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Need and Interest in Nature Prescriptions to Protect Cardiovascular and Mental Health: A Nationally-Representative Study With Insights for Future Randomised Trials - 02/02/23

Doi : 10.1016/j.hlc.2022.11.008 
Thomas Astell-Burt, PhD a, b, , J. Aaron Hipp, PhD c, Birgitta Gatersleben, PhD d, Deepti Adlakha, PhD e, Melissa Marselle, PhD d, Katarzyna Olcoń, PhD a, Evangelos Pappas, PhD f, Michelle Kondo, PhD g, Gillian Booth, PhD h, Simon Bacon, PhD i, j, Melissa Lem, MD k, Monique Francois, PhD f, l, Elizabeth Halcomb, PhD m, Lorna Moxham, PhD l, m, n, Patricia Davidson, PhD o, Xiaoqi Feng, PhD b, p, q,
a School of Health and Society, University of Wollongong, Wollongong, NSW, Australia 
b Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia 
c Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, NC State University, Raleigh, NC, USA 
d Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, UK 
e Department of Landscape Architecture and Environmental Planning, Natural Learning Initiative, College of Design, NC State University, Raleigh, NC, USA 
f School of Medicine, University of Wollongong, Wollongong, NSW, Australia 
g USDA Forest Service, Northern Research Station, Philadelphia Field Station, Philadelphia, PA, USA 
h MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada 
i Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Québec, Canada 
j Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada 
k Department of Family Practice, University of British Columbia, Vancouver, BC, Canada 
l Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 
m School of Nursing, University of Wollongong, Wollongong, NSW, Australia 
n Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia 
o The Vice-Chancellor's Unit (P.M.D.), University of Wollongong, Wollongong, NSW, Australia 
p School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia 
q The George Institute of Global Health, Sydney, NSW, Australia 

Corresponding author at: Professor Thomas Astell-Burt, School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW 2522, AustraliaSchool of Health and SocietyFaculty of Arts, Social Sciences, and HumanitiesUniversity of WollongongWollongongNSW 2522Australia∗∗Corresponding author at: Professor Xiaoqi Feng, School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, AustraliaSchool of Population HealthFaculty of Medicine and HealthUniversity of New South WalesSydneyNSWAustralia

Abstract

Objective

“Nature prescriptions” are increasingly being adopted by health sectors as an adjunct to standard care to attend to health and social needs. We investigated levels of need and interest in nature prescriptions in adults with cardiovascular diseases, psychological distress and concomitants (e.g. physical inactivity, sedentary behaviour, obesity, loneliness, burn-out).

Methods

A nationally-representative survey of 3,319 adults across all states and territories of Australia was completed in February 2021 (response 84.0%). Participants were classified across 15 target groups using validated health indicators and surveyed on (1) time and frequency of visits to green and blue spaces (nature spaces), (2) interest in a nature prescription, and (3) potential confounders (e.g. age, income). Analyses were done using weighted logistic regressions.

Results

The sample was 50.5% female, 52.0% were aged ≥45 years, 15.2% were living alone and 19.3% were born overseas in non-English-speaking countries. Two-thirds of the sample spent 2 hours or more a week in nature, but these levels were generally lower in target groups (e.g. 57.7% in adults with type 2 diabetes). Most participants (81.9%) were interested in a nature prescription, even among those spending fewer than 2 hours a week in nature (76.4%). For example, 2 hours a week or more in nature was lowest among sedentary adults (36.9%) yet interest in nature prescriptions in this group was still high (74.0%). Lower levels of nature contact in target groups was not explained by differences in access to or preference for local nature spaces.

Conclusions

High levels of interest in nature prescriptions amid low levels of nature contact in many target health groups provides impetus for developing randomised trials of interventions that enable people to spend more time in nature. These findings can inform intervention co-design processes with a wide range of community stakeholders, end-users in target health groups, and the health professionals who support them.

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Keywords : Nature, Prevention, Management, Cardiovascular health, Mental health


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Vol 32 - N° 1

P. 114-123 - janvier 2023 Retour au numéro
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