PHENOTYPE. Therapeutic Study in Barcelona

Study Overview
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Brief Summary
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The study aimed to explore therapeutic effects of natural environments. To do so, the investigators evaluated the immediate and sustained changes in several indicators of well-being while people (n=26) with poor mental health were engaged in unconstrained exposures to natural (green, blue) and urban environments. The indicators included: affection, cognition, physiological responses. Each participant was exposed to all environments for a period of 210 minutes between October 2013 and January 2014. During the exposure period, participants were instructed to do what they would usually do in that environment. Before, during (at 30 and 210 minutes) and after each exposure, several psycho-physiological measures were taken: (i) heart rate variability and heart rate using a Holter monitor, (ii) blood pressure using a digital blood pressure monitor, (iii) physical activity using the CalFIT application installed in a Smartphone, (iv) lung function using a portable computerized spirometer, (v) stress level using salivary cortisol samples collected using Salivettes, (vi) affect, perceived restoration and social interactions using questionnaires, (vii) cognitive functioning using the backwards digit-span task test.

Official Title
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Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe. Work Package 4: Therapeutic Study in Barcelona

Conditions
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Poor Mental Health, Natural Outdoor Environments

Intervention / Treatment
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* Other: There was no intervention.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: MHI-5 scored in the lower 50th percentile of the Barcelona city PHENOTYPE sample willing to participate Exclusion Criteria: no able to walk for 30 minutes at self-directed pace. with chest, abdomen surgery or heart attack during the last three months. with retinal detachment or eyes surgery or hospitalized for heart problem during the last month. with tuberculosis treatment, or respiratory infection during the last three weeks. being asthmatic or pregnant using inhaler the 24 hours previous to the study day. taking medication different from the usual the 24 hours previous to the study day.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: There was no intervention.|Participants were transported one day to a urban setting, one day to a green space, one day to a beach. No intervention was done.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline heart rate variability at 30 min |  | after 30 minutes of exposure to green/blue/urban environment | 
| Change from Baseline heart rate at 30 min |  | after 30 minutes of exposure to green/blue/urban environment | 
| Change from blood pressure at 30min |  | after 30 minutes of exposure to green/blue/urban environment | 
| Change from stress level at 30min (salivary cortisol) |  | after 30 of exposure to green/blue/urban environment | 
| Change from affect at 30 min (BRUMS/POMS) |  | after 30 minutes of exposure to green/blue/urban environment | 
| Change from cognitive functioning at 30 min (backward digit span task) |  | after 30 minutes of exposure to green/blue/urban environment | 
| Change from Baseline heart rate variability at 210 min |  | after 210 minutes of exposure to green/blue/urban environment | 
| Change from Baseline heart rate at 210 min |  | after 210 minutes of exposure to green/blue/urban environment | 
| Change from blood pressure at 210min |  | after 210 minutes of exposure to green/blue/urban environment | 
| Change from stress level at 210min (salivary cortisol) |  | after 210 minutes of exposure to green/blue/urban environment | 
| Change from affect at 210 min (BRUMS/POMS) |  | after 210 minutes of exposure to green/blue/urban environment | 
| Change from cognitive functioning at 210 min (backward digit span task) |  | after 210 minutes of exposure to green/blue/urban environment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| objectively measured physical activity 30 | Measured with a Smartphone application (CalFIT) | During the first 30 minutes of exposure to green/blue/urban environment | 
| perceived restoration 30 (ROS - Korpela's Restoration outcome scale) |  | after 30 minutes of exposure to green/blue/urban environment | 
| subjectively recorded social interactions 30 | Measurement tool developed by the research team | after 30 minutes of exposure to green/blue/urban environment | 
| ambient air pollution exposure 30 (PM2.5) | Measured with MicroAthelometer | During the first 30 minutes of exposure to green/blue/urban environment | 
| objectively measured physical activity 210 | Measured with a Smartphone application (CalFIT) | During the first 210 minutes of exposure to green/blue/urban environment | 
| perceived restoration 210 (ROS- Korpela's Restoration outcome scale) |  | after 210 minutes of exposure to green/blue/urban environment | 
| subjectively recorded social interactions 210 | Measurement tool developed by the research team | after 210 minutes of exposure to green/blue/urban environment | 
| ambient air pollution exposure 210 (PM2.5) | Measured with MicroAthelometer | During the first 210 minutes of exposure to green/blue/urban environment | 
| personal air pollution (CO, NO, NO2) | Personal sensors designed and built at Cambridge University, UK (CamPerS) | During all the data collection day |