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Building Individual and Community Resilience Through Nature-based Therapies - Case Study 8 Nature for All

Not Applicable
Not yet recruiting
Conditions
Mobility Disability
Interventions
Behavioral: Audioguided Nature tour
Behavioral: Non audio guided nature tour
Registration Number
NCT06205940
Lead Sponsor
University of Copenhagen
Brief Summary

The aim of this randomized controlled trial is to test if digital engagement instructions (a nature guide APP) can enhance the nature connection and provide positive health outcomes for individuals with mobility disabilities.

The study has an active control group, that will have the same nature exposure without the guidance of the APP. 124 participants will be randomized to either the intervention group or the control group.

The intervention consists of two parts:

Intervention day 1: The intervention starts for both the 'intervention group' and the 'control group' in the Hoersholm arboretum, which contain Denmark's largest collection of different trees and shrubs. The intervention group will listen to the 'intervention APP' during a tour with three stops along a trail in the arboretum. The active control group will take the same tour but does not have access to the 'intervention APP'.

4 week intervention: During the following 4 weeks the participants will be encouraged to visit nature for 120 minutes in total per week on their own. The intervention group will still be encouraged to use the APP during the nature visits.

Detailed Description

See protocol

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
124
Inclusion Criteria
  • Not being able to walk at all or be able to walk short distances (ICF 2017: d4500, walking short distances; walking for less than a kilometer, such as walking around rooms or hallways, within a building or for short distances outside)
  • All types of assistive devices, including e.g. scooters, walkers, and canes. Also service dogs and personal carers are included.
  • Adults (+18 years)
  • All genders
  • All educational levels
  • All religious affiliations
  • All types of marital status
  • All types of households
  • All types of employment and income
Exclusion Criteria
    • Do not understand Danish (APP, questionnaires and interviews in Danish)
  • Physically not able to use a smartphone with touch screen, by themselves or with the help of a personal carer
  • Participating in mindfulness program during intervention (intervention day 1 and 4-week intervention period)
  • Cognitive limitations (difficulties in understanding and using information from APP, understanding and responding to questionnaires and interviews.)
  • Known drug or alcohol abuse
  • Diagnosed epilepsy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Audio guided nature tourAudioguided Nature tourListening to audio instructions by an app while visiting nature.
Non audio guided nature tourNon audio guided nature tourVisiting nature without audio guided instructions (app).
Primary Outcome Measures
NameTimeMethod
The Nature Connection IndexBaseline 0 (1 week before intervention), After intervention day 1, End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up

Questionnaire Nature Connection Index (NCI) is a 6-item self-report measure of connection to nature. The level of agreement with each of the 6 statements is rated on a scale from 1 (completely agree) to 7 (completely disagree), where a higher score indicates higher level of nature connection.

Secondary Outcome Measures
NameTimeMethod
The Restorative Outcome ScaleAfter tour on intervention day 1, End of intervention (after 4 months)

The Restorative Outcome Scale (ROS) is a 6-item self-report measure of the restorative effect of natural environments. The level of agreement with each of the six statement is rated on a 7 point scale from 0 (completely disagree) to 6 (completely agree), where a higher score indicates higher level of self perceived restorative outcome.

The Subjective Vitality ScaleBaseline 0 (1 week before intervention), After intervention day 1, End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up

The Subjective Vitality Scale (SVS) is a 6-item self-report measure of subjective vitality. The level of agreement with each of the six statement is rated on a 7 point scale from 1(completely disagree) to 7 (completely agree), where a higher score indicates higher level of subjective vitality.

The Health-related Quality of Life Short Form SurveyBaseline 0 (1 week before intervention), End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up

The Health-related Quality of Life Short Form Survey (SF-12) is a 12-item Short Form Survey measuring health related quality of life. Each question is answered on a 6 point scale ranging from not at all (1) to all the time (6). A higher total score indicates higher level of health-related quality of life.

the State Mindfulness ScaleBaseline 1 (just before intervention), After tour on intervention day 1, End of intervention (after 4 months)

The State Mindfulness Scale (SMS) is a 21-item self-report measure of state mindfulness. The level of agreement with each of the 21 statements is rated on a scale from 1 (not at all) to 5 (very much), where a higher score indicates higher level of state mindfulness.

Heart Rate VariabilityDuring tour on intervention day 1

HRV analysis will be performed on electrocardiograms, ECG signals

The State-Trait Assessment of Resilience ScaleBaseline 0 (1 week before intervention), After intervention day 1, End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up

The State-Trait Assessment of Resilience Scale (STARS) is a 7-item self-report measure of resilience. The level of agreement with each of the 7 statements is rated on a 4 point scale from 1(disagree) to 4 (completely agree). Item 3,4,5 have reverse scoring. A higher score indicates higher level of subjective vitality.

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