Exploring the Facilitators of the Gerotranscendence Theory: Correlations among Sustainable Behaviors, Biophilic Design, and Nature Connectedness

Aim: This study aims to shift views away from negative perceptions towards aging by exploring the following research question: How are the multiple levels of the gerotranscendence theory influenced by the sustainable behavior and attitude toward the biophilic design of older adults? Background: Improving perceptions of aging is vital for positively impacting both the biological and societal aspects of the global aging phenomenon. Methods: The study utilized a mixed-method design. Initially, 300 older Turkish adults completed self-reported measures including the Gerotranscendence Scale (GS), Pro-environmental Behavior (PB), Environmental Identity Scale (EID), Biophilic Design Importance Level (BDI), and Inclusion of Nature in the Self Scale (INS). Subsequently, the second phase involved diary logs from 30 participants who volunteered during the initial phase. Results: Results indicated that a higher importance level placed on biophilic design was linked to a greater inclusion of nature in the self. Moreover, a stronger interest in nature correlated positively with the gerotranscendence experience. Conclusions: The results bring significant attention to biophilic design, especially its relevance in supporting sustainable environmental behaviors and positive aging.

A Mixed Methods Approach to Understanding the Public Health Impact of a School-Based Citizen Science Program to Reduce Arsenic in Private Well Water

BACKGROUND

Exposure to arsenic (As) in well water is a well-documented public health issue for Maine and New Hampshire, as well as for other states in the United States and abroad. Arsenic contamination of well water in these locations is primarily attributed to metasedimentary bedrock that leaches As into groundwater. However, As can also enter groundwater reserves from soils contaminated by the historical use of arsenical pesticides. Approximately half of the households in Maine and New Hampshire rely on private wells, many of which have elevated As. Arsenic exposure has been associated with an increased risk of cancer, cardiovascular disease, reduced infection resistance, and lower intelligence quotient in children. Despite these known health impacts, well water testing and treatment are not universal.

OBJECTIVES

We have approached the problem of low well water testing rates in Maine and New Hampshire communities by developing the All About Arsenic (AAA) project, which engages secondary school teachers and students as citizen scientists in collecting well water samples for analysis of As and other toxic metals and supports their outreach efforts to their communities.

METHODS

We assessed this project's public health impact by analyzing student data relative to existing well water quality datasets in both states. In addition, we surveyed private well owners who contributed well water samples to the project to determine the actions taken to mitigate As in well water.

RESULTS

Students collected 3,070 drinking water samples for metals testing, and 752 exceeded New Hampshire's As standard of 5  ppb . The AAA data has more than doubled the amount of information available to public health agencies about well water quality in multiple municipalities across both states. Students also collected information about well types and treatment systems. Their data reveal that some homeowners did not know what type of wells they had or whether they had filtration systems. Those with filtration systems were often unaware of the type of system, what the system was filtering for, or whether the system was designed to remove As. Through interviews with pilot survey participants, we learned that some had begun mitigating their exposure to As and other toxic metals in response to test results from the AAA project.

DISCUSSION

A school-based approach to collecting and analyzing private well water samples can successfully reach communities with low testing rates for toxic elements, such as As and other metals. Importantly, information generated through the program can impact household decision-making, and students can influence local and state policymaking by sharing information in their communities. https://doi.org/10.1289/EHP13421.

Associations of nature contact with emotional ill-being and well-being: the role of emotion regulation

Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation.

There's no place like dorm: actual-ideal dorm ambiance as a unique predictor of undergraduate mental health

ABSTRACTUndergraduate students are a high risk population for mental health challenges. Critically, residing in a setting that fails to evoke desired emotions and perceptions may have important implications for psychological wellbeing. Although previous research has investigated the relationship between student satisfaction and architecture/building amenities, little research has investigated how the ambiance of students' residences relates to mental health. Across a pair of studies, we evaluate the relationship between actual-ideal ambiance congruency (A-IAC) and mental health outcomes and mood. In Study 1, participants completed a pair of Q-sort tasks that required them to describe both their ideal room ambiance and their current room's actual ambiance. The discrepancy between these sorts was predictive of depressive symptoms, even when controlling for key covariates (e.g., personality, health, academics). In Study 2, these results were replicated among roommate pairs using dyadic analyses, while also being predictive of anxiety symptoms. Collectively, these studies reveal a novel environmental predictor of student wellbeing that can be of value for university staff. Ultimately, these findings suggest that having the ability to create one's ideal space may prove to be beneficial and possibly protective for the mental health of undergraduate university students.

The relationship between urban greenspace perception and use within the adolescent population: A focused ethnography

INTRODUCTION

Greenspace is beneficial for improving adolescent mental health, yet healthcare professionals still do not understand the connection between the built environment and subjective mental well-being. We also need to understand how this population uses greenspace and how they feel when in it.

AIM

The aim of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace and to explore how they feel when they are in greenspace.

DESIGN

Focused ethnography.

METHODS

Data were collected between June 2022 and August 2022 using participant observation, photo elicitation and semi-structured interviews. Braun and Clarke's (2006) six phases of thematic analysis were used to guide data collection and analysis.

RESULTS

A total of 11 adolescents between ages 12 and 18 who resided in and around Newark, NJ, were recruited. Three themes were identified from the data: (1) A tranquil space in an unsafe place; (2) Park means family connection with burgeoning independence; and (3) My park: Sense of ownership and responsibility.

CONCLUSIONS

This study deepens the understanding between subjective mental well-being and urban greenspace exposure. Adolescents accepted responsibility for maintaining "my park", which strengthens community cohesion, detailing the importance of youth input during urban planning.

IMPLICATIONS FOR PRACTICE

Implications from this study suggest that environmental interventions may help ameliorate an ongoing mental health care crisis among adolescents. Healthcare providers should consider the built environment as another approach to promoting mental health.

PATIENT OR PUBLIC CONTRIBUTION

None other than research participants.

Nature and human well-being: The olfactory pathway

The world is undergoing massive atmospheric and ecological change, driving unprecedented challenges to human well-being. Olfaction is a key sensory system through which these impacts occur. The sense of smell influences quality of and satisfaction with life, emotion, emotion regulation, cognitive function, social interactions, dietary choices, stress, and depressive symptoms. Exposures via the olfactory pathway can also lead to (anti-)inflammatory outcomes. Increased understanding is needed regarding the ways in which odorants generated by nature (i.e., natural olfactory environments) affect human well-being. With perspectives from a range of health, social, and natural sciences, we provide an overview of this unique sensory system, four consensus statements regarding olfaction and the environment, and a conceptual framework that integrates the olfactory pathway into an understanding of the effects of natural environments on human well-being. We then discuss how this framework can contribute to better accounting of the impacts of policy and land-use decision-making on natural olfactory environments and, in turn, on planetary health.

Susceptibility to stress and nature exposure: Unveiling differential susceptibility to physical environments; a randomized controlled trial

BACKGROUND

Emerging epidemiological evidence indicates nature exposure could be associated with greater health benefits among groups in lower versus higher socioeconomic positions. One possible mechanism underpinning this evidence is described by our framework: (susceptibility) adults in low socioeconomic positions face higher exposure to persistent psychosocial stressors in early life, inducing a pro-inflammatory phenotype as a lifelong susceptibility to stress; (differential susceptibility) susceptible adults are more sensitive to the health risks of adverse (stress-promoting) environments, but also to the health benefits of protective (stress-buffering) environments.

OBJECTIVE

Experimental investigation of a pro-inflammatory phenotype as a mechanism facilitating greater stress recovery from nature exposure.

METHODS

We determined differences in stress recovery (via heart rate variability) caused by exposure to a nature or office virtual reality environment (10 min) after an acute stressor among 64 healthy college-age males with varying levels of susceptibility (socioeconomic status, early life stress, and a pro-inflammatory state [inflammatory reactivity and glucocorticoid resistance to an in vitro bacterial challenge]).

RESULTS

Findings for inflammatory reactivity and glucocorticoid resistance were modest but consistently trended towards better recovery in the nature condition. Differences in recovery were not observed for socioeconomic status or early life stress.

DISCUSSION

Among healthy college-age males, we observed expected trends according to their differential susceptibility when assessed as inflammatory reactivity and glucocorticoid resistance, suggesting these biological correlates of susceptibility could be more proximal indicators than self-reported assessments of socioeconomic status and early life stress. If future research in more diverse populations aligns with these trends, this could support an alternative conceptualization of susceptibility as increased environmental sensitivity, reflecting heightened responses to adverse, but also protective environments. With this knowledge, future investigators could examine how individual differences in environmental sensitivity could provide an opportunity for those who are the most susceptible to experience the greatest health benefits from nature exposure.

Public nature and health for homeless populations: Professionals' perceptions of contingent human benefits and harms

This article investigates relationships between public nature and health for unsheltered homeless populations. It examines perceptions of health benefits and harms for people living in public natural areas including local, state, and national forests and parks in the Seattle metropolitan area (USA). Interviews with environmental, social service, and law enforcement professionals who regularly interact with this vulnerable population were conducted and thematically analyzed to understand perceptions of physical and mental health outcomes. Results show professionals' perspectives on the health benefits and detriments of time spent in natural environments and the contextual factors perceived to influence health. Interviewees' observations about the variability of personal circumstances and biophysical, social, and weather conditions encourage the nuanced consideration of how contingent therapeutic landscapes provide deeply needed benefits, but for a population with a diminished capacity to adapt when conditions change. We conclude with insights for future research that directly assesses homeless populations' exposures and health outcomes of living in public natural areas.

Contact with nature for emotion regulation: the roles of nature connectedness and beauty engagement in urban young adults

Contact with nature has emotional benefits, but the psychological mechanism and potential moderator underlying the association between nature contact and emotion regulation remain unclear. The present study investigated how self-reported frequency of nature contact is associated with the use of emotion regulation strategies and explored the mediating role of nature connectedness (i.e., psychological connection to nature) and the moderating role of engagement with natural beauty. Employing mediation and moderated mediation analyses, in a cross-sectional sample of 2097 young adults aged 18-35 years old (M = 24.01, SD = 4.80) residing in urban China, we obtained three major findings. First, nature connectedness mediated the associations between direct/indirect nature contact and cognitive reappraisal as well as expressive suppression. Second, engagement with natural beauty moderated the path from direct/indirect nature contact to cognitive reappraisal in the mediation models. Third, engagement with natural beauty moderated the path from indirect nature contact to nature connectedness in the mediation models. Our study is the first to reveal mediating and moderating factors in the relationships among direct/indirect contact with nature, nature connectedness, engagement with natural beauty, and emotion regulation strategies. These findings provide support for the emotional health of nature contact and have implications for nature-based education and urban planning.

Therapeutic Hospital Gardens: Literature Review and Working Definition

AIM

This review explores the role of purposefully designed and well-integrated therapeutic hospital gardens (THGs) for the benefits of patients, their families, and staff.

BACKGROUND

Significant benefits are realized when people are in contact with nature in the city. Although hospital gardens are prevalent and the beneficial effects of nature on health are widely acknowledged, the establishment of a consistent definition for hospital gardens that promote health is vital to attain reliable and quantifiable health outcomes.

METHODS

Twenty-eight peer-reviewed journals were critiqued for the period of 2016-2021 and updated with 12 articles from 2021 to 2023 to analyze and synthesize the latest thinking and development in this emergent field. Subsequently, current books and exemplar practice literature were synthesized with the results of the literature review to produce a working definition of THGs.

RESULTS

Three themes and 14 subthemes were established showing the interconnectedness of THG definition, user needs and experiences, and the benefits and values of THGs. Two original findings can be established-a need to have a consensus on terminology and to establish design processes. The working definition was produced as a foundational step to guide stakeholders in implementing THGs.

CONCLUSION

THGs can play a role in improving well-being when they are purposefully designed and well-integrated in hospital programs and health policy. Hospital CEOs, designers, and healthcare experts can use the findings and working definition to assist the establishment of such health promoting gardens.

Green sleep: Immediate residential greenspace and access to larger green areas are associated with better sleep quality, in a longitudinal population-based cohort

OBJECTIVE

Sleep is pivotal to health, wellbeing and functioning in daily life, but sleep difficulties are common and may be affected by modifiable qualities in the residential surrounding environment, in terms of greenspace. However, population-based studies on individual-level greenspace and sleep are limited. The objective of the current study was thus to investigate prospective associations between fine-grained individual-level residential greenspace and sleep, and moderating effects of life style (physical activity, work status) and sex, in a nationwide population-based Swedish cohort.

METHODS

Participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH)-a population-based sample of adults in Sweden-were studied during 2014-2018 (19,375 individuals; 43,062 observations). Residential greenspace land cover, and coherent green area size, were assessed via high resolution geographic information systems, at 50, 100, 300, 500 and 1000 m buffers around residences. Prospective greenspace and sleep associations were assessed via multilevel general linear models, adjusting for demographic, socioeconomic (individual and neighborhood), life style and urban factors.

RESULTS

Higher greenspace availability in the immediate residential surroundings (50 m and 100 m buffer zones) was associated with less sleep difficulties, even after adjustment for confounders. Greenspace effects were generally greater among non-working individuals. Among the physically active, and among non-working, greenspace and green area size further away from home (300, 500 and 1000 m, i.e. dependent on mobility) were also associated with less sleep difficulties.

CONCLUSIONS

Residential greenspace in the immediate residential surroundings is associated with significantly less sleep difficulties. Greenspace further away from home was associated with better sleep especially among the physically active, and non-working individuals. The results highlight the importance of greenspace in the immediate residential-surrounding environment for sleep, and the need to integrate health and environmental policies, urban planning and greening.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Resurrecting Gaia: harnessing the Free Energy Principle to preserve life as we know it

This paper applies the Free Energy Principle (FEP) to propose that the lack of action in response to the global ecological crisis should be considered a maladaptive symptom of human activity that we refer to as biophilia deficiency syndrome. The paper is organised into four parts: the characterisation of the natural world under the Gaia Hypothesis, the employment of the FEP as a description of the behavior of self-organising systems, the application of the FEP to Gaia to understand coupling dynamics between living systems and purportedly non-living planetary processes, and the offering of positive interventions for addressing the current state of ecological crisis under this framework. For the latter, we emphasize the importance of perturbing stuck states for healthy development, and the necessary appreciation of life existing as nested systems at multiple levels in a hierarchy. We propose the development of human biophilia virtue in accordance with the FEP as a practical intervention for treating biophilia deficiency syndrome and helping to safeguard the balance of planetary processes and the integrity of living systems that depend on them, offering some examples of what this might look like in practice. Overall, this paper provides novel insights into how to catalyse meaningful ecological change, proposing a deliberate and disruptive approach to addressing the dysfunctional relationship between humans and the rest of the natural world.

Emotion regulation and virtual nature: cognitive reappraisal as an individual-level moderator for impacts on subjective vitality

People who make habitual use of an emotion regulation strategy such as cognitive reappraisal may be more sensitive to the emotion cues coming from a surrounding natural environment and, thus, get more benefits from virtual nature exposure such as enhanced subjective vitality. However, no previous study investigated the moderating role of cognitive reappraisal in the relationship between exposure to different types of natural environments (a national park, a lacustrine environment, and an arctic environment vs. an urban environment) and subjective vitality. We designed a between-subject design (four conditions, one per type of environment) with a sample of 187 university students (M_age = 21.17, SD = 2.55). Participants were exposed to four 360° panoramic photos of the environment for one minute each with a virtual reality head-mounted display. The results of a multicategorical moderation analysis attested that there were two significant interactions, respectively between lacustrine and arctic environments and cognitive reappraisal. More specifically, for participants with low levels of habitual use of cognitive reappraisal, the effects of virtual nature (vs. urban) exposure on subjective vitality were not significant, while for participants with high levels, the effects were significant and positive. Findings show how the potential of virtual nature may be boosted with training aimed at increasing the general use of cognitive reappraisal, supports enhancing the applications of virtual nature, and demonstrates the need to take individual differences into account when determining the benefits of these applications.

Applying an ecosystem services framework on nature and mental health to recreational blue space visits across 18 countries

The effects of 'nature' on mental health and subjective well-being have yet to be consistently integrated into ecosystem service models and frameworks. To address this gap, we used data on subjective mental well-being from an 18-country survey to test a conceptual model integrating mental health with ecosystem services, initially proposed by Bratman et al. We analysed a range of individual and contextual factors in the context of 14,998 recreational visits to blue spaces, outdoor environments which prominently feature water. Consistent with the conceptual model, subjective mental well-being outcomes were dependent upon on a complex interplay of environmental type and quality, visit characteristics, and individual factors. These results have implications for public health and environmental management, as they may help identify the bluespace locations, environmental features, and key activities, that are most likely to impact well-being, but also potentially affect recreational demand on fragile aquatic ecosystems.

The impact of a values affirmation intervention on body dissatisfaction and negative mood in women exposed to fitspiration

Fitspiration (fitness inspiration) exposure on Instagram has been associated with body dissatisfaction, but minimal research has investigated interventions to protect against its negative effects. Values affirmation interventions, in which individuals reflect on a higher value to affirm their sense of personal worth, could be helpful in this context. This online study's aim was to examine the impact of a values affirmation intervention on body dissatisfaction and negative mood in women exposed to fitspiration images from Instagram. Participants consisted of 238 female college students (Age M = 19.89, SD = 1.25) in the U.S. who were randomized into three groups: Values Affirmation Intervention + Fitspiration (described importance of top value and viewed fitspiration images), Control Intervention + Fitspiration (described their daily activities and viewed fitspiration images), and Travel (control-viewed travel images only). State body dissatisfaction and negative mood were completed pre- and post-exposure for all groups. Body dissatisfaction and negative mood significantly increased in the Control Intervention + Fitspiration, did not change in the Values Affirmation Intervention + Fitspiration group, and decreased in the Travel group from pre-exposure to post-exposure. These findings suggest that a values affirmation intervention could partially protect college women from the negative effects of fitspiration exposure.

Group Nature-Based Mindfulness Interventions: Nature-Based Mindfulness Training for College Students with Anxiety

The mental health crisis across college campuses is accelerating, with anxiety listed as the top mental health issue for undergraduate college students. Although evidence suggests the COVID-19 pandemic escalated the mental health crisis on college campuses, pre-COVID-19 anxiety among college students was on the rise. Research supports Mindfulness Based Interventions (MBIs) to reduce anxiety among college students. Additionally, exposure to natural environments, which are accessible to students on college campuses, is effective in reducing anxiety. While brief nature-based mindfulness interventions appear effective in reducing anxiety among college students, these interventions are often offered in isolation without social interaction among group members and lack intentional integration of mindfulness and nature-related theories. The purpose of this work is to describe a framework for integrating the use of Mindfulness and Attention Restoration Theory (ART) in an innovative psychoeducational group intervention, Nature-Based Mindfulness Training © (NBMT), for college students with anxiety. In conclusion, we argue for the need to intentionally integrate mindfulness and nature into nature-based mindfulness interventions as an effective and sustainable means to reduce anxiety. Limitations and areas for future research are described.

The Effects of Natural Sounds and Proxemic Distances on the Perception of a Noisy Domestic Flying Robot

When flying robots are used in close-range interaction with humans, the noise they generate, also called consequential sound, is a critical parameter for user acceptance. We conjecture that there is a benefit in adding natural sounds to noisy domestic drones. To test our hypothesis experimentally, we carried out a mixed-methods research study (N=56) on reported user perception of a sonified domestic flying robot with three sound conditions at three distances. The natural sounds studied were respectively added to the robot’s inherent noises during flying; namely a bird song and a rain sound, plus a control condition of no added sound. The distances studied were set according to proxemics; namely near , middle , and far . Our results show that adding bird song or rain sound affects the participants’ perceptions, and the proxemic distances play a nonnegligible role. For instance, we found that participants liked the bird condition the most when the drone was at far , while they disliked the same sound the most when at near . We also found that participants’ perceptions strongly depended on their associations and interpretations deriving from previous experience. We derived six concrete design recommendations.

A Systematic Review and Conceptual Framework of Biophilic Design Parameters in Clinical Environments

OBJECTIVES

To provide a live-experience knowledge base about biophilic design parameters and environmental features to inform policy and design in clinical therapeutic environments.

BACKGROUND

It is increasingly important to review hospital design to make the best use of the affordances of natural elements in supporting both patients' and staff's physical and psychological well-being. The biophilic design theory provides an appropriate design approach. However, current biophilic design frameworks fail to provide efficiently standardized guidance. This systematic review aims to examine the experience of hospital users (patients and staff) with a view to informing a standardized biophilic design framework to improve future design in this context.

METHODS

This study performed a review and synthesis of nine studies identified using systematic procedures focusing on biophilic design features in healthcare environments.

RESULTS

The study identified a selection of biophilic parameters specifically relevant to this building typology, according to three different user groups: outpatients (fresh air, light-daylight, thermal comfort, welcoming and relaxing), inpatients (feeling relaxed and comfortable, prospect refuge, security and protection, light-daylight, view), and staff (privacy-refuge, quietness).

CONCLUSIONS

The systematically identified studies helped to identify and rank the biophilic design parameters that appear the most critical for promoting and supporting human health and well-being in clinical therapeutic environments from the user's perspective. It also provides an up-to-date compilation of crucial design interventions related to biophilic parameters and as such provides benchmark information for future research and design guidance in these environments.

The effects of walking in nature on negative and positive affect in adult psychiatric outpatients with major depressive disorder: A randomized-controlled study

BACKGROUND

While walking in nature has been shown to improve affect in adults from the community to a greater extent than walking in urban settings, it is unknown whether such benefits apply to individuals suffering from depression. Using a parallel group design, this randomized controlled trial examined the effects of a single walk in nature versus urban settings on negative and positive affect in adult psychiatric outpatients diagnosed with major depressive disorder (MDD).

METHOD

Participants recruited from a psychiatric outpatient clinic for adults with MDD were randomly assigned to a nature or urban walk condition. Thirty-seven adults (mean age = 49 years) completed a single 60-minute walk. Negative and positive affect were assessed using The Positive and Negative Affect Schedule or PANAS at 6 time points: before the walk, halfway during the walk, immediately post-walk, at home before bedtime, 24 h post-walk, and 48 h post-walk.

RESULTS

Controlling for baseline levels of affect before the walk, individuals who walked in nature experienced overall lower levels of negative affect, F(1, 35.039) = 4.239, p = .047, compared to those who walked in urban settings. Positive affect did not differ across walk conditions.

LIMITATIONS

The generalizability of results are limited by the small sample size and the presence of more female than male participants.

CONCLUSIONS

Walking in nature might be a useful strategy to improve negative affect in adults with MDD. Future research should investigate different ways to integrate the beneficial effects of nature exposure into existing treatment plans for psychiatric outpatients with MDD.

The Impact of a Woodland Walk on Body Image: A Field Experiment and an Assessment of Dispositional and Environmental Determinants

Studies have shown that nature exposure is associated with a more positive body image, but field studies remain relatively infrequent. Here, we examine the impact of a woodland walk on an index of state positive body image (i.e., state body appreciation), as well as dispositional and environmental determinants of body image improvements. Eighty-seven Polish women went for a walk in Cygański Las, an ancient woodland, and completed a measure of state body appreciation before and after the walk. As hypothesised, state body appreciation was significantly higher post-walk compared to pre-walk (d = 0.56). Additionally, we found that the trait of self-compassion-but not the traits of connectedness to nature, perceived aesthetic qualities of the woodland, or subjective restoration-was significantly associated with larger improvements in state body appreciation. These results suggest that even relatively brief exposure to nature results in elevated state body appreciation, with the dispositional trait of self-compassion being associated with larger effects.

An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain

Chronic pain results from a complex series of biomechanical, inflammatory, neurological, psychological, social, and environmental mechanisms. Pain and pain-related diseases are the leading causes of disability and disease burden globally. Employing nature-based interventions for the treatment of pain is an emerging field. Current theory driving the suggested mechanism(s) linking the pain reducing effects of nature-based interventions is lacking. A two-step approach was taken to complete a theoretical review and analysis. First, a literature review was completed to gather a substantive amount of research related to theoretical frameworks on the topic of nature-based interventions and pain. Secondly, a theoretical analysis as proposed by Walker and Avant was completed to explore current theoretical frameworks accepted in the literature on nature-based interventions and pain. Stress reduction theory and attention restoration theory were the most common theoretical frameworks identified. Neither theoretical framework explicitly identifies, describes, or intends to adequately measure the concept of pain, revealing a limitation for their application in research with nature-based interventions and pain. Theoretical development is needed, as it pertains to nature-based interventions and pain. Without this development, research on nature-based interventions and pain will continue to use proxy concepts for measurement and may result in misrepresented findings.

A Systematic Review of Mechanisms Underpinning Psychological Change Following Nature Exposure in an Adolescent Population

This systematic review aimed to identify mechanisms of psychological change following exposure to nature within an adolescent population. Keyword searches within Scopus, PsychINFO and Web of Science were carried out to include articles published by 14 September 2021. Records were reviewed in line with inclusion criteria: samples with an average age of 24 and under, exposure to nature vs. control using an experimental or quasi-experimental design and outcomes of mental health and psychological status. The review resulted in 27 papers that were assessed for methodological quality and manually searched for mediation analyses. A range of psychological outcomes were identified and grouped into 10 categories: Mood and Affect, Mental Health, Wellbeing, Perceived Restoration, Stress, Energy, Cognitive Functioning, Resilience, Self-Concept and Pro-Social Behaviour. Only one formal mediation analysis was reported, highlighting a mediating role of belonging in increases in resilience. Limitations include the majority use of university student samples and over half of the papers being of low methodological quality. No firm conclusions on key mechanisms in an adolescent population were made due to insufficient evidence of mediating variables. The development of methodologically rigorous experimental studies with the inclusion of statistical pathway modelling is needed to test and specify plausible mechanisms.

Connecting to Nature through 360° Videos during COVID-19 Confinement: A Pilot Study of a Brief Psychological Intervention

Psychological interventions have been shown to be beneficial in mitigating stress related to COVID-19 confinement. According to theories of restorative environments, exposure to natural surroundings has positive effects on well-being and stress through its restorative qualities. With 360° video-based Virtual Reality (VR), people can be exposed to nature and so better manage the consequences associated with mobility restrictions during confinement. The main aim of this pilot study was to examine whether a 360° video-based VR intervention composed of five 13-minute sessions (once a day) has positive effects on affect, well-being, and stress. The sample was made up of 10 participants (4 men and 6 women; age : M = 46.5, SD = 11.7) who were confined at home (voluntarily or not) during the COVID-19 pandemic. Participants were instructed to watch a 360° video each day (of a “beach” or “lake” environment) using their smartphone and VR glasses sent to them by mail. Participants responded with several self-reports before and/or after each session (emotions and sense of presence) and before and/or after the intervention (affect, well-being, perceived stress, perceived restorativeness of nature, and the usefulness and acceptability of the intervention). Results showed a tendency to improve positive (e.g., happiness) and negative (e.g., anxiousness) emotions and experience a high sense of presence after each session. Moreover, perceived restorative qualities of the environment and their cognitive and behavioral effects were high. A significant decrease in negative affect was found after the intervention. Usefulness and acceptability were also high. This is the first study to show that an affordable and accessible technology can be used to overcome the negative consequences of confinement and counteract its harmful psychological effects.

Visual post-occupancy evaluation of a restorative garden using virtual reality photography: Restoration, emotions, and behavior in older and younger people

Natural environments have a restorative effect from mental/attentional fatigue, prevent stress, and help to revitalize psychological and physical resources. These benefits are crucial for promoting active aging, which is particularly relevant given the phenomenon of population aging in recent decades. To be considered restorative, green spaces have to meet specific requirements in ecological and psychological terms that can be assessed through Post-Occupancy Evaluation (POE), a multimethod approach commonly used by environmental psychologists and landscape architects after construction to evaluate the design outcomes from the users’ perspective. Generally, POEs consist of surveys and/or interviews accompanied by more or less structured observations of onsite users’ behavior. Despite this, various practical constraints can prevent physical access to the renovated area (e.g., weather conditions, time/resources limits, health issues, bureaucratic constraints). Exploiting digital tools for such an assessment can be a crucial support in such circumstances. The current study presents the visual POE of a restorative garden for older adults in Milan, Italy. We developed a web application, that includes the exp-EIA© patented method, which allows participants to virtually explore a visual simulation of the environment and provide their feedback. We identified 3 representative viewpoints in the redeveloped garden differing from each other for the functions and the design principles that inspired the transformation. For each point of view, we created 360° Virtual Reality photographs, that can be navigated by looking around, i.e., panning, from the standing point of each view. In connection to each virtual scene, a survey was conducted (N = 321). The focus was the psychological experience related to each viewpoint, assessed with two psychometric scales investigating the constructs of emotions (pleasure and arousal) and restoration (fascination, being away, coherence, scope, and environmental preference); such information is integrated with behavioral aspects, including the main activities prefigured by participants and their visual exploration of the VR photography. The results of the virtual exploration show that the garden is perceived as restorative, with a more intense effect in a spot purposely designed. The emotions experienced in the garden are positive and a mild level of arousal is observed. The behavioral dimension is characterized by predominantly contemplative activities and contact with nature. A cartographic representation of the psychological and behavioral data is developed, to support the maintenance of the garden.

Effects of Restorative Environment and Presence on Anxiety and Depression Based on Interactive Virtual Reality Scenarios

Anxiety and depression have been growing global mental health problems. The following studies explored the effect of interactive VR scenarios to find a low-cost and high-efficiency solution. Study 1 designed a 2 (anxiety and depression state) × 4 (interactive VR scenarios) experiment, the results of 20 participants showed that the designed scenarios had good restoration and presence, assisting to improve depression mood for people with mild to moderate anxiety and depression. Study 2 further investigated the intervention effects of two environment types (urban and park) and four interactive activities (automatic viewing, free-roaming, fishing, and watering plants in the park environment), based on data from a 10-minute experiment conducted by 195 participants with mild to moderate anxiety and depression. The subjective scales, EEG and EMG, and scenario experience were analyzed and the results showed that: (1) the restorative and present VR scenarios were beneficial in alleviating state anxiety and depression; (2) the restorative environment and presence were significantly and positively related to the reduction of anxiety and depression respectively, moreover, presence mediated the restorative environment on the recovery from anxiety and depression; (3) the environmental settings, the complexity of interaction, human factors, and maturity of VR devices and technology were also key factors that influenced the effects of interactive VR scenario experience and intervention. These studies revealed VR psychological intervention scenarios could be designed with comprehensive factors. Moreover, they might help pave the way for future study in exploring the physiology and psychology mode in virtual and real spaces, enhancing intervention effectiveness.

Development and validation of self-efficacy and intention measures for spending time in nature

PURPOSE

The purpose of this study was to develop and evaluate the reliability and validity of self-efficacy and intentions measures for time spent in nature (TSN). TSN is related to improvement in psychological well-being and health, yet most American adults spend very little time in such settings. Theory-based interventions have been effective in increasing physical activity, a related behavior, and may be one mechanism to increase TSN. Self-efficacy and intentions have been shown to be strong predictors of health behaviors and are used across several theories. However, scales to measure these factors have not yet been developed and are needed to facilitate effective interventions.

METHODS

TSN self-efficacy and intentions scales were developed using a sequential nine-step procedure: identification of the domain and item generation; content validity; pre-testing of questions; sampling and survey administration; item reduction; extraction of factors; tests of dimensionality; tests of reliability; and tests of validity. The 14-member multidisciplinary, researcher and practitioner investigative team generated 50 unique items for self-efficacy and 24 unique items for intentions. After subjecting items to content validity and pre-testing, item sets were reduced to 21 assessing self-efficacy and nine assessing intentions. A nationwide sample of 2109 adult participants (49.7% female, Mean Age = 58.1; 59.8% White, 18.4% Hispanic, 13.3% Black) answered these items via an on-line survey.

RESULTS

Using split-half measures, principal components analysis indicated a one-factor solution for both scales. The factor structure was upheld in confirmatory factor analyses and had high internal consistency (α = .93 self-efficacy; .91 intentions). The scales were moderately correlated with each other (r = .56, p < .001) and were strongly related to TSN with large effect sizes (eta2 > .20).

CONCLUSIONS

The study resulted in reliable and valid self-efficacy (14 items) and intentions (8 items) scales that can be used to develop future theory-based interventions to increase TSN and thereby improve population health.

Developing a model linking self-reported nature exposure and positive body image: A study protocol for the body image in nature survey (BINS)

Exposure to natural environments has been shown to be associated with more positive body image, but much of the existing research is limited to Western European nations and little is known about the robustness of these associations in other national contexts. In this protocol paper, we present a conceptual model of the direct and indirect associations (i.e., via self-compassion, connectedness to nature, and restorative experiences in nature) between nature exposure and body appreciation. This model brings together conceptualisations from existing research, but also extends it in a number of important ways. The model will be tested through the Body Image in Nature Survey (BINS), a researcher-crowdsourced project involving researchers in multiple nations worldwide. Data collection began in December 2020 and is expected to be completed in February 2022. Data will be analysed to examine the extent to which our conceptual model is robust across nations, as well as other sociodemographic characteristics. We will also determine the extent to which key variables included in our survey are invariant across nations and associated with cultural, socioeconomic, and gender-related factors. The BINS will likely have important implications for the development of nature-based interventions to promote healthier body appreciation in diverse national contexts.

Use of the Natural Outdoor Environment in Different Populations in Europe in Relation to Access: Implications for Policy

This cross-cultural study explores the relationship of natural outdoor environment (NOE) use with NOE access. Most urban planning recommendations suggest optimal accessibility to be 300 m-500 m straight distance to spaces with vegetation of at least 1 hectare. Exploring this recommendation, we used data (n = 3947) from four European cities collected in the framework of the PHENOTYPE study: Barcelona (Spain), Doetinchem (The Netherlands), Kaunas (Lithuania) and Stoke-on-Trent (United Kingdom) to obtain residential access to NOE (straight or network distances, using 300 m and 150 m buffers, to NOE larger than 1 hectare or 0.5 hectare) and use of NOE (i.e., self-reported time spent in NOE). Poisson regression models were used to examine the associations between residential access and use of NOE. The models with the strongest association with time spent in NOE in the combined sample were for those living within 300 m straight line distance to either 0.5 ha or 1 ha NOE. Noting that the only indicator that was consistent across all individual cities was living with 150 m network buffer of NOE (of at least 1 ha), this warrants further exploration in reducing recommendations of 300 m straight-line distance to 150 m network distance to 1 ha of NOE for a general indicator for cities within Europe.

The Mediating Effect of Nature Restorativeness, Stress Level, and Nature Connectedness in the Association between Nature Exposure and Quality of Life

This study aimed to test the mediating effects of nature restorativeness, stress, and nature connectedness in the association between nature exposure and quality of life (QoL). Urban and rural Lithuanian inhabitants (n = 924; 73.6% were women), mean age of 40.0 ± 12.4 years (age range of 18–79) participated in the study. In total, 31% of the respondents lived in rural areas. Study participants completed an online survey form with measures on sociodemographic factors, nature proximity, nature exposure, nature connectedness, and nature restorativeness, stress, and QoL assessed by the abbreviated version of the World Health Organization’s Quality of Life Questionnaire’s (WHOQOL-BREF). Path analysis was conducted to test the mediating effects of nature restorativeness, stress, and nature connectedness in the model of nature exposure and QoL. Nature exposure was directly associated with a greater QoL (β = 0.14; B = 2.60; SE = 0.57; p < 0.001) and mediated the association between nature proximity and QoL. Nature restorativeness and lower stress levels were mediators between nature exposure and QoL. Nature connectedness was a mediator between nature exposure and QoL. A path model was invariant across genders and the urban and rural place of residence groups: patterns of loadings of the pathways were found to be similar. Nature restorativeness (β = 0.10–0.12; p < 0.01) had a positive effect on the psychological, physical, social, and environmental domains of QoL. Connectedness to nature positively predicted psychological (β = 0.079; p < 0.05) and environmental (β = 0.082; p < 0.05) domains of QoL. Enhancing nature exposure and nature connectedness might help strengthen QoL in urban and rural inhabitants.

What can we do when the smoke rolls in? An exploratory qualitative analysis of the impacts of rural wildfire smoke on mental health and wellbeing, and opportunities for adaptation

BACKGROUND

Extreme, prolonged wildfire smoke (WFS) events are becoming increasingly frequent phenomena across the Western United States. Rural communities, dependent on contributions of nature to people's quality of life, are particularly hard hit. While prior research has explored the physical health impacts of WFS exposure, little work has been done to assess WFS impacts on mental health and wellbeing, or potential adaptation solutions.

METHODS

Using qualitative methods, we explore the mental health and wellbeing impacts experienced by community members in a rural Washington State community that has been particularly hard hit by WFS in recent years, as well as individual, family, and community adaptation solutions. We conducted focus groups with residents and key informant interviews with local health and social service providers.

RESULTS

Participants identified a variety of negative mental health and wellbeing impacts of WFS events, including heightened anxiety, depression, isolation, and a lack of motivation, as well as physical health impacts (e.g., respiratory issues and lack of exercise). Both positive and negative economic and social impacts, as well as temporary or permanent relocation impacts, were also described. The impacts were not equitably distributed; differential experiences based on income level, outdoor occupations, age (child or elderly), preexisting health conditions, housing status, and social isolation were described as making some residents more vulnerable to WFS-induced physical and mental health and wellbeing challenges than others. Proposed solutions included stress reduction (e.g., meditation and relaxation lessons), increased distribution of air filters, development of community clean air spaces, enhancing community response capacity, hosting social gatherings, increasing education, expanding and coordination risk communications, and identifying opportunities for volunteering. Findings were incorporated into a pamphlet for community distribution. We present a template version herein for adaptation and use in other communities.

CONCLUSIONS

Wildfire smoke events present significant mental health and wellbeing impacts for rural communities. Community-led solutions that promote stress reduction, physical protection, and community cohesion have the opportunity to bolster resilience amid this growing public health crisis.

Is Football or Badminton Associated With More Positive Affect? The Links Between Affects and Sports Club Membership Among French Adolescents

Prior studies extensively examined the way sports club membership can lead to beneficial affective outcomes. Prior experiments also found that team sports, intensive sports, and sports that are frequently pursued can lead to even more affective benefits. However, no prior studies examined the differences between the affective benefits of specific sports. Based on prior results, we supposed that certain sports that meet all the previously set criteria—will provide the greatest affective benefits. The present large-scale investigation examined the data of adolescents (N = 12,849, female = 5,812, aged between 10 and 18, Mage = 12.56 years, and SDage = 2.00) and aimed to fill this gap. Firstly, the results showed that—although differences in affect can be found between the lack of club membership and most of the sports club memberships—the differences between the specific sports are less striking. Secondly, the sports that are associated with the highest level of positive and the lowest level of negative affectivity are not necessarily the ones expected. Finally, adolescents who practice athletics, reported the lowest means of negative, and the highest means of positive affect. However, it did not differ significantly from the results regarding the most practiced sport in France: soccer. Our results suggest that soccer as the most practice sport among French adolescents was associated with more positive affects than the majority of the 10 most licensed members French sports practiced by teens between 2008 and 2019. All in all, being a member of a sports club is associated with affective benefits, and some specific sports clubs can have some extra benefits.

Nature versus urban hiking for Veterans with post-traumatic stress disorder: a pilot randomised trial conducted in the Pacific Northwest USA

OBJECTIVES

To evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD).

DESIGN AND SETTING

A pilot randomised controlled trial conducted in the US Pacific Northwest.

PARTICIPANTS

Veterans with PTSD due to any cause.

INTERVENTIONS

Twenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13).

PRIMARY AND SECONDARY OUTCOME MEASURES

Feasibility was assessed based on recruitment, retention and attendance. Questionnaires and postintervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up.

RESULTS

Of 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group.

CONCLUSIONS

This pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes.

TRIAL REGISTRATION NUMBER

NCT03997344.