Targeted health promotion with guided nature walks or group exercise: a controlled trial in primary care

Frontiers in Public Health

Public Health

Annika Kolster¹  Timo Partonen²  Heini Wennman²  Malin Heikkinen³  Adela Pajunen⁴  Anders Mickos⁵ 

[1] Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland;Health Services, Western Uusimaa Wellbeing Services County, Espoo, Finland;Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland;Health and Social Welfare Service, Eastern Uusimaa Wellbeing Services County, Sipoo, Finland;Luonnontie, Helsinki, Finland;Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland;

关键词: green space;    mental wellbeing;    sleep;    primary care;    social prescribing;    exercise;    nature-based interventions;    health promotion;   

DOI  :  10.3389/fpubh.2023.1208858

 received in 2023-04-19, accepted in 2023-07-21,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundContact with nature promotes wellbeing through diverse pathways, providing a potential way of supporting health especially in primary care, where patients commonly suffer from multimorbidity and poor general health. Social prescribing is a non-pharmaceutical approach for improving health as well as social inclusion. This field study explores and compares the effects of a nature-based and an exercise-based social prescribing scheme on mental wellbeing and sleep, in a primary care population.MethodsPrimary care patients identified to benefit from a general improvement to their health were recruited by nurses, doctors, or social workers to this non-randomized, intention-to-treat, pilot field-study. Participants (n = 79) chose between the group interventions, either taking part in guided walks in nature, including immersion in a forest with high biodiversity, or participating in a versatile sports program. Mental wellbeing was assessed with the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), with additional questions evaluating self-rated health and sleep. Impact on mental wellbeing was explored in relation to perceived health. The amount and quality of sleep was measured with wrist-worn accelerometers. With a focus on everyday life impacts, the assessments took place before and after the 8-week intervention. All participants lived in Sipoo, Finland, an area with abundant accessible green space.ResultsParticipants (mean age 57 years, 79% female) rated their general and mental health lower than the general population. Participation in the Nature-group resulted in improved mental wellbeing (change in WEMWBS by 3.15, p = 0.008), with a positive change for feeling relaxed, being cheerful, having energy to spare, feeling able to deal well with problems, feeling good about oneself and feeling close to other people. The Sports-group was beneficial for those initially rating their health as good. Sleep duration improved in the Sports-group, while participants in the Nature-group reported better sleep quality. Following the interventions there was improvement in perceived health and ability to function in both groups, while perceived mental health improved only in the Nature-group.ConclusionWe attest that even in areas surrounded by greenery, active interventions can further improve health in a primary care population, and that nature-based interventions are beneficial for those in poor health.Clinical trial registrationClinicalTrials.gov, Identifier NCT05893212.

【 授权许可】

Unknown   
Copyright © 2023 Kolster, Heikkinen, Pajunen, Mickos, Wennman and Partonen.