Testing a Nature-based Socila Intevention on Loneliness: the RECETAS-PRG Trial
- Conditions
- Loneliness
- Interventions
- Behavioral: Nature-based social intervention (NBIS)Behavioral: Usual care + menu with nature based activities
- Registration Number
- NCT05522140
- Lead Sponsor
- Vladimíra Dostálová
- Brief Summary
RECETAS (Re-imagine Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is an European project (H2020 No 945095) that aims to reduce loneliness by linking lonely pople to nature-based social actvitities through a group-based intervention.
Background: Loneliness is a person's own perception when his/her need for satisfying social contact and relationships is not met. The feeling of loneliness can be experienced even by a person who is surrounded by people. RECETAS aims to design and test nature-based socila itervention (NBSI) that is group-based and includes access to nature as a main component. The testing will be conducted in six different citites: Barcelona, Helsinki, Prague, Marseille, Cuenca in Ecuador and Melbourne. If succesful, this will provide an evidence-based approach for using social prescribing to address loneliness.
Objectives: to assess the effectiveness of a 10-week NBSI on loneliness and health-related quality of life in vulnerable people in the area of Prague suffering from it compared to usual social and health care at post-intervention, and at 6-, and 12-months post-randomization.
A pilot study was conducted from May to June 2022 prior to the start of the study in January 2023. The main aim of the pilot study was to identify barriers and obstacles to conducting the trial itself.
Methods: The study design is a randomized controlled trial (RCT) including a process evaluation based on Medical health Council guidance, a nested qualitative study and a Health Economics evaluation.
Participants will be recruited mainly from primary care settings (health and social), third sector organisations, community groups, and volunteer organisations. A total of 316 participants will be randomly allocated in two arms after the baseline assessment: NBSI tratment and control arms. All of them will be asked to sign the informed consent form.
- Detailed Description
RECETAS (Re-imagine Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is project that adresses loneliness and the role of nature-based social prescription (NBSP) to reduce it. This project has received funding from European Union's Horizon research and innovation under grant agreement No 945094. More information at: https://recetasproject.eu/
Background: Loneliness is a person's own perception when his/her need for satisfying social contact and relationships is not met. The feeling of loneliness can be experienced even by a person who is surrounded by people. Loneliness is a modifiable health condition that is potentially dangerous to health and can reduce people's life span. In Europe, 30 million people European adults frequently felt lonely.
Social prescription is a non-medical approach that aims to connect people with the community through social outdoor activities to improve their wellbeing. NBSP is an intervention where nature-based social activities connect people, places and institutions that form strong social networks and connections. Nature-based activities can facilitate a dynamic process and social interactions and can thus contribute to reducing feelings of loneliness. We will design and test nature-based social intervention (NBSI) that is group-based and includes access to nature as a main component. The testing will be conducted in six urban areas: Barcelona, Helsinki, Prague, Cuenca in Ecuador and Melbourne.
Objectives: to assess the effectiveness of a 10-week NBSI on loneliness and health-related quality of life in vulnerable people in the area of Prague suffering from it compared to usual social and health care at post-intervention, and at 6-, and 12-months post-randomization.
A pilot study was conducted from May to June 2022 prior to the start of the study in January 2023. The main aim of the pilot study was to identify barriers and obstacles to conducting the trial itself.
Methods: A randomized controlled trial (RCT) will be used to assess the effect of NBSI on reducing feelings of loneliness. The RCT will use mixed-method approach collecting qunatitative information to assess the the main outcomes and qualitative methods to explore participant's and professional's experiences. ISGlobal coordinates the overall RECETAS project. Charles University leads the implementation of the RECETAS-PRG and is responsible for the recruitment process, intervention, assessment, evaluation, data analysis and qualitative part of the study.
Recruitment will be carried out in cooperation with the Centre of Longevity and Long-Term Care, the Czech Alzheimer's Society, general practitioners and other outpatient specialists, and home care organizations based on a long-term focus on the target group. Participants will be recruited mainly from primary care settings (health and social), third sector organisations, community groups, and volunteer organisations. A total of 316 participants will be randomly allocated in two arm (158 each): NBSP intervention arm and control arm. All of them will be asked to sign the informed consent form.
The intervention is a theory-informed, multicomponent, multi-level, behaviorally based complex intervention that requires a specific trainning to prepare facilitators. The intervention model is adapted from the "Circle of Friends" methodology developed by the University of Helsinky by Pitkälä KH et al. It consists in: a) individualized session with facilitators (one-to-one); b) group-based program (5-15 people) for 9 sessions, one a wiil, including nature-based activities in the area chosen by the participants. Control group participants will recieve usual care, and list of natrure-based activities available ti their area.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 316
- Able to give informed consent in Czech
- Older adults (60+) with a risk of social isolation and loneliness
- Currently experiencing loneliness according to the screening question "Do you suffer from loneliness?"
- Willing to undergo study measurement.
- Unable to go outdoors due to poor mobility or severe diseases.
- Poor hearing or sight in case it prevents them to participate of the group dynamics and activities in the nature.
- Severe, moderate or mild cognitive decline.
- Any mental health disorders that might interfere with the group dynamics.
- Severe disease with poor prognosis < 6 months.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention arm Nature-based social intervention (NBIS) The intervention arm will undergo following steps: 1. Groups of 5-15 persons, who lives in Prague. Two trained facilitators support the group dynamics forstering empowerment. 2. Each participant will undergo an individual session with the facilitator(s) aimed at building relationships and trust, and getting to know the expectations and characteristics of the participants. 3. 9 group activities with the aim to promote accessibility and engagement with the nature and outdoor activities available in their town. Collaborative mapping of nature-based community activities will direct the group to activities they want to approach and test. Control arm Usual care + menu with nature based activities Participants randomly assigned to the control arm will receive usual care, which is a list of community resources in the city (Prague). Usual care is an appropriate comparison rather than placebo for complex interventions
- Primary Outcome Measures
Name Time Method De Jong Gierveld Loneliness Scale 11 item Post-intervention (10 weeks) Change in loneliness. De Jong Gierveld Loneliness Scale (minimum 0 (best) and maximum 11 (worst))
15D instrument of health-related quality of life Post-intervention (10 weeks) Change in health related quality of life. Minimum 0 (worst) and maximum 1 (best). 15D will be used as an index ( 0 to 1) and the changes in various 15 dimensions will also be explored.
- Secondary Outcome Measures
Name Time Method Psychological Wellbeing Scale by Routasalo et al. 2009 From baseline to 3months, 6months, 12 months Change in psychological wellbeing.Minimum 0 (worst) and maximum 1 (best).
Clock drawing test From baseline to 3months, 6months, 12 months Change in executive function. Minimum 0 (worst) and maximum 6 (best)
Instrumental Activities of Daily Living Scale From baseline to 3months, 6months, 12 months Change in instrumental activities of daily living. Minimum 0 (worst) and maximum 10 (best)
15D instrument of health-related quality of life Baseline (before intervention), 6- and 12-months follow up Change in health related quality of life. Minimum 0 (worst) and maximum 1 (best). 15D will be used as an index ( 0 to 1) and the changes in various 15 dimensions will also be explored.
De Jong Gierveld Loneliness Scale 11 item Baseline (before intervention), 6- and 12-months follow up Change in loneliness. De Jong Gierveld Loneliness Scale (minimum 0 (best) and maximum 11 (worst))
International Physical Activity Questionnaire From baseline to 3months, 6months, 12 months Change in physical activity. Minimum 1 (worst) and maximum 3 (best)
Geriatric Depression Scale From baseline to 3months, 6months, 12 months Change in depression. Minimum 0 (best) and maximum 15 (worst)
Lubben Social Network Scale From baseline to 3months, 6months, 12 months Change in social network. Minimum 0 (worst) and maximum 5 (best)
EURO-QOL 5D-5L From baseline to 3months, 6months, 12 months Health economic analyses. Cost of health services with EQ5D-5L
ICEpop CAPability mesure for Adults (ICECAP-A) From baseline to 3months, 6months, 12 months Self-reported measure of capability wellbeing for adults
Nature connection index From baseline to 3months, 6months, 12 months Relationship with nature. Min = 1 Max = 7. Higher scores indicating stronger connectedness to nature
Trial Locations
- Locations (1)
Charles University
🇨🇿Prag, Czechia