Planetary Health and Loneliness

Study Overview
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Brief Summary
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The aim of this online study is the evaluation of planetary health behaviors in relation to levels of eco-anxiety, general well-being, and levels of loneliness. As climate change progresses at a dangerous rate, it is important to establish and maintain lifestyles that are productive, fulfilling, environmentally conscious, and low in anxiety. Through a better understanding of the interconnected nature of planetary health behaviors with other aspects of healthy living and perception of social isolation, this study will add to current state of science to help inform the creation of interventions promoting sustainable, healthy, happy living among the general public and specific subgroups.

Detailed Description
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The aim of this online study is the evaluation of healthy behaviors and anxiety levels in relation to selected physical, mental, and environmental health aspects. The umbrella terminology of planetary health is used in the context of this study. As climate change progresses at a dangerous rate, it is important to establish and maintain lifestyles that are productive, fulfilling, environmentally conscious, and low in anxiety. By evaluating prevalence of healthy behaviors and levels of eco-anxiety as well as loneliness as one early indicator of health risk, this study hopes to build on existing public health knowledge to develop interventions targeting and encouraging multiple aspects of healthy, eco-friendly lifestyles. This study will also help later intervention design by determining effective methods of persuasion and promotion of sustainable planetary health behaviors. Main research questions are I. Are climate-sensitive people and rehabilitation patients (in terms of EMCB, YCSCB and Mindful Health) more likely to also promote their own health (in terms of physical activity and healthy nutrition)? II. What is the (non-)linear relationship between eco-anxiety and climate-sensitiveness/health behavior? III. Is climate-sensitiveness and eco-anxiety invariant to partner status, number of people in the household, gender, occupation, and age? (No differences) IV. Is loneliness linked to partner status, number of people in the household and younger age but uncorrelated to eco-anxiety, climate-sensitiveness/health behavior? V. What is the prevalence of loneliness in 2023 in comparison to 2022, 2021, 2020, and 2019? Do people and rehabilitation patients who feel more lonely after the corona pandemic than before show more eco-anxiety and climate-sensitiveness but less healthy behavior than people who feel as/less lonely than prior to the corona pandemic? VI. Is active persuasion involving mental simulation more effective in promoting eco-friendly behaviours than passive persuasion involving information dissemination as measured by the YCSCB and EMCB? (testing two mini interventions) VII. To what extent are medical rehabilitation patients different from the general population?

Official Title
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Planetary Health and Loneliness: Survey and Mini-intervention to Study the Interrelations of Multiple Behavior Change and Perception of Social Isolation

Conditions
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Loneliness, Anxiety, Health-Related Behavior, Healthy Lifestyle, Healthy Nutrition, Healthy Diet, Health Behavior

Intervention / Treatment
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* Behavioral: Prompting open-ended question promoting sustainability
* Behavioral: Sustainability Passage


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ability to participate in surveys (e.g., sufficient German or English language skills) Exclusion Criteria: Not being of age Illiteracy Massively limited cognitive abilities (linguistic components of the digital offerings must be able to be used and questionnaires completed or interviews participated in)

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Health Promoting<br>The survey will be organized so health promoting behavioral scale questions will be asked first concerning personal wellbeing. This will be followed by eco-friendly behavior scale questions involving one's concern for the wellbeing of the planet. After this, there will be two surveys concerning loneliness and eco-anxiety before the intervention. | Behavioral: Prompting open-ended question promoting sustainability<br>* This intervention will include active persuasion through prompting participants to answer an open-ended question regarding how they will alter their behavior to become more sustainable and eco-friendly.<br>Behavioral: Sustainability Passage<br>* This intervention will include passive persuasion through presenting participants with a passage discussing the serious issue of climate change and the pressing need for systemic and individual change to adopt sustainable practices and lifestyles.<br>|
| Experimental: Eco-friendly behavior<br>The survey will be organized so eco-friendly behavior scale questions involving one's concern for the wellbeing of the planet will be asked first. This will be followed by health promoting behavioral scale questions concerning personal wellbeing. After this, there will be two surveys concerning loneliness and eco-anxiety before the intervention. | Behavioral: Prompting open-ended question promoting sustainability<br>* This intervention will include active persuasion through prompting participants to answer an open-ended question regarding how they will alter their behavior to become more sustainable and eco-friendly.<br>Behavioral: Sustainability Passage<br>* This intervention will include passive persuasion through presenting participants with a passage discussing the serious issue of climate change and the pressing need for systemic and individual change to adopt sustainable practices and lifestyles.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Young Consumers' Sustainable Consumption Behaviors (YCSCB) validated scale | The primary outcome measure will be the YCSCB validated scale questionnaire. This will be given to participants right after they have completed the intervention section of the survey. The answering options range from Never (0, minimum score) to Sometimes (1) and Often (2) up to Always (3, maximum score). The items are worded I eat meat (steak, ham, etc.). I eat dairy products (butter, cheese, yoghurt, etc.). I keep a healthy diet. There are times when I discard food products. I buy locally grown food products. I reuse my leftovers for the next meal. and items # 1, 2 and 4 need to be reversed, then all items can be used as single items or as aggregated scales, with higher scores indicating a better outcome in terms of planetary health. | This scale will take approximately 2 minutes to fill out completely. | 
| Ethically Minded Consumer Behavior (EMCB) validated scale | The second primary outcome measure will be the EMCB validated scale questionnaire. This will be given to participants right after they have completed the intervention section of the survey. The answering options range from Never true (0, minimum score) to Rarely true (1), Sometimes true (2), Mostly true (3) and Always true (4, maximum score). The items are worded (for instance) 1. When there is a choice, I always choose the product that contributes to the least amount of environmental damage. 2. I have switched products for environmental reasons. 3. If I understand the potential damage to the environment that some products can cause, I do not purchase those products. ... 10. I have paid more for socially responsible products when there is a cheaper alternative. All items can be used as single items or as aggregated scales, with higher scores indicating a better outcome in terms of planetary health. | This scale will take approximately 2 minutes to fill out completely. | 
| Loneliness item from the Center for Epidemiological Studies-Depression-(CES D)-Scale | To study some of the research questions unrelated to the intervention, the perceived social isolation is measured with a standardized scale building on the item in the Center for Epidemiological Studies-Depression-(CES-D)-Scale. The item is worded How often did you feel lonely? with the answering options Daily (3), Several times a week (2), Once a week (1) and Rarely/never (0). The item can be used as single items, with higher scores indicating a worse outcome in terms of more loneliness. | This item will take less than 1 minute to complete. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Planetary Health, Eco-Friendly Behavior, Eco-Anxiety, Covid-19