protocolSection identificationModule nctId: NCT06365723, orgStudyIdInfo id: SPH-2023-32410, briefTitle: Effects of Walking in Greenspace and the Built Environment in Adults With Prediabetes: A Randomized Crossover Trial, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2025-01-15, primaryCompletionDateStruct date: 2030-06-15, completionDateStruct date: 2032-06-15, studyFirstPostDateStruct date: 2024-04-15, lastUpdatePostDateStruct date: 2024-04-15, sponsorCollaboratorsModule leadSponsor name: University of Minnesota, class: OTHER, descriptionModule briefSummary: Approximately 92 million U.S. adults (\~38% of population) have prediabetes (PreD). Because people with PreD are at high risk CMD, they are a target population for diabetes prevention programs. The focus is people with PreD because of their high risk for developing CMD and large numbers, providing an opportunity to investigate behavioral and environmental approaches as preventive measures in a well-defined population. Urbanization affords challenges and opportunities to public health that include exposure to obesogenic environments, air pollution, and psychosocial stressors. In healthy adults suggest exposure to nature has health benefits relative to exposure to built environments. Hypothesized mechanisms for health benefits of Greenspace exposure include increased physical activity (PA), attention restoration, stress reduction, and reduced exposure to pollution. Many of the health benefits are associated with reduced psychological and physiological stress leading to better autonomic functioning as assessed by heart rate variability (HRV) and other biomarkers. Multiple studies suggest that PA and exposure to natural environments may act together to improve health. Yet, aside from our preliminary studies, we are not aware of any studies that examined how physical activity may interact with exposure to urban Greenspace ('Green') compared with built urban environments ('Gray'), to reduce stress and improve health. The purpose of this proposed study is to conduct a randomized crossover trial comparing differences in the psychosocial and physiological effects of walking in urban Green and Gray spaces in adults with PreD., conditionsModule conditions: PreDiabetes, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: RANDOMIZED, interventionModel: CROSSOVER, interventionModelDescription: The study is a randomized crossover trial with a 4-week washout period., primaryPurpose: SUPPORTIVE_CARE, maskingInfo masking: SINGLE, whoMasked: OUTCOMES_ASSESSOR, enrollmentInfo count: 216, type: ESTIMATED, armsInterventionsModule interventions name: Green Walk, interventions name: Gray Walk, outcomesModule primaryOutcomes measure: Measure of Anxiety, primaryOutcomes measure: Perceived stress assessment, primaryOutcomes measure: Mood assessment, secondaryOutcomes measure: Heart Rate variability, secondaryOutcomes measure: Salivary cortisol levels, secondaryOutcomes measure: Ambient Particulate Matter, secondaryOutcomes measure: Black Carbon levels, secondaryOutcomes measure: CMD risk, secondaryOutcomes measure: State and Trait anxiety, eligibilityModule sex: ALL, minimumAge: 25 Years, maximumAge: 64 Years, stdAges: ADULT, contactsLocationsModule, hasResults: False