nature and health: how does lifestyle and environment affect health and wellness

Conditions: Chronic Disease; Risk Reduction; Mental Health Wellness 1; Physical Inactivity; Sleep; Depression; Anxiety

Summary: the purpose of this study is to examine if and how implementing nature prescriptions can increase time in nature and improve health to yield an actionable understanding of the nature-health connection. it aims to explore how public green spaces can be better used to improve individual and community health. finally, this study aims to advance science by conducting a randomized controlled trial to improve understanding of the linkages between time in nature and human health.

the investigators will conduct a randomized controlled trial in which physicians prescribe time in nature as an intervention to the study group. in total a goal of 240 patients will be recruited, including both children (13+) and adults. 120 of them will be assigned to the study group and 120 to the assigned to the control group. all study participants will be provided with a global positioning system (gps)-enabled wearable device (garmin vivosmart 5) that is able to measure their activity levels, location, and additional health-related metrics, such as heart rate. all participants will be asked to provide information about their health and well-being through survey instruments and electronic health records. both groups (intervention and control) will receive regular health advice targeting lifestyle factors associated with risk of chronic diseases. the treatment group will additionally receive a park prescription with information about the benefits of spending time in nature. they will also received a specified target amount of time to spend in nature, along with frequency of visits and recommended locations (e.g., specific parks), and information about parks and programming in the study area. participants will also be asked to answer brief questions regarding their mental and physical health, as well as their physical excercise patterns every 72-hours through a research-grade smartphone app called urban mind over the course of this study. at baseline and end of study at 6-months the participants will also answer questionnaires that will assess their mental and physical health, as well as lifestyle factors such as physical activity, sleep, stress and exposure to nature. these questionnaires will be administered through the redcap survey system.

Eligibility criteria:
inclusion criteria: * participants must be a patient of the ahn forbes family medicine clinic. * participants must have one or more chronic conditions, or significant lifestyle risks as identified by their healthcare provider. * participants must be between 13-65 years old. * participants must be willing and able to provide informed consent to participate * participants under 18 must be willing and able to assent for themselves and obtain parental consent. * participants must be willing to comply with all study procedures for the duration of the study. * participants must reside in the greater pittsburgh area for the duration of 6-month study. * participants must have a smartphone that is capable of running the urban mind app and connecting to the garmin wearable device (iphone 6 and newer as well as most android phones). * minors who participate must have their own smartphone. * participants must have their own email address to register with the urban mind app and the garmin app. * only one participant from a household may enroll in the study. * participants must be able to comprehend written english (questionnaires will be provided to participants in english). * participants may not be an employee of forbes family medicine clinic exclusion criteria: * none, must meet all inclusion criteria.

Keywords: nature park prescription mental health physical health chronic disease lifestyle