Nature and Well-Being Project

NCT ID: NCT04642235

Last Updated: 2022-09-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 74 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-04-12
• Study Completion Date: 2022-08-23

Brief Summary

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.

Detailed 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.

Conditions

Environmental Exposure; Health Behavior; Health, Subjective

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Nature Nook

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.

Group Type: EXPERIMENTAL

Nature Nook

Intervention Type: OTHER

The Nature Nook intervention will take place on lots that already have the standard greening intervention. In addition, design elements will be added such as a simple path and benches to explicitly invite people into the space. An additional difference is the exclusive use of larger, corner lots, rather than smaller mid-block spaces, to maximize visibility.

Nature Coach

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.

Group Type: EXPERIMENTAL

Nature Coach

Intervention Type: BEHAVIORAL

The Nature Coach Intervention consists of 3 components - home visit, text message follow up, and goal feedback.

Home visit. During the 1-hour home visit, the coach will (a) provide education about the health benefits of nature, (b) identify nearby nature targets for the participant to visit, (c) complete a pre-commitment contract based on individualized weekly nature goals, and (d) brainstorm barriers and solutions to reaching the goals.

Personalized weekly text messages. Texts will serve as reminders of goals set with the Nature Coach, as well as encouragement to meet the goals. The context of text messages with change slightly based on individual participants, the goals they set, and the barriers they identify.

Goal feedback- At the end of each week, participants will receive a progression badge via text message that shows the amount of days and time they spent in nature, and how this matched up to the goal set with the Nature Coach.

Nature Nook + Nature Coach

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

Group Type: EXPERIMENTAL

Nature Nook + Nature Coach

Intervention Type: OTHER

The combined intervention will involve the installation of Nature Nooks to blighted vacant lots followed by the delivery of the Nature Coach intervention to people living in the immediate surrounding blocks. The intervention will be tailored to explicitly direct participants to use the Nature Nook.

Control

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

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Nature Nook

The Nature Nook intervention will take place on lots that already have the standard greening intervention. In addition, design elements will be added such as a simple path and benches to explicitly invite people into the space. An additional difference is the exclusive use of larger, corner lots, rather than smaller mid-block spaces, to maximize visibility.

Intervention Type: OTHER

Nature Coach

The Nature Coach Intervention consists of 3 components - home visit, text message follow up, and goal feedback.

Home visit. During the 1-hour home visit, the coach will (a) provide education about the health benefits of nature, (b) identify nearby nature targets for the participant to visit, (c) complete a pre-commitment contract based on individualized weekly nature goals, and (d) brainstorm barriers and solutions to reaching the goals.

Personalized weekly text messages. Texts will serve as reminders of goals set with the Nature Coach, as well as encouragement to meet the goals. The context of text messages with change slightly based on individual participants, the goals they set, and the barriers they identify.

Goal feedback- At the end of each week, participants will receive a progression badge via text message that shows the amount of days and time they spent in nature, and how this matched up to the goal set with the Nature Coach.

Intervention Type: BEHAVIORAL

Nature Nook + Nature Coach

The combined intervention will involve the installation of Nature Nooks to blighted vacant lots followed by the delivery of the Nature Coach intervention to people living in the immediate surrounding blocks. The intervention will be tailored to explicitly direct participants to use the Nature Nook.

Intervention Type: OTHER

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

American Heart Association

OTHER

Sponsor Role: collaborator

Pennsylvania Horticultural Society

UNKNOWN

Sponsor Role: collaborator

United States Forest Service

UNKNOWN

Sponsor Role: collaborator

OLIN Studio

UNKNOWN

Sponsor Role: collaborator

University of Pennsylvania

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Eugenia South, MD MS

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

University of Pennsylvania, Department of Emergency Medicine

Philadelphia, Pennsylvania, United States

Countries

United States

Other Identifiers

842575

Identifier Type: -

Identifier Source: org_study_id