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Lan Y, Helbich M. Short-term exposure sequences and anxiety symptoms: a time series clustering of smartphone-based mobility trajectories. Int J Health Geogr 2023; 22:27. [PMID: 37817189 PMCID: PMC10563352 DOI: 10.1186/s12942-023-00348-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Short-term environmental exposures, including green space, air pollution, and noise, have been suggested to affect health. However, the evidence is limited to aggregated exposure estimates which do not allow the capture of daily spatiotemporal exposure sequences. We aimed to (1) determine individuals' sequential exposure patterns along their daily mobility paths and (2) examine whether and to what extent these exposure patterns were associated with anxiety symptoms. METHODS We cross-sectionally tracked 141 participants aged 18-65 using their global positioning system (GPS) enabled smartphones for up to 7 days in the Netherlands. We estimated their location-dependent exposures for green space, fine particulate matter, and noise along their moving trajectories at 10-min intervals. The resulting time-resolved exposure sequences were then partitioned using multivariate time series clustering with dynamic time warping as the similarity measure. Respondents' anxiety symptoms were assessed with the Generalized Anxiety Disorders-7 questionnaire. We fitted linear regressions to assess the associations between sequential exposure patterns and anxiety symptoms. RESULTS We found four distinctive daily sequential exposure patterns across the participants. Exposure patterns differed in terms of exposure levels and daily variations. Regression results revealed that participants with a "moderately health-threatening" exposure pattern were significantly associated with fewer anxiety symptoms than participants with a "strongly health-threatening" exposure pattern. CONCLUSIONS Our findings support that environmental exposures' daily sequence and short-term magnitudes may be associated with mental health. We urge more time-resolved mobility-based assessments in future analyses of environmental health effects in daily life.
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Affiliation(s)
- Yuliang Lan
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 BC, Utrecht, The Netherlands.
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 BC, Utrecht, The Netherlands
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Hammoud R, Tognin S, Bakolis I, Ivanova D, Fitzpatrick N, Burgess L, Smythe M, Gibbons J, Davidson N, Mechelli A. Lonely in a crowd: investigating the association between overcrowding and loneliness using smartphone technologies. Sci Rep 2021; 11:24134. [PMID: 34930971 PMCID: PMC8688521 DOI: 10.1038/s41598-021-03398-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
Loneliness is a major public health concern with links to social and environmental factors. Previous studies have typically investigated loneliness as a stable emotional state using retrospective cross-sectional designs. Yet people experience different levels of loneliness throughout the day depending on their surrounding environment. In the present study, we investigated the associations between loneliness and social and environmental factors (i.e. overcrowding, population density, social inclusivity and contact with nature) in real-time. Ecological momentary assessment data was collected from participants using the Urban Mind smartphone application. Data from 756 participants who completed 16,602 assessments between April 2018 and March 2020 were used in order to investigate associations between momentary feeling of loneliness, the social environment (i.e. overcrowding, social inclusivity, population density) and the built environment (i.e. contact with nature) using multilevel modelling. Increased overcrowding and population density were associated with higher levels of loneliness; in contrast, social inclusivity and contact with nature were associated with lower levels of loneliness. These associations remained significant after adjusting for age, gender, ethnicity, education and occupation. The positive association between social inclusivity and lower levels of loneliness was more pronounced when participants were in contact with nature, indicating an interaction between the social and built environment on loneliness. The feeling of loneliness changes in relation to both social and environmental factors. Our findings have potential implications for public health strategies and interventions aimed at reducing the burden of loneliness on society. Specific measures, which would increase social inclusion and contact with nature while reducing overcrowding, should be implemented, especially in densely populated cities.
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Affiliation(s)
- Ryan Hammoud
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ioannis Bakolis
- Health Services and Population Research Department, Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniela Ivanova
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Naomi Fitzpatrick
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucie Burgess
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael Smythe
- Nomad Projects, Sunbury Workshops, 24 Swanfield St., London, UK
| | | | | | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Marselle MR, Hartig T, Cox DTC, de Bell S, Knapp S, Lindley S, Triguero-Mas M, Böhning-Gaese K, Braubach M, Cook PA, de Vries S, Heintz-Buschart A, Hofmann M, Irvine KN, Kabisch N, Kolek F, Kraemer R, Markevych I, Martens D, Müller R, Nieuwenhuijsen M, Potts JM, Stadler J, Walton S, Warber SL, Bonn A. Pathways linking biodiversity to human health: A conceptual framework. ENVIRONMENT INTERNATIONAL 2021; 150:106420. [PMID: 33556912 DOI: 10.1016/j.envint.2021.106420] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/10/2021] [Accepted: 01/22/2021] [Indexed: 05/05/2023]
Abstract
Biodiversity is a cornerstone of human health and well-being. However, while evidence of the contributions of nature to human health is rapidly building, research into how biodiversity relates to human health remains limited in important respects. In particular, a better mechanistic understanding of the range of pathways through which biodiversity can influence human health is needed. These pathways relate to both psychological and social processes as well as biophysical processes. Building on evidence from across the natural, social and health sciences, we present a conceptual framework organizing the pathways linking biodiversity to human health. Four domains of pathways-both beneficial as well as harmful-link biodiversity with human health: (i) reducing harm (e.g. provision of medicines, decreasing exposure to air and noise pollution); (ii) restoring capacities (e.g. attention restoration, stress reduction); (iii) building capacities (e.g. promoting physical activity, transcendent experiences); and (iv) causing harm (e.g. dangerous wildlife, zoonotic diseases, allergens). We discuss how to test components of the biodiversity-health framework with available analytical approaches and existing datasets. In a world with accelerating declines in biodiversity, profound land-use change, and an increase in non-communicable and zoonotic diseases globally, greater understanding of these pathways can reinforce biodiversity conservation as a strategy for the promotion of health for both people and nature. We conclude by identifying research avenues and recommendations for policy and practice to foster biodiversity-focused public health actions.
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Affiliation(s)
- Melissa R Marselle
- Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstraße 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Institute of Biodiversity, Friedrich Schiller University Jena, Dornburger Straße 159, 07743 Jena, Germany; Institute of Psychological Sciences, De Montfort University, Leicester, United Kingdom.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Box 514, SE-75120 Uppsala, Sweden; Department of Psychology, Uppsala University, Box 1225, SE-75142 Uppsala, Sweden
| | - Daniel T C Cox
- Environment and Sustainability Institute, University of Exeter, Penryn, Cornwall TR10 9FE, United Kingdom
| | - Siân de Bell
- European Centre for Environment and Human Health, University of Exeter, Truro, Cornwall TR1 3HD, United Kingdom
| | - Sonja Knapp
- Helmholtz Centre for Environmental Research - UFZ, Department of Community Ecology, Theodor-Lieser-Str. 4, 06120 Halle, Germany
| | - Sarah Lindley
- Department of Geography, School of Environment, Education and Development, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Margarita Triguero-Mas
- Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - Katrin Böhning-Gaese
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Senckenberg Biodiversity and Climate Research Centre (SBiK-F), Senckenberganlage 25, 60325 Frankfurt (Main), Germany; Goethe University Frankfurt am Main, Institute for Ecology, Evolution & Diversity, Max-von-Laue-Str. 13, 60439 Frankfurt (Main), Germany
| | - Matthias Braubach
- WHO Regional Office for Europe, European Centre for Environment and Health, Platz der Vereinten Nationen 1, 53113 Bonn, Germany
| | - Penny A Cook
- School of Health and Society, University of Salford, Salford M6 6PU, United Kingdom
| | - Sjerp de Vries
- Cultural Geography, Wageningen Environmental Research, Wageningen University & Research, P.O. Box 47, 6700 AA Wageningen, the Netherlands
| | - Anna Heintz-Buschart
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Helmholtz Centre for Environmental Research - UFZ, Department of Soil Ecology, Theodor-Lieser-Str. 4, 06120 Halle, Germany
| | - Max Hofmann
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Institute of Biology, Martin Luther University Halle-Wittenberg, Am Kirchtor 1, 06108 Halle (Saale), Germany; Leibniz Institute of Agricultural Development in Transition Economies (IAMO), Theodor-Lieser- Strasse 2, 06120 Halle (Saale), Germany
| | - Katherine N Irvine
- Social, Economic and Geographical Sciences Department, The James Hutton Institute, Aberdeen AB15 8QH, United Kingdom
| | - Nadja Kabisch
- Humboldt-Universität zu Berlin, Geography Department, Unter den Linden 6, 10099 Berlin, Germany; Helmholtz Centre for Environmental Research-UFZ, Department of Urban and Environmental Sociology, Leipzig, Germany
| | - Franziska Kolek
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Germany - German Research Centre for Environmental Health, Augsburg, Germany
| | - Roland Kraemer
- Humboldt-Universität zu Berlin, Geography Department, Unter den Linden 6, 10099 Berlin, Germany; Helmholtz Centre for Environmental Research - UFZ, Department of Monitoring and Exploration Technologies, Permoserstraße 15, 04318 Leipzig, Germany
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Ingardena 6, 33-332 Krakow, Poland
| | - Dörte Martens
- Eberswalde University for Sustainable Development, Faculty of Landscape Management and Nature Conservation, Eberswalde, Germany
| | - Ruth Müller
- Unit Entomology, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium; Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt (Main), Germany
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Mary MacKillop Institute for Health Research, Melbourne, Australia
| | - Jacqueline M Potts
- Biomathematics and Statistics Scotland, Craigiebuckler, Aberdeen AB15 8QH, United Kingdom
| | - Jutta Stadler
- German Federal Agency for Nature Conservation (BfN), Germany
| | - Samantha Walton
- Department of English Literature, Bath Spa University, Bath, United Kingdom
| | - Sara L Warber
- European Centre for Environment and Human Health, University of Exeter, Truro, Cornwall TR1 3HD, United Kingdom; Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Aletta Bonn
- Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstraße 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Institute of Biodiversity, Friedrich Schiller University Jena, Dornburger Straße 159, 07743 Jena, Germany
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How Are Information and Communication Technologies Supporting Routine Outcome Monitoring and Measurement-Based Care in Psychotherapy? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093170. [PMID: 32370140 PMCID: PMC7246636 DOI: 10.3390/ijerph17093170] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 11/16/2022]
Abstract
Psychotherapy has proven to be effective for a wide range of mental health problems. However, not all patients respond to the treatment as expected (not-on-track patients). Routine outcome monitoring (ROM) and measurement-based care (MBC), which consist of monitoring patients between appointments and using this data to guide the intervention, have been shown to be particularly useful for these not-on-track patients. Traditionally, though, ROM and MBC have been challenging, due to the difficulties associated with repeated monitoring of patients and providing real-time feedback to therapists. The use of information and communication technologies (ICTs) might help reduce these challenges. Therefore, we systematically reviewed evidence regarding the use of ICTs for ROM and MBC in face-to-face psychological interventions for mental health problems. The search included published and unpublished studies indexed in the electronic databases PubMed, PsycINFO, and SCOPUS. Main search terms were variations of the terms “psychological treatment”, “progress monitoring or measurement-based care”, and “technology”. Eighteen studies met eligibility criteria. In these, ICTs were frequently handheld technologies, such as smartphone apps, tablets, or laptops, which were involved in the whole process (assessment and feedback). Overall, the use of technology for ROM and MBC during psychological interventions was feasible and acceptable. In addition, the use of ICTs was found to be effective, particularly for not-on-track patients, which is consistent with similar non-ICT research. Given the heterogeneity of reviewed studies, more research and replication is needed to obtain robust findings with different technological solutions and to facilitate the generalization of findings to different mental health populations.
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Beute F, de Kort YAW. Stopping the Train of Thought: A Pilot Study Using an Ecological Momentary Intervention with Twice-Daily Exposure to Natural versus Urban Scenes to Lower Stress and Rumination. Appl Psychol Health Well Being 2018; 10:236-253. [PMID: 29722135 DOI: 10.1111/aphw.12128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stress, and specifically perseverative cognition, is considered to have considerable detrimental effects on mental and physical health. Interventions that can offer temporary stress relief could, therefore, bring considerable health benefits. Previous research has pointed to stress-reducing effects of exposure to nature after acute stressors, but has not yet investigated effects in the realm of everyday life. The present pilot study explores whether an ecological momentary intervention using exposure to natural images could be effective in lowering stress and improve mood. METHODS Fifteen participants (12 females) scoring above threshold on stress, depression, or anxiety completed two study periods of 6 days. They watched an urban (control) or natural slideshow twice daily. Using Ecological Momentary Assessment, effects on mood, and stress-related complaints were measured in everyday life. RESULTS Compliance to the study protocol was high, especially in the first week, with slightly more videos watched in the morning than in the evening. We found indications of improvements in mood, self-reported worrying (but not stress levels), and heart rate. CONCLUSIONS The results suggest that twice-daily exposure to restorative visual content could be a viable Ecological Momentary Intervention, with the potential to reduce self-reported worry, lower autonomic activity, and increase positive affect.
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Affiliation(s)
- Femke Beute
- Eindhoven University of Technology, The Netherlands
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Bakolis I, Hammoud R, Smythe M, Gibbons J, Davidson N, Tognin S, Mechelli A. Urban Mind: Using Smartphone Technologies to Investigate the Impact of Nature on Mental Well-Being in Real Time. Bioscience 2018; 68:134-145. [PMID: 29599549 PMCID: PMC5862247 DOI: 10.1093/biosci/bix149] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Existing evidence on the beneficial effects of nature on mental health comes from studies using cross-sectional designs. We developed a smartphone-based tool (Urban Mind; www.urbanmind.info) to examine how exposure to natural features within the built environment affects mental well-being in real time. The tool was used to monitor 108 individuals who completed 3013 assessments over a 1-week period. Significant immediate and lagged associations with mental well-being were found for several natural features. These associations were stronger in people with higher trait impulsivity, a psychological measure of one's tendency to behave with little forethought or consideration of the consequences, which is indicative of a higher risk of developing mental-health issues. Our investigation suggests that the benefits of nature on mental well-being are time-lasting and interact with an individual's vulnerability to mental illness. These findings have potential implications from the perspectives of global mental health as well as urban planning and design.
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Affiliation(s)
- Ioannis Bakolis
- Lecturer, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Ryan Hammoud
- PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Michael Smythe
- Artist and action-based researcher at Nomad Projects (https://nomadprojects.org) in London, United Kingdom
| | - Johanna Gibbons
- Landscape architects at J & L Gibbons (http://jlg-london.com) in London, United Kingdom
| | - Neil Davidson
- Landscape architects at J & L Gibbons (http://jlg-london.com) in London, United Kingdom
| | - Stefania Tognin
- Lecturer, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
| | - Andrea Mechelli
- Reader, PhD student at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, United Kingdom
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