI: -3.98, -1.92 for coverage 5%-10%; -2.08, 95%CI: -3.28, -0.88 for coverage ≥30%). Findings support the consideration of nature exposure to improve people's mental wellbeing and resilience when designing lockdown measures in response to future public health emergencies.

Increased appreciation of forests and their restorative effects during the COVID-19 pandemic

Public expectations of forests as high-quality restorative environments that facilitate subjective well-being and stress relief along with numerous health benefits have been rising sharply during recent decades. In addition, the COVID-19 pandemic and its accompanying restrictive measures also transformed forests into some of the few places to spend time away from home. The presented study drew on the assumption that the pandemic situation and a rise in the number of forest visits would affect the experience, recognition, and appreciation of the well-being aspects related to spending time in forests. The study goal was to elucidate the potential effects of the COVID-19 pandemic on the relationships between forest visits, well-being and stress relief, emotions, perception of nature and forest value and importance, pro-environmental behavior, and societal expectations of the role of forests and forest ecosystem services. A survey using a digital questionnaire was conducted several months after the pandemic outbreak on a representative sample of the Slovak population. The Wilcoxon test and ordinal regression analysis were used to identify significant relationships, e.g., between the recency of anger episodes and the number of forest visits. The results showed that the pandemic strengthened the perception of forests as a high-quality restorative environment and that emotions associated with forest visits played an important role in the perceived importance of forests and their possible overexploitation. The results underscore the urgent need to put demands for forest recreation on par with the forest bioeconomy and to sensitize forest visitors to management and conservation requirements.

Negotiating Complexity: Challenges to Implementing Community-Led Nature-Based Solutions in England Pre- and Post-COVID-19

Nature-based solutions (NbS), including green social prescribing (GSP), are sustainable ways to address health and wellbeing, especially since the COVID-19 pandemic exacerbated the strain on healthcare. NbS require national and local cross-sector coordination across complex, interrelated systems, but little is known about the specific challenges this poses for community-led NbS. We carried out a traditional literature review to establish the context and knowledge base for this study and interviewed 26 stakeholders. These came from environment, health and social care sectors at national and local levels, with local-level stakeholders from Bradford and Walsall: English cities significantly affected by the pandemic, with high levels of deprivation and health inequality. The interviews explored experiences of implementing NbS, both pre- and post-pandemic and the resulting renewed interest in the salutogenic effects of engaging with natural environments. We coded the interview transcriptions using NVivo to identify the challenges existing in the systems within which these stakeholders operate to create and manage NbS. By synthesizing what is known about the challenges from existing literature with findings from the interviews, we developed eight categories of challenges (perception and knowledge, political, financial, access to natural spaces, engagement, institutional and organisational, coordination, GSP referral and services) faced by multiple sectors in implementing community-led NbS in England. Furthermore, this study highlights the new challenges related to the pandemic. Identifying these challenges helps stakeholders in existing complex systems recognise what is needed to support and mainstream NbS in England.

Urban greenspace and anxiety symptoms during the COVID-19 pandemic: A 20-month follow up of 19,848 participants in England

This study examined the association between greenspace and the growth trajectories of anxiety symptoms during the COVID-19 pandemic. Using data from 19,848 urban residents in England who were followed for 20 months between March 2020 and October 2021, we found that living in an area with higher greenspace coverage (exposure) was associated with fewer anxiety symptoms independent of population density, area deprivation levels, socio-demographics, and health profiles. There was limited evidence that greenspace was related to the change of anxiety symptoms over time. No association with anxiety trajectories was found when considering distance to nearest greenspace (proximity), highlighting potentially differential mental health effects of simply having access to local parks and recreation areas versus living in areas of greater natural environment land cover. These findings have important implications for mental health intervention and policymaking.