Nature and Well-Being Project

University of Pennsylvania

Status: Completed

Conditions: Environmental Exposure; Health Behavior; Health, Subjective

Treatments: Other: Nature Nook + Nature Coach; Behavioral: Nature Coach; Other: Nature Nook

Study type: Interventional

Funder types: Other

Identifiers

NCT04642235

842575

Details and patient eligibility

About

The investigators pilot test two intervention strategies to increase green space use- place-based and person-based, as well as evaluate the dose-response relationship between green space use and health.

Full description

Neighborhood conditions can positively impact mental health and wellbeing. Green space has been cited as a potential buffer between inequitable neighborhood conditions and poor health. However, there is limited evidence how to increase exposure to green space and how much exposure is needed to produce benefit. Place-based and person-based interventions offer contrasting approaches to improving the impact of the environment on health. The environment influences people as they traverse the spaces between home, work, and recreation, in ways that can be healthy or harmful. Place-based approaches directly change the environment to encourage healthy behaviors, and potentially have broad population impact. Alternatively, person-based approaches directly target individuals' behavior and may be more feasible. To our knowledge, no studies combine both approaches into a single intervention, which may be more effective over either alone.

The broad objectives of this proposal are to pilot test two intervention strategies to increase green space use- place-based and person-based, as well as evaluate the dose-response relationship between green space use and health. Our place-based intervention, Nature Nooks, builds on our prior greening treatment by adding new features to encourage use - a path and benches to invite people into the space and instillation on large corner lots to maximize visibility. The investigators develop our person-based intervention, Nature Coach, as a novel adoption of an analogous, established patient navigator concept in healthcare.

Enrollment: 74 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years or older
• Live in one of the 8 target neighborhoods identified
• Have a smartphone
• Able to understand and respond to an oral interview in English.

Exclusion criteria

• Unwilling to go outside
• Not ambulatory

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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74 participants in 4 patient groups

Nature Nook

Experimental group

Description:

Nature Nook builds on our prior work with a standard vacant lot greening intervention involving: removing trash, grading the land, planting new grass and trees, installing a low wooden perimeter fence, and regular maintenance. This greening intervention was designed as a blight removal strategy. People in this arm receive no intervention.

Treatment:

Other: Nature Nook

Nature Coach

Experimental group

Description:

The Nature Coach intervention, developed in a prior study (NCT04146025), will be delivered to people in their homes. Participants will live in the blocks immediately surrounding the study vacant lots randomized to this arm. The lots in this arm receive no intervention.

Treatment:

Behavioral: Nature Coach

Nature Nook + Nature Coach

Experimental group

Description:

This is a combined arm: a place-based intervention (Nature Nook) and a person-based intervention (Nature Coach).

Treatment:

Other: Nature Nook + Nature Coach

Control

No Intervention group

Description:

The study lots randomly selected for this arm, as well as the participants living near them, receive no intervention.