Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis
Mental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for...
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doaj-533f1baf384740c7aa3397cba7075d2a2021-10-03T04:41:51ZengElsevierSSM: Population Health2352-82732021-12-0116100934Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysisPeter A. Coventry0JenniferV.E. Brown1Jodi Pervin2Sally Brabyn3Rachel Pateman4Josefien Breedvelt5Simon Gilbody6Rachel Stancliffe7Rosemary McEachan8PiranC.L. White9Department of Health Sciences, University of York, York, YO10 5DD, UK; York Environmental Sustainability Institute, University of York, York, YO10 5NG, UK; Corresponding author. Department of Health Sciences, University of York, York, YO10 5DD, UK.Department of Health Sciences, University of York, York, YO10 5DD, UKDepartment of Health Sciences, University of York, York, YO10 5DD, UKDepartment of Health Sciences, University of York, York, YO10 5DD, UKStockholm Environment Institute, Department of Environment and Geography, University of York, York, YO10 5NG, UKNational Centre for Social Research, London, United KingdomDepartment of Health Sciences, University of York, York, YO10 5DD, UK; Hull York Medical School, University of York, York, YO10 5DD, UKCentre for Sustainable Healthcare, Oxford, OX2 7JQ, UKBradford Institute for Health Research, Bradford, BD9 6RJ, UKYork Environmental Sustainability Institute, University of York, York, YO10 5NG, UK; Department of Environment and Geography, University of York, York, YO10 5NG, UKMental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for community based adults. However, it is unclear which NBIs are most effective, or what format and dose is most efficacious. We systematically reviewed the controlled and uncontrolled evidence for outdoor NBIs. The protocol was registered at PROSPERO (CRD42020163103). Studies that included adults (aged ≥18 years) in community-based settings with or without mental and/or physical health problems were eligible for inclusion. Eligible interventions were structured outdoor activities in green and/or blue space for health and wellbeing. We searched ASSIA, CENTRAL, Embase, Greenfile, MEDLINE, PsycINFO, and Web of Science in October 2019; the search was updated in September 2020. We screened 14,321 records and included 50 studies. Sixteen studies were randomised controlled trials (RCTs); 18 were controlled studies; and 16 were uncontrolled before and after studies. Risk of bias for RCTs was low to moderate; and moderate to high for controlled and uncontrolled studies. Random effects meta-analysis of RCTs showed that NBIs were effective for improving depressive mood −0.64 (95% CI: 1.05 to −0.23), reducing anxiety −0.94 (95% CI: 0.94 to −0.01), improving positive affect 0.95 (95% CI: 0.59 to 1.31), and reducing negative affect −0.52 (95% CI: 0.77 to −0.26). Results from controlled and uncontrolled studies largely reflected findings from RCTs. There was less evidence that NBIs improved physical health. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. NBIs, specifically gardening, green exercise and nature-based therapy, are effective for improving mental health outcomes in adults, including those with pre-existing mental health problems.http://www.sciencedirect.com/science/article/pii/S2352827321002093GreenspaceBluespaceNature-based interventionMental healthPhysical health |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Peter A. Coventry JenniferV.E. Brown Jodi Pervin Sally Brabyn Rachel Pateman Josefien Breedvelt Simon Gilbody Rachel Stancliffe Rosemary McEachan PiranC.L. White |
spellingShingle |
Peter A. Coventry JenniferV.E. Brown Jodi Pervin Sally Brabyn Rachel Pateman Josefien Breedvelt Simon Gilbody Rachel Stancliffe Rosemary McEachan PiranC.L. White Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis SSM: Population Health Greenspace Bluespace Nature-based intervention Mental health Physical health |
author_facet |
Peter A. Coventry JenniferV.E. Brown Jodi Pervin Sally Brabyn Rachel Pateman Josefien Breedvelt Simon Gilbody Rachel Stancliffe Rosemary McEachan PiranC.L. White |
author_sort |
Peter A. Coventry |
title |
Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis |
title_short |
Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis |
title_full |
Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis |
title_fullStr |
Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis |
title_full_unstemmed |
Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis |
title_sort |
nature-based outdoor activities for mental and physical health: systematic review and meta-analysis |
publisher |
Elsevier |
series |
SSM: Population Health |
issn |
2352-8273 |
publishDate |
2021-12-01 |
description |
Mental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for community based adults. However, it is unclear which NBIs are most effective, or what format and dose is most efficacious. We systematically reviewed the controlled and uncontrolled evidence for outdoor NBIs. The protocol was registered at PROSPERO (CRD42020163103). Studies that included adults (aged ≥18 years) in community-based settings with or without mental and/or physical health problems were eligible for inclusion. Eligible interventions were structured outdoor activities in green and/or blue space for health and wellbeing. We searched ASSIA, CENTRAL, Embase, Greenfile, MEDLINE, PsycINFO, and Web of Science in October 2019; the search was updated in September 2020. We screened 14,321 records and included 50 studies. Sixteen studies were randomised controlled trials (RCTs); 18 were controlled studies; and 16 were uncontrolled before and after studies. Risk of bias for RCTs was low to moderate; and moderate to high for controlled and uncontrolled studies. Random effects meta-analysis of RCTs showed that NBIs were effective for improving depressive mood −0.64 (95% CI: 1.05 to −0.23), reducing anxiety −0.94 (95% CI: 0.94 to −0.01), improving positive affect 0.95 (95% CI: 0.59 to 1.31), and reducing negative affect −0.52 (95% CI: 0.77 to −0.26). Results from controlled and uncontrolled studies largely reflected findings from RCTs. There was less evidence that NBIs improved physical health. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. NBIs, specifically gardening, green exercise and nature-based therapy, are effective for improving mental health outcomes in adults, including those with pre-existing mental health problems. |
topic |
Greenspace Bluespace Nature-based intervention Mental health Physical health |
url |
http://www.sciencedirect.com/science/article/pii/S2352827321002093 |
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