Stay Healthy In Nature Everyday: Family Nature Outings in a Low Income Population

Not Applicable

Completed

Interventions: Behavioral: Family outings
Device: Pedometry
Behavioral: Park prescription
Behavioral: Case Management

Brief Summary: The SHINE study is a randomized controlled study of the effect of a park-based family support group on multiple outcomes (including stress and physical activity) in a low income population.

Detailed Description: Despite mounting evidence that nature matters for human health, we are not aware of any prospective intervention trials looking at the use of nature as a health intervention. Like other protective factors, such as the presence of a caring adult, safe play places, greater stimulation, the presence of green-space in a child's life has been empirically linked to greater resilience. Nature has been proposed as a buffer to stress through several pathways: by providing a space for friends and families to gather (thereby increasing social support and improving family relationships), by increasing opportunities for physical activity, and by improving cognition. Research to date suggests that participation in outdoor activities facilitates a sense of connectedness to place. This sense of attachment may also provide a form of social support. Families served by Children's Hospital Oakland Primary Care Clinic experience high levels of stress. As a safety-net clinic, the primary care clinic serves a diverse set of patients, with a common thread of poverty. The Stay Healthy In Nature program was developed to encourage stress management skills through play and physical activity in parks. The program uses a combination of facilitated and independent outings into local parks to encourage sustained behavior change and measurable health benefits.

Recruitment & Eligibility

Inclusion Criteria

Child must be 4 years and older, a patient in our clinic, physically able, available for follow up, able to answer questionnaire
Caregiver must be 18 or older, legal guardian, physically able, able for follow up, able to answer questionnaire

Exclusion Criteria

Enrolled in a weight loss program, unable to be physically active, unable to give informed consent, unable to follow up for study duration.

Arm && Interventions

Group	Intervention	Description
Park prescription and family outings	Case Management	Park prescription, pedometry, case management and 3 weekly family outings.
Park prescription	Pedometry	Park prescription, pedometry.
Park prescription and family outings	Family outings	Park prescription, pedometry, case management and 3 weekly family outings.
Park prescription and family outings	Park prescription	Park prescription, pedometry, case management and 3 weekly family outings.
Park prescription and family outings	Pedometry	Park prescription, pedometry, case management and 3 weekly family outings.
Park prescription	Park prescription	Park prescription, pedometry.

Primary Outcome Measures

Name	Time	Method
Change in Stress	1 month	measured through the Perceived Stress Score10 (PSS10), a ten item, validated instrument which ranges from 0-40.

Secondary Outcome Measures

Name	Time	Method
Change in Park Visits Per Week	3 month	Self-reported number of park visits in the last week, measured at 0, 1, and 3 months.
Change in Minutes of Moderate Physical Activity Per Day	1 month	Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1months follow up. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results.
Change in Cortisol Level in Parents	1 month	Salivary cortisol from parents