A Dose of Nature: An Interdisciplinary Study of Green Prescriptions

Summary

The idea that spending time in natural environments can enhance one's health has been researched for several years. However, the concept of green prescribing--or prescribing a systematic nature-based intervention that can be monitored over time--has only recently generated traction in practice (although the principles can be traced back to several hundred years ago).

Green prescriptions (social prescribing with nature) could potentially help to reduce the costs of mainstream healthcare and could have important 'co-benefits', for example, by simultaneously enhancing the environment.

There are still a number of critical questions that need answering, such as what works best for whom, where and when, and a number of key constraints need to be addressed. The conceptual framework for this proposed trial has been informed by the results of a UK-wide green prescribing questionnaire (Stage 1 of PhD) and recommendations from the Improving Wellbeing through Urban Nature (IWUN) research project (www.iwun.uk).

The main (perceived) constraints to green prescribing acquired from the questionnaire include:

\- A lack of funding for all stakeholders

* The research project aims to be cost-effective and not strictly reliant on other organisations

\- A lack of knowledge of how to start a green prescribing service
* The project aims to demonstrate how to start a green prescribing service

\- A lack of opportunities and awareness of service availability
* As above

\- Patient motivation and ease of access/travel etc.
* The novel situational aspect of the project (within the premises of GP practices) aims to maximise access/minimise travel for patients

\- A lack of knowledge of the evidence and mechanisms
* The research project aims to collect evidence on mental health, wellbeing and nature connectedness via an RCT-style experimental design

\- Referral and set-up time
* As per funding objective - see top. The research project will also evaluate patient appointments/attendances (number and frequency) via the RCT approach

The researcher is proposing to conduct a 3-6 month randomised controlled trial (RCT) interventional study involving adult patients with mild-moderate depression as determined using the well-established PHQ-9 questionnaire. A key aim is to sustain this green prescribing service once the research is complete and to hopefully stimulate other trials across Sheffield and the UK (providing opportunities for important meta-analyses).

The intervention will include pocket gardening (activities in small, semi-permanent, versatile gardens) and nature-based activities hosted in the premises of GP surgeries in Sheffield's Network North region.

Conditions

• Mental Health Issue
• Depression

Interventions

OTHER

Green prescription

Green prescription intervention will include horticultural activities such as planting, harvesting, learning about ecology and sustainable food growing.

Sponsors & Collaborators

• Greener Practice, Sheffield

  collaborator UNKNOWN

• Sheffield Network North Primary Care Network (PCN)

  collaborator UNKNOWN

• University of Sheffield

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2020-03-31

Primary Completion

2020-09-30

Completion

2021-12-31