Clinical trial NCT06858189: Promoting Active Therapy: Path to Wellness
Official title: Can Nature-based Physical Activity Improve Symptoms of Depression and Anxiety?
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE2
Conditions: Depression, Anxiety
Physical Activity
Time in Nature
Self-Efficacy
Feasibility Pilot Study
Keywords: therapy
nature prescriptions
park prescriptions (ParkRx)
exercise
mental health
walk-and-talk
Lead sponsor: Kansas State University
Sponsor class: OTHER
Collaborators: name: REI Cooperative Action Fund
First posted: 2025-03-05
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This project will examine changes in depression and anxiety following a 10-week intervention promoting nature-based physical activity in mental health settings. We will recruit ten licensed therapists whose caseload includes adults with depression and anxiety. Following a training by our team, each participating therapist will recruit six clients, who will be randomly assigned to the intervention or control condition. Clients in the intervention condition will engage in walk-and-talk therapy outdoors during weekly sessions and discuss strategies for being active outdoors on their own. We will assess changes in depression, anxiety, and nature-based physical activity in both groups.

Detailed description: For this project, we will recruit ten licensed therapists whose caseload includes adults with depression and anxiety. We aim to recruit therapists who practice in northeast Kansas. Our team will lead a 3-hour in-person training for participating therapists that covers project aims and procedures, benefits of nature-based physical activity for mental health, identifying and enrolling suitable clients for participation, recommending and engaging in nature-based physical activity with clients, and completing project assessments.

Following the training, each therapist will recruit six clients aged 18-65 who are willing to participate in a 10-week research study and meet the following criteria: 1) diagnosed depressive or anxiety disorder, 2) able to safely engage in moderate physical activity, and 3) willing to complete all research requirements. Clients who are part of an underrepresented minority group (i.e., racial/ethnic minority, low SES, LGTBQ) will be prioritize during recruitment. Therapists will invite eligible clients to participate in the study, and those who agree will sign an informed consent document. Clients will be randomly assigned to the intervention or active waitlist control (usual care) condition. All participants will receive a Fitbit and download the NatureDose app. During the 10-week intervention, clients and therapists will engage in walk-and-talk therapy outdoors in natural settings during weekly therapy sessions. In addition, therapists will work with clients to set realistic goals for increased nature-based physical activity outside of the therapy setting. Therapists will check in with clients weekly regarding their progress and assist with goal revision, barrier planning, and self-monitoring. Control participants will receive information about nature-based physical activity, and then will receive the full intervention after 10 weeks.

All participating clients will complete surveys assessing depression and anxiety symptoms at baseline (following informed consent) and at the end of the 10-week intervention. Throughout the 10-week intervention, therapists will keep a weekly log of frequency and duration of walk-and talk sessions. Clients will also keep a weekly log of nature-based physical activity, use the NatureDose app to measure time spent in nature each day, and wear a Fitbit to track their daily physical activity. At the end of the intervention, clients will complete a brief satisfaction survey, and therapists will complete an individual interview with the research team.

Eligibility criteria: Inclusion Criteria:

* Current client of a participating therapist who has completed study training
* Diagnosed depressive or anxiety disorder
* Able to safely engage in moderate physical activity
* Willing to complete all study requirements

Exclusion Criteria:

* Planning to discontinue therapy in less than 6 months
* Active suicidal ideation
* Does not pass exercise risk screener

Primary outcomes:
measure: Participation in walk-and-talk therapy
timeFrame: Weekly throughout the 10-week intervention
measure: Perceived therapist support for nature-based physical activity
timeFrame: End of intervention (after 10 weeks)
measure: Acceptability
timeFrame: End of intervention (after 10 weeks)
Secondary outcomes:
measure: Self-efficacy for physical activity
timeFrame: baseline, 10 weeks
measure: Self-efficacy for time in nature
timeFrame: baseline, 10 weeks
measure: Physical activity
timeFrame: Weekly throughout the 10-week intervention
measure: Time in nature
timeFrame: Weekly throughout the 10-week intervention
Other outcomes:
measure: Depression
timeFrame: baseline, 10 weeks
measure: Anxiety
timeFrame: baseline, 10 weeks
Locations:
city: Manhattan
country: United States
facility: Kansas State University
state: Kansas
Study officials:
References: