The Emotional, Physical and Cognitive Benefits of Purposeful Green Space Activities on Seniors

Not Applicable

Completed

Conditions: Social Isolation
Mood
Physical Activity
Loneliness
Well Aging
Mobility Limitation

Interventions: Other: Green space

Registration Number: NCT04913363

Lead Sponsor: University of Virginia

Brief Summary: This project explores if various nature based activities can lead to acute improvements in emotional, physical and cognitive health outcomes and encouraging senior center (JABA) service users to return to a safe environment. The activities the investigators will use include walking in nature, engaging in physical planting and cerebral, citizen science based activities.

Detailed Description: This study builds on the previous experimental work and expands it to focus on older adults in the Charlottesville area. The study objective is to understand the impact of different types of activities in green settings on physical and mental health outcomes in older adults at JABA centers using a repeated measures, crossover design in 20 participants.

There are three activity sessions in this project; walking (contemplative), planting (physical) and citizen science (cerebral). The walking condition will be a short green walk (10-15 minutes). The planting session will be run by JABA staff and a Master Gardener and will allow participants an opportunity to be outdoors and plant and tend to plants. The citizen science session will be run by JABA staff and a consultant and will rely less on physical exertion but rather focus on understanding green space at a more academic level. All sessions will be outdoors and will follow COVID-19 guidelines in place at the time of testing.

Outcome Measures The investigators will use various measures to assess the impact of green activity on emotional, physical and cognitive health outcomes, including;

* Loneliness; measured by the UCLA Loneliness Scale, a 3-item scale that captures feelings of loneliness.

* Belonging; measured by the General Belonging Scale (GBS), a 12-item scale capturing social acceptance/inclusion and social rejection/exclusion.

* Acute Mood; pre and post measures of mood will be taken using the UWIST Mood Adjective Checklist (MACL), an acute measure of hedonic tone, stress and arousal.

* Restoration; Psychological restorative qualities of the setting measured by the Perceived Restorativeness Scale, a three point scale determining the restorative quality of activity spaces.

* Physical Activity_OMNIT; In addition to the arousal measure of the MACL, the investigators used the 11 point scale (from 0 to 10) of the OMNIT Perceived Exertion scale (tiredness), to understand how physically tired the activities made them.

* Physical Activity_OMNIH; In addition to the arousal measure of the MACL, the investigators used the 11 point scale (from 0 to 10) of the OMNIH Perceived Exertion scale (exertion), to understand how much perceived physical effort participants put in.

* Accelerometer; the investigators will use accelerometers to measure participant movement throughout the activities to correlate with physical activity measures.

All outcome measures will be scored and subsequently analysed using a one-way ANOVA to determine if experimental condition leads to any statistically significant difference between outcome scores. The investigators will look for correlations between outcome measures in order to establish relationships between variables.

The investigators will also send a short survey to a number of JABA service users (n=30) to understand mood, wellbeing and current barriers to returning to their local JABA center. This survey will include the UCLA Loneliness Scale, the GBS, mood and physical activity measures included above, as well as broader questions assessing their experience of the lockdown and their needs for safe return to the center.

Participants will be sent consent information in advance and have an opportunity to talk to the research time prior to attending their first session. For all conditions, participants would meet at a pre-determined location near their local JABA center and taken to the activity site directly. Participants will complete the short surveys, listed above, both pre and post their activity. All activities will last around 20 minutes. Participants will return for two consecutive weeks to undertake the alternative activities to which they originally completed.

Activities Participants will undertake three activities, on separate days, throughout this project.

1. Walking; this contemplative activity will see users taken to a local green space area near their center and encouraged to walk around the space. It is anticipated that walks will last around 15-20 minutes.

2. Planting; this physical activity will see users, lead by a local Master Gardener, engage with planting vegetables/fruit in raised beds. Not only will this allow users a chance to engage physically with nature, but it is anticipated that the grown produce will be used for center users.

3. Citizen Science; this cerebral activity sees users engage with local green spaces, under the instruction of a citizen scientist, to learn about the intricacies of the space. This may include lichen counts (or similar) where the main outcome is learning based.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 24

Inclusion Criteria

Over 65 years
A JABA center user
Can walk unassisted for 20 minutes
Willing to comply with COVID-19 regulations

Exclusion Criteria

Under 65 years
Never used a JABA center
unable to walk unassisted for 20 minutes.
Unwilling to comply with COVID-19 regulations

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Walking	Green space	This contemplative activity will see users taken to a local green space area near their center and encouraged to walk around the space. It is anticipated walks will last around 15-20 minutes.
Citizen Science	Green space	This cerebral activity sees users engage with local green spaces, under the instruction of a citizen scientist, to learn about the intricacies of the space. This may include lichen counts (or similar) where the main outcome is learning based.
Planting	Green space	This physical activity will see users, lead by a local Master Gardener, engage with planting vegetables/fruit in raised beds. Not only will this allow users a chance to engage physically with nature, but it is anticipated that the grown produce will be used for center users.

Primary Outcome Measures

Name	Time	Method
Loneliness (Time 1)	Pre activity	Loneliness was measured by the University of California, Los Angeles (UCLA) Loneliness Scale, a 3-item scale that captures feelings of loneliness. Scores range from 3 to 9 with higher scores indicating higher levels of perceived loneliness
Loneliness (Time 2)	Post activity (20 minutes after pre-activity measure)	Loneliness was measured by the University of California, Los Angeles (UCLA) Loneliness Scale, a 3-item scale that captures feelings of loneliness. Scores range from 3 to 9 with higher scores indicating higher levels of perceived loneliness
Social Isolation (Time 1)	Pre activity	Social Isolation was measured by the General Belonging Scale (GBS), a 12-item scale capturing social acceptance/inclusion and social rejection/exclusion. Scores will range from 12 to 84, with higher scores indicating higher levels of perceived belonging.
Social Isolation (Time 2)	Post activity (20 minutes after pre-activity measure)	Social Isolation was measured by the General Belonging Scale (GBS), a 12-item scale capturing social acceptance/inclusion and social rejection/exclusion. Scores will range from 12 to 84, with higher scores indicating higher levels of perceived belonging.
Mood_hedonic Tone (Time 1)	Pre activity	Pre measures of mood (hedonic tone) was taken using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (MACL), an average measure of hedonic tone. The subscale will range from 4 to 16, with higher scores indicating higher valence.
Mood_hedonic Tone (Time 2)	Post activity (20 minutes after pre-activity measure)	Post measures of (hedonic tone) was taken using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (MACL), an average measure of hedonic tone. The subscale will range from 4 to 16, with higher scores indicating higher valence.
Well Aging_ Using Perceived Restorativeness Scale	Post activity (20 minutes after pre-activity measure). This measure is a post-condition measure only that measures restoration as a result of the condition. This cannot be done before exposure to the condition.	Psychological restorative qualities of the setting was measured by the Perceived Restorativeness Scale, a three point scale determining the restorative quality of activity spaces. Scores range from 4 to 28, with higher scores indicating higher levels of perceived restoration.
Physical Activity_OMNIT	Post activity (20 minutes after pre-activity measure). OMNIT is administered post-activity ONLY.	In addition to the arousal measure of the MACL, the investigators used the 11 point scale (from 0 to 10) of the OMNIT Perceived Exertion scale (tiredness), to understand how physically tired the activities made them. Lower scores indicate the tasks are easy; higher scores indicate the tasks are hard.
Physical Activity_OMNIH	Post activity (20 minutes after pre-activity measure). OMNIH is administered post-activity ONLY.	In addition to the arousal measure of the MACL, the investigators used the 11 point scale (from 0 to 10) of the OMNIH Perceived Exertion scale (exertion), to understand how much perceived physical effort participants put in. Lower scores indicate the tasks are easy; higher scores indicate the tasks are hard.
Mood_Stress (Time 1)	Pre activity	Pre measures of mood (stress) was taken using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (MACL), an average measure of stress. The subscale will range from 4 to 16, with higher scores indicating higher stress.
Mood_Stress (Time 2)	Post activity (20 minutes after pre-activity measure)	Post measures of mood (stress) was taken using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (MACL), an average measure of stress. The subscale will range from 4 to 16, with higher scores indicating higher stress.
Mood_arousal (Time 1)	Pre activity	Pre measures of mood (arousal) was taken using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (MACL), an average measure of arousal. The subscale will range from 4 to 16, with higher scores indicating higher arousal.
Mood_arousal (Time 2)	Post activity (20 minutes after pre-activity measure)	Post measures of mood (arousal) was taken using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (MACL), an average measure of arousal. The subscale will range from 4 to 16, with higher scores indicating higher arousal.

Secondary Outcome Measures

Name	Time	Method
Mobility Limitation	Throughout activity (measure taken for 20 minutes)	Mobility Limitation was determined using accelerometers to measure participant movement throughout the activities to correlate with physical activity measures.