The Impact of Green Spaces on the General Well-being and Stress of Students

Study Overview
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Brief Summary
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The number of students with psychological problems is on the rise, due to a combination of increasing performance pressure, high expectations, difficulties handling stress, social pressure, and studying. Spending time in a green space has been shown to have positive effects on the mental and general health. This project aims to alleviate the symptoms of mental fatigue and stress related disorders such as burn out in students by offering a nature-based activity. Participants are asked to take a thirty-minute walk in a nature-based area for five consecutive days, followed by a control period (regular schedule of the participant) for five days, or vice versa. The investigators test stress-related parameters including concentration tests, cognitive tests, cortisol levels, and cardiovascular measurements.

Detailed Description
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This project aims study the effectiveness of nature-based solutions on the prevention of stress-related symptoms due to high study pressure in students. A nature-based physical activity is recommended once a day to prevent stress build-up and positively influence the cardiovascular system. Participants are randomized into two groups: the first group of participants are asked to walk a nature-based route near the University campus for thirty minutes per day for two weeks (phase 1). After each activity-based phase, a washout period of one week is implemented to avoid carry-over of results (phase 2 and 4). In the third phase, the participants are asked to resume their daily activities for two weeks (control). The second group undergo the same phases but reversed: participants start with two weeks of their usual daily activities, followed by two weeks of nature-based activity. After each phase, the investigators measure neurocognition through neurocognitive tests, the emotional status through detailed questionnaires and assess stress levels through cardiovascular measurements, including salivary cortisol levels of saliva collected upon awakening, 30 min after waking and at 8 pm.

Official Title
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The Impact of Green Spaces on the General Well-being and Stress of Students: an Intervention Study

Conditions
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Stress, Neurocognition, Psychological, Cardiovascular

Intervention / Treatment
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* Other: Nature based solution for stress reduction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Student of Hasselt university or university college PXL and dutch speaking Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group 1: intervention/control group<br>Phase 1: Two weeks of green space intervention Phase 2: One week wash out period Resume daily activities Phase 3: Two weeks of 'daily activities' Regular, daily activities are resumed by the participants Phase 4: One week wash out period Resume daily activities Between each phase, detailed questionnaires, neurocognitive tests and cardiovascular measurements are taken from the participants. | Other: Nature based solution for stress reduction<br>* participation in nature activities: daily 30 min walking in nature<br>|
| Experimental: Group 2: control/intervention group<br>Phase 1: Two weeks of 'daily activities' Regular, daily activities are resumed by the participants Phase 2: One week wash out period Resume daily activities Phase 3: Two weeks of green space intervention Phase 4: One week wash out period Resume daily activities Between each phase, detailed questionnaires, neurocognitive tests and cardiovascular measurements are taken from the participants. | Other: Nature based solution for stress reduction<br>* participation in nature activities: daily 30 min walking in nature<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| General health | An questionnaire is used to collect sociodemographic data and life-style factors, including movement data and health of the participant | 5 minutes | 
| Stress levels | Assessed via questionnaires (the burn out assessment tool (score 1-5) and general health questionnaire (score 0-12) and Five Item Well Being Index (score 0-100). Scores are used as continuous variables. Lower scores represent a lower risk of burn out, higher scores represent a higher risk of burnout. The score is constructed from questions concerning exhaustion, mental distance, emotional disorder(s), and cognitive disorder(s). | 10 minutes | 
| cortisol level (stress levels) | Assessed by salivary cortisol levels. Scale is µg/dl and used as a continuous variable. | 5 minutes | 
| visual memory | Computerized tests (eye-tracking test). The scale is pupil size, spontaneous blinking rate and eye movements and is used as a continuous variable. | 5 minutes | 
| selective attention | Computerized tests (stroop test). The scale is mean reaction time and is used as a continuous variable. | 5 minutes | 
| short-term memory | Computerized tests (Digit Span Test). The scale is number of digits and is used as a continuous variable. | 10minutes | 
| visual information processing speed | Computerized tests (Digit Symbol Test). The scale is number of digits and is used as a continuous variable. | 5 minutes | 
| visual information processing speed | Computerized tests (Pattern Comparison test). The scale is reaction time and is used as a continuous variable. | 5 minutes | 
| Heart rate variability | The heart rate is monitored throughout the entire baseline and follow-up visit through a small patch attached to the participant's skin. The results is used as a continuous variable in milliseconds (ms). | 30 minutes | 
| Blood pressure | Blood pressure is measured through an automated system. The results is used as a continuous variable in mmHg. | 5 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Green space