Attention Restoration Theory: A systematic review of the attention restoration potential of exposure to natural environments

Encouraging online consumers into making better food choices: The power of nature exposure on healthy food choices

BACKGROUND

online environments can influence food desire and choices. We tested if online calming nature and stressful street environments can affect desire for healthy and unhealthy foods.

METHOD

we asked 238 participants (40 ± 14 yrs) to rate their desire (100 mm VAS) for 7 low calorie nutrient rich foods (Healthy) and 7 high calorie nutrient poor foods (Unhealthy), and perceived stress (state anxiety in STAI), before and after imagining themselves in a control, nature park, or busy street condition.

RESULTS

participants who imagined themselves being in a nature park had a significant higher desire for Healthy foods, than participants in the busy street condition (p < 0.05). Participants in the busy street condition decreased their desire for Healthy foods after they imagined themselves in a busy street (p < 0.05)). However, perceived stress did not impact the association between condition and desire for low calorie foods nor high calorie foods.

CONCLUSION

this study suggests that online environments can have an impact on healthy food desires, which could be of importance for the increased number of food choices which are made in online environments.

Bi-directional association between outdoor or social activities and cognitive function: do the PM2.5 exposure catalyze the detrimental inactivity-poor cognition cycle?

BACKGROUND

Previous research has shown that lack of leisure activities, either outdoor or social activities, impedes cognitive function. However, the interrelationship between poor cognition and deficient activities is understudied. In addition, whether exposure to air pollution, such as PM2.5, can accelerate the detrimental 'inactivity-poor cognition' cycle, is worthy of investigation.

METHODS

We used data from the 2008, 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We assessed the frequency of outdoor or social activities at each wave. The cognitive function was examined using a China-Modified Mini-mental State Examination. We estimated the residential exposure to fine particular matter (PM2.5) via a satellite-based model. We applied cross-lagged panel (CLP) model to examine the bi-directional relationship between outdoor or social activities and cognitive function. We then examined the effect of PM2.5 exposure with sequent cognitive function and activities using generalized estimation equation (GEE) model.

FINDINGS

Overall, we observed significant bi-directional associations between outdoor or social activities and cognitive function. Participants with better cognitive function in the last wave were more likely to engage in outdoor or social activities in the following wave (outdoor activities: β = 0.37, 95% CI [0.27,0.48], P < 0.01; social activities: β = 0.05, 95% CI [0.02,0.09] P < 0.01). Meanwhile, higher engagement in outdoor or social activities in the last wave was associated with more favorable cognitive function in the following wave (outdoor activities: β = 0.06, 95% CI [0.03,0.09], P < 0.01; social activities: β = 0.10, 95% CI [0.03,0.18], P < 0.01). Notably, an increase in PM2.5 exposure during the preceding year was significantly associated with a declining cognitive function (β = -0.05, 95% CI [-0.08,-0.03], P < 0.01), outdoor activities (β = -0.02, 95% CI [-0.04, -0.01], P < 0.01) and social activities (β = -0.02, 95% CI [-0.02, -0.01], P < 0.01) in the current year; the lagged effects of the PM2.5 exposure in the past year of the last wave on activities and cognitive function of the following wave were also observed.

INTERPRETATION

Our findings not only indicate the bi-directional links between the frequency of outdoor or social activities and cognitive function, but also report that PM2.5 exposure plays a role in catalyzing the detrimental inactivity-poor cognition cycle. Future research should investigate whether the policy-driven interventions, such as clean air policies, can break the unfavorable activity-cognition cycle, and thereby promoting health from the dual gains in leisure activities and cognition.

Consideration of Mental Health and Well-Being in High-Level Sport: When Will a Coach-Centred Approach Be Introduced?

Coverage of problems relating to mental health and well-being is gaining ground in the sports sector today, both in the media and in the scientific literature. Despite exposure to numerous stressors and suffering from poor mental health, coaches have in general been largely overlooked in the scientific literature. Previous studies have mainly focused upon athlete populations. The absence of research means that there are real shortcomings in both understanding the mechanisms involved in the deterioration of coaches' mental health and well-being and in the lack of specific support systems available. This paper first describes findings from the recent, albeit quite scarce, research investigating mental health and well-being in coaches. It then proposes a number of avenues for research and support protocols, both of which are currently ongoing at the French Football Federation Research Centre. The aim is to help support these key participants in the sports sector who arguably have not been given sufficient consideration until now.

Psychophysiological effects of walking in forests and urban built environments with disparate road traffic noise exposure: study protocol of a randomized controlled trial

BACKGROUND

Stress is a widespread phenomenon and reality of everyday life, entailing negative consequences for physical and psychological wellbeing. Previous studies have indicated that exposure to greenspaces and nature-based interventions are promising approaches to reducing stress and promoting restoration. However, an increasing percentage of the population lives in urban regions with limited opportunities to spend time in greenspaces. In addition, urban settings typically feature increased levels of noise, which represents a major environmental stressor. Although various studies have compared the effects of exposure to greenspaces versus urban built environments, evidence of the effects of noise in this context is very limited. Psychophysiological benefits of exposure to greenspaces compared to urban built environments reported in earlier studies might be less (or at least not only) due to features of the greenspaces than to additional stressors, such as road traffic noise in the urban built environment. Hence, differences in the effects attributed to greenness in previous studies may also be due to potentially detrimental noise effects in comparison settings. This paper reports the study protocol for a randomized, controlled intervention study comparing the effects of walking in forest versus urban built environments, taking road traffic noise exposure during walks in the respective settings into account.

METHODS

The protocol envisages a field study employing a pretest-posttest design to compare the effects of 30-min walks in urban built environments and forests with different road traffic noise levels. Assessments will consist of self-reported measures, physiological data (salivary cortisol and skin conductance), an attention test, and noise, as well as greenness measurements. The outcomes will be restoration, stress, positive and negative affect, attention, rumination, and nature connectedness.

DISCUSSION

The results will inform about the restorative effect of walking in general, of exposure to different types of environments, and to different noise levels in these sites. The study will provide insights into the benefits of walking and nature-based interventions, taking into account the potential detrimental effects of noise exposure. It will thus facilitate a better understanding of low-threshold interventions to prevent stress and foster wellbeing.

TRIAL REGISTRATION

ISRCTN48943261 ; Registered 23.11.2023.

Improving immersive experiences in virtual natural setting for public health and environmental design: A systematic review and meta-analysis of randomized controlled trials

In recent years, virtual reality (VR) technology has emerged as a powerful tool in the field of therapeutic landscapes. For hospitalized patients or individuals with limited mobility, VR provides highly personalized therapy by simulating authentic natural environments within a safe, convenient, and engaging setting. This study investigated the effectiveness of immersing patients in virtual natural environments for health recovery and compared the varying impacts of different types of landscapes on patients' recovery levels. The aim was to complement traditional medical approaches and enhance environmental design in the field of public health. Researchers systematically reviewed databases (January 2018 to August 2, 2023) to identify randomized controlled trials comparing the efficacy of virtual nature immersion with other treatments. The inclusion/exclusion criteria were established based on the population, intervention, comparison, outcomes, study design, and other aspects (expanded PICO) framework. The Cochrane tool was employed to assess the risk of bias. Meta-analysis was conducted by pooling the mean differences with a 95% confidence interval. Among 30 trials, a total of 2123 patients met the inclusion criteria, with 15 studies included in the meta-analysis. 30 trials met the criteria. Results show significant improvements in pain, anxiety, fear, and some physiological indicators with virtual nature-based treatments. On the other hand, natural scenes incorporating blue and green elements have been applied more extensively and have shown more significant effects. In comparison to conventional methods, this study strongly advocates that virtual reality environments are a crucial tool in bridging the gap between patients and nature, demonstrating their potential to reshape medical interventions and improve environmental design in the field of public health.

Interplay among Anxiety, Digital Environmental Exposure, and Cognitive Control: Implications of Natural Settings

Inhibitory control performance may differ greatly as a function of individual differences such as anxiety. Nonetheless, how cognitive control proficiency might be influenced by exposure to various environments and how anxiety traits might impact these effects remain unexplored. A cohort of thirty healthy volunteers participated in the study. Participants performed a Go/No-Go task before exposure to a 'forest' and 'urban' virtual environment, in a counterbalanced design, before repeating the GNG task. The State-Trait Anxiety Inventory (STAI) was finally filled-in. Our findings unveiled an initial negative correlation between anxiety trait levels and GNG task performance, consistent with the established literature attributing difficulties in inhibitory functionality to anxiety. Additionally, different environmental exposures reported opposite trends. Exposure to the 'forest' environment distinctly improved the GNG performance in relation to anxiety traits, while the 'urban' setting demonstrated adverse effects on task performance. These results underscore the intricate relationship among cognitive control, environmental exposure, and trait anxiety. In particular, our findings highlight the potential of natural settings, such as forests, to mitigate the impact of anxiety on inhibition. This might have implications for interventions aimed at improving cognitive control.

A scoping review of human health co-benefits of forest-based climate change mitigation in Europe

Climate change is a pressing global challenge with profound implications for human health. Forest-based climate change mitigation strategies, such as afforestation, reforestation, and sustainable forest management, offer promising solutions to mitigate climate change and simultaneously yield substantial co-benefits for human health. The objective of this scoping review was to examine research trends related to the interdisciplinary nexus between forests as carbon sinks and human health co-benefits. We developed a conceptual framework model, supporting the inclusion of exposure pathways, such as recreational opportunities or aesthetic experiences, in the co-benefit context. We used a scoping review methodology to identify the proportion of European research on forest-based mitigation strategies that acknowledge the interconnection between mitigation strategies and human impacts. We also aimed to assess whether synergies and trade-offs between forest-based carbon sink capacity and human co-benefits has been analysed and quantified. From the initial 4,062 records retrieved, 349 reports analysed European forest management principles and factors related to climate change mitigation capacity. Of those, 97 studies acknowledged human co-benefits and 13 studies quantified the impacts on exposure pathways or health co-benefits and were included for full review. Our analysis demonstrates that there is potential for synergies related to optimising carbon sink capacity together with human co-benefits, but there is currently a lack of holistic research approaches assessing these interrelationships. We suggest enhanced interdisciplinary efforts, using for example multideterminant modelling approaches, to advance evidence and understanding of the forest and health nexus in the context of climate change mitigation.

Acute effects of outdoor and indoor walking on cigarette cravings, withdrawal symptoms and affective response during temporary smoking abstinence

RATIONALE

Cigarette smoking is one of the leading preventable causes of premature death worldwide. There is evidence in the literature that brief exercise units indoors can improve well-being in temporarily abstinent smokers and reduce cigarette cravings and withdrawal symptoms.

OBJECTIVE

Because exercise in natural environments showed enhanced psychological effects, the aim of our study was to examine the acute effects of outdoor exercise compared with indoor exercise on craving, withdrawal symptoms and affective response in temporarily abstinent smokers.

METHODS

In a randomized controlled within-subject-design, temporarily abstinent smokers (N = 16) participated in three interventions lasting 10 min: outdoor walking (OUT-EX), indoor walking (IN-EX) and a sedentary control condition (CC). Self-reported cigarette craving, withdrawal symptoms and affective response were assessed pre-, mid-, post-interventions and at follow-up.

RESULTS

In contrast to CC, OUT-EX and IN-EX significantly reduced cigarette cravings during and at the end of the intervention compared to pre-intervention, but not at 20 min follow-up. Cigarette withdrawal symptoms decreased significantly over time in all three groups, but no significant group differences were found. OUT-EX and IN-EX, but not CC, showed significantly improved affective valence at the end of the intervention and at follow-ups. Outdoor walking resulted in significantly lower cigarette cravings than indoor walking at the end of the intervention.

CONCLUSION

The study adds to existing evidence that short bouts of indoor or outdoor exercise can help reduce cigarette cravings and increase well-being in abstinent smokers. Further studies are needed to address the potential additional effect of outdoor exercise on craving, affective states and smoking cessation.

Watching (natural) beauty boosts task performance: testing the nature-as-reward hypothesis

In two online studies, we tested the "nature-as-reward hypothesis", which suggests that superior cognitive task performance following nature exposure reflects a general performance improvement, driven by the reward value of beautiful things. In both between-subjects experiments, participants viewed either beautiful or less beautiful images for 10 s, comprising beautiful mountain photos (vs. less beautiful mountain drawings) in Study 1 and beautiful fractals (vs. less beautiful pixelated images) in Study 2. Following image exposure, participants engaged in a ticking task requiring them to freely tick up to 200 boxes. Participants had to complete four (Study 1) or five (Study 2) of such ticking tasks, with each task being preceded by either a beautiful or less beautiful image. In Study 1, for a subset of participants the ticking task was framed as a game. We found that in Study 1, ticking declined over the ticking rounds when participants had viewed less beautiful line drawings of mountains, while ticking performance remained unchanged over the rounds after seeing beautiful mountain images. However, when the ticking task was framed as a game, there was no significant difference in ticking performance between the two beauty conditions over the four ticking rounds. In Study 2, participants ticked more boxes over all ticking rounds after viewing images of beautiful fractals compared to less beautiful pixelated images. In line with the nature-as-reward hypothesis, these findings show that brief exposures to beautiful (nature) images can motivate to work and that framing tasks as a game can attenuate this beauty advantage.

Human Attention Restoration, Flow, and Creativity: A Conceptual Integration

In today's fast paced, attention-demanding society, executive functions and attentional resources are often taxed. Individuals need ways to sustain and restore these resources. We first review the concepts of attention and restoration, as instantiated in Attention Restoration Theory (ART). ART emphasizes the role of nature in restoring attention. We then discuss the essentials of experiments on the causal influences of nature. Next, we expand the concept of ART to include modern, designed environments. We outline a wider perspective termed attentional ecology, in which attention behavior is viewed within a larger system involving the human and their interactions with environmental demands over time. When the ecology is optimal, mental functioning can be a positive "flow" that is productive, sustainable for the individual, and sometimes creative.

How can plant-enriched natural environments benefit human health: a narrative review of relevant theories

Plant-enriched environments, the most common terrestrial landscapes, are usually coded as "green space" in urban studies. To understand how these natural environments can benefit human health, many theories have been developed, such as the well-known Attention Restoration Theory. Nowadays, more theories are emerging with regard to various and complex health dimensions. In this context, we searched online databases (from 2000 to 2022) and conducted a narrative review aiming to introduce relevant theories concerning psychological (e.g. Perceptual Fluency Account and Conditioned Restoration Theory), physiological (e.g. volatile organic compounds and environmental microbiomes), and behavioural (e.g. physical activity and social contact) perspectives. We also slightly mentioned some limitations and directions to be considered when using these theories. These results may offer general readers insights into the value of nature exposure and also help relevant researchers with study design and result interpretation.

Associations of residential green space with internalizing and externalizing behavior in early childhood

BACKGROUND

Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4-6 years.

METHODS

Children's internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures-residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity-averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms.

RESULTS

Children were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant.

CONCLUSIONS

Our findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.

Immersion in nature enhances neural indices of executive attention

There is conjecture that our modern urban environments place high demand on our attentional resources, which can become depleted over time and cause mental fatigue. Natural environments, on the other hand, are thought to provide relief from this demand and allow our resources to be replenished. While these claims have been assessed with self-report and behavioral measures, there is limited understanding of the neural mechanisms underlying these attentional benefits. The present randomized controlled trial fills this gap in the literature by using electroencephalography to explore three aspects of attention-alerting, orienting, and executive control-from a behavioral and neural perspective. Participants (N = 92) completed the Attention Network Task before and after either a 40-min walk in nature or a 40-min walk in a control, urban environment. Participants that walked in nature reported their walk to be more restorative than those that walked in the urban environment. Furthermore, the nature group showed an enhanced error-related negativity after their walk, an event-related brain component that indexes executive control capacity, whereas the urban group did not. These findings demonstrate that a 40-min nature walk enhances executive control at a neural level, providing a potential neural mechanism for attention restoration in nature.

Green spaces and the impact on cognitive frailty: a scoping review

Some literature indicates that contact with green spaces can benefit health and wellbeing, but it is unclear whether this is protective of cognitive health in older people. Using Arskey and O'Malley's framework the aim was to investigate ageing, cognitive frailty and the effects of green access including any causality. The evidence was somewhat inconsistent but suggestive for a beneficial role of green space exposure on cognitive functions. Results suggested that globally, the poorer urban environments are high risk for older people's mental health and these places often lack parks and green spaces. There is evidence that the level of activity and social participation may be greater with access to green spaces and therefore reduces health risks. Green spaces seem to have a role in preventing cognitive frailty, especially for more vulnerable older populations living in poorer urban environments.

Walking in nature may improve affect but not cognition

Beneficial effects of natural environments on affect have been consistently reported, but effects on cognition have been less consistent. We examined affect and cognitive performance in the domains of attention, working memory, executive function, and recall and recognition memory in a sample of 188 undergraduate participants who completed a walk in one of three environments: an outdoor nature environment, an outdoor urban environment, or an indoor (treadmill) environment. Supporting the hypotheses, the outdoor nature environment resulted in the greatest increase in positive affect and decrease in negative affect from pre-to post-walk. However, there were no effects of location on any cognitive measure. These results suggest that cognitive effects do not always occur in tandem with affective benefits. Possible explanations, including prior frequent exposure to nature in our participants and extremity of the natural environment, are discussed.

Exploring the association between campus environment of higher education and student health: A systematic review of findings and measures

Numerous studies have investigated the relationship between the neighborhood environments and residents' health. However, other important settings, such as university campuses, have received little attention. This paper conducted a systematic review and synthesized existing empirical works examining the association between the university/college campuses built and natural environments and students' health. Following the PRISMA guidelines, we searched nine databases using keywords related to higher-education campuses and health-related outcomes. A total of 19 articles were identified, including fifteen cross-sectional studies, three experimental studies, and one longitudinal study. The majority of the studies were conducted in Asian countries and published in the past five years. The findings indicate that active transportation infrastructure, such as increased road intersections and better walkability, were found to be positively associated with students' physical activity. The natural environments, including perceived naturalness, blue space, and greenness was shown to support student's mental health and quality of life. Specifically, blue space was found to be the most preferred place for mental restoration, and scattered trees demonstrated a supportive effect in reducing depression symptoms. Even just viewing virtual trees had a restorative effect and feel less anxiety. Additionally, during the summer, tree shadows were identified as the most important factors for enhancing thermal comfort. This review emphasizes the crucial role of campus environments in promoting college students' health. Future longitudinal studies and investigations using multiple campuses would provide a more comprehensive understanding of this relationship. Such endeavors can contribute to the development of evidence-based strategies for designing and planning healthy campus environments that optimize students' well-being.

Forest Bathing Increases Adolescents' Mental Well-Being: A Mixed-Methods Study

Previous research has demonstrated that practicing forest bathing has significant positive effects on adult psychological well-being. Considering the ongoing adolescents' mental health crisis of increasing anxiety and depression, determining whether forest bathing has similar effects on adolescents is an important expansion of forest bathing research. This study investigated the possibility that forest bathing could improve adolescents' mental well-being and sought to determine participants' experiences of forest bathing. It used a convergent, parallel, mixed-methods design that was partially co-created with 24 participants aged 16-18 as part of a youth participatory action research (YPAR) project in which participants practiced forest bathing three times over 3 weeks. As measured using the Warwick-Edinburgh Mental Well-Being Survey, the mean participant mental well-being increased significantly after forest bathing, with moderate to large effect sizes. Participants described reduced stress and increased feelings of relaxation, peace, and happiness. These findings correlate with previous forest bathing research involving adult participants. It is recommended that educators and others who work with adolescents consider forest bathing as a simple, low-cost way to improve adolescents' mental well-being.

Greenspace use during the COVID-19 pandemic: A longitudinal population mobility study in the United Kingdom

BACKGROUND

The coronavirus pandemic greatly disrupted the lives of people. Restrictions introduced worldwide to limit the spread of infection included stay-at-home orders, closure of venues, restrictions to travel and limits to social contacts. During this time, parks and outdoor greenspaces gained prominent attention as alternative location for respite. Population mobility data offers a unique opportunity to understand the impact of the pandemic on outdoor behaviour. We examine the role of the restrictions on park use throughout the full span of the pandemic while controlling for weather and region.

METHODS

This study provides a longitudinal population analysis of park visitation using Google COVID-19 Community Mobility Reports data in the UK. Daily park visitation was plotted and ANOVA analyses tested season and year effects in visitation. Then, regressions examined park visitation beyond weather (temperature and rain), according to COVID-19 restrictions, while controlling for region specificities through unit fixed effect models.

RESULTS

Time series and ANOVA analyses documented the significant decrease in park visitation in the spring of 2020, the seasonal pattern in visitation, and an overall sustained and elevated use over nearly three years. Regressions confirmed park visitation increased significantly when temperature was greater and when it rained less. More visitation was also seen when there were fewer COVID-19 cases and when the stringency level of restrictions was lower. Of special interest, a significant interaction effect was found between temperature and stringency, with stringency significantly supressing the effect of higher temperature on visitation.

CONCLUSIONS

COVID-19 restrictions negatively impacted park visitation on warm days. Given the general health, social, and wellbeing benefits of greenspace use, one should consider the collateral negative impact of restrictions on park visitation. When social distancing of contacts is required, the few remaining locations where it can safely occur should instead be promoted.

The outdoor office: a pilot study of environmental qualities, experiences of office workers, and work-related well-being

Outdoor office work is an emerging aspect of the concept of 'new ways of working', but only sparse data are available about the environmental qualities of the outdoor office space, experiences of office workers, and work-related well-being of outdoor office work. Here, we present an exploratory pilot study on well-being and outdoor office work in a public urban space. An outdoor office was set up in the courtyard of a university campus, and the participants (n = 16) conducted office work outdoors for 30 min and thereafter participated in an eye-tracking session for 11-15 min (n = 8) and subsequently filled out surveys (n = 16). The eye tracker allowed the discovery of natural and built elements in the outdoor environment that caught the participants' visual attention, whereas the surveys assessed aspects of their subjective experiences of the outdoor office space (its visual and spatial qualities) and the work there. The results are presented as network graphs where correlations are shown regarding different aspects of office work outdoors. The results indicate that outdoor office work in a public urban space may promote work-related well-being in terms of positive outdoor office space experiences. Based on the findings, a preliminary set of outdoor office qualities is proposed. Those qualities relate to the legibility and imageability of the outdoor office space, its focal points, and depth/spaciousness, in addition to attributes of usability and environmental richness, including if the outdoor office space affords natural contact and supports activities, in addition to social and individual interactions and relations.

More than greening: Using a novel index to assess restorative nature and vulnerability relationships

Urban living limits access to nature yet spending time in nature is crucial for human health and well-being. To overcome this, urban planners and policymakers are actively looking for different ways to conserve and create more urban nature through parks, street trees, and other greening strategies. However, research shows that in most cities, these greening efforts are not equitably distributed, nor are they equal in terms of their quality or benefits they provide. Creating more equitable access to urban nature is a challenge and a priority in the next decade, and so is improving the quality of urban nature and associated benefits for urbanites. To address this challenge and contribute at both practical and conceptual levels, we propose a new Local Restorative Nature (LRN) index for geospatially assessing the "restorative quality" of urban nature that can support mental well-being. To contextualize the LRN index, we map the distribution of restorative nature in relation to social vulnerability in Vancouver, Canada. The novel LRN index provides critical insights showing that many neighborhoods with vulnerable populations in Vancouver have less exposure to restorative nature to support mental health and highlights where to strategically prioritize urban greening investment in areas that need it the most. The LRN index is scalable and can be used by urban planners in other cities and contexts to improve equitable distribution of restorative nature and better support urbanites' well-being.

Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health

Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.

Restorative Effects of Biophilic Workplace and Nature Exposure during Working Time: A Systematic Review

The work environment plays a crucial role in the health and performance of employees. The growing interest in workers' well-being has driven the inclusion of nature in workplaces, despite many employees spending most of their time indoors, away from nature. Studies show that biophilic design in offices can have positive effects and promote workers' well-being. However, research on the beneficial effects of nature exposure in the workplace is limited and scattered. Thus, the aim of this systematic review was to consolidate current knowledge on the restorative effects of nature exposure on workers during work activities. Different types of exposure, both outdoors and indoors, were considered, with a focus on outcomes related to well-being, motivation, job satisfaction, and work performance. Out of the initially identified 1225 articles, only 16 met the criteria for analysis. Although the analysed studies provided compelling evidence regarding the restorative effects of nature exposure in the workplace, the review also points out gaps and limitations concerning the number of specific studies in this area and the need to adequately assess the sensory dimensions involved in these effects. Conducting more comprehensive and multidimensional investigations into the impacts of nature on the work environment could contribute to guiding more effective design strategies and creating healthier and more productive workplaces for employees.

The effect of brief exposure to virtual nature on mental wellbeing in adolescents

Adolescence is a time of multiple transitions and a vulnerability period for mental health difficulties. There are many barriers to the treatment of mental health conditions which is one reason for developing alternatives to help improve efficacy in treatment and prevention. One approach is to use nature-based interventions (NBIs) to improve mental wellbeing. In this experimental proof-of-principle intervention study, we randomly allocated a sample of adolescents to brief exposure (6 min) to either a virtual woodland nature video or a busy train journey and tested the effect on mental wellbeing. Results showed beneficial effects in the nature condition on several self-reported outcomes including stress, relaxation, affect, mood, attention, nature connection and nature spirituality. The intervention was mainly acceptable and feasible to do suggesting that overall brief virtual nature interventions may have utility in a range of mental health contexts for adolescents including as self-help universal or targeted prevention strategies, adjunct to psychological therapy and as preparation for more intensive NBIs. Additionally, brief virtual nature interventions support accessibility for those who may be limited on time, unable to access real-life nature or who may be more biophobic.

Green-blue space exposure changes and impact on individual-level well-being and mental health: a population-wide dynamic longitudinal panel study with linked survey data

Background

Cross-sectional evidence suggests that living near green and blue spaces benefits mental health; longitudinal evidence is limited.

Objectives

To quantify the impact of changes in green and blue spaces on common mental health disorders, well-being and health service use.

Design

A retrospective, dynamic longitudinal panel study.

Setting

Wales, UK.

Participants

An e-cohort comprising 99,682,902 observations of 2,801,483 adults (≥ 16 years) registered with a general practice in Wales (2008-2019). A 5312-strong 'National Survey for Wales (NSW) subgroup' was surveyed on well-being and visits to green and blue spaces.

Main outcome measures

Common mental health disorders, general practice records; subjective well-being, Warwick-Edinburgh Mental Well-being Scale.

Data sources

Common mental health disorder and use of general practice services were extracted quarterly from the Welsh Longitudinal General Practice Dataset. Annual ambient greenness exposure, enhanced vegetation index and access to green and blue spaces (2018) from planning and satellite data. Data were linked within the Secure Anonymised Information Linkage Databank.

Methods

Multilevel regression models examined associations between exposure to green and blue spaces and common mental health disorders and use of general practice. For the National Survey for Wales subgroup, generalised linear models examined associations between exposure to green and blue spaces and subjective well-being and common mental health disorders.

Results and conclusions

Our longitudinal analyses found no evidence that changes in green and blue spaces through time impacted on common mental health disorders. However, time-aggregated exposure to green and blue spaces contrasting differences between people were associated with subsequent common mental health disorders. Similarly, our cross-sectional findings add to growing evidence that residential green and blue spaces and visits are associated with well-being benefits: Greater ambient greenness (+ 1 enhanced vegetation index) was associated with lower likelihood of subsequently seeking care for a common mental health disorder [adjusted odds ratio (AOR) 0.80, 95% confidence interval, (CI) 0.80 to 0.81] and with well-being with a U-shaped relationship [Warwick-Edinburgh Mental Well-being Scale; enhanced vegetation index beta (adjusted) -10.15, 95% CI -17.13 to -3.17; EVI2 beta (quadratic term; adj.) 12.49, 95% CI 3.02 to 21.97]. Those who used green and blue spaces for leisure reported better well-being, with diminishing extra benefit with increasing time (Warwick-Edinburgh Mental Well-being Scale: time outdoors (hours) beta 0.88, 95% CI 0.53 to 1.24, time outdoors2 beta -0.06, 95% CI -0.11 to -0.01) and had 4% lower odds of seeking help for common mental health disorders (AOR 0.96, 95% CI 0.93 to 0.99). Those in urban areas benefited most from greater access to green and blue spaces (AOR 0.89, 95% CI 0.89 to 0.89). Those in material deprivation benefited most from leisure time outdoors (until approximately four hours per week; Warwick-Edinburgh Mental Well-being Scale: time outdoors × in material deprivation: 1.41, 95% CI 0.39 to 2.43; time outdoors2 × in material deprivation -0.18, 95% CI -0.33 to -0.04) although well-being remained generally lower.

Limitations

Longitudinal analyses were restricted by high baseline levels and limited temporal variation in ambient greenness in Wales. Changes in access to green and blue spaces could not be captured annually due to technical issues with national-level planning datasets.

Future work

Further analyses could investigate mental health impacts in population subgroups potentially most sensitive to local changes in access to specific types of green and blue spaces. Deriving green and blue spaces changes from planning data is needed to overcome temporal uncertainties.

Funding

This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (Project number 16/07/07) and will be published in full in Public Health Research; Vol. 11, No. 10. Sarah Rodgers is part-funded by the NIHR Applied Research Collaboration North West Coast.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Multisensory Stimuli, Restorative Effect, and Satisfaction of Visits to Forest Recreation Destinations: A Case Study of the Jhihben National Forest Recreation Area in Taiwan

The perceived quality of the restorative environment of forest resources should be a key consideration for forest recreational areas in managing ecosystem services to provide health benefits to visitors. However, previous studies on utilizing forests as a resource for restorative services have rarely explored the simultaneous integration of on-site sensory experiences from a multisensory perspective or evaluated visitor satisfaction from a service-oriented standpoint. Therefore, this study aimed to understand the association among multisensory stimuli, perceived restorativeness, and satisfaction with visits to forest recreation areas and clarify the mediating role of perceived restorativeness in the relationship between multisensory stimuli and satisfaction. This study deployed a questionnaire and collected 458 valid responses from visitors to the Jhihben National Forest Recreation Area in Taiwan. Structural equation modeling was conducted to test the study hypotheses. The results indicated that visual sensations, auditory sensations, olfactory sensations, and tactile sensations had significant positive effects on perceived restorativeness and satisfaction and that perceived restorativeness also had a significant positive effect on satisfaction. Perceived restorativeness played a partial mediating role in this causal model. This study verified the psychological model of the relationships among a natural setting's multisensory stimuli, perceived restorativeness, and satisfaction. In practice, the findings of this study offer guidance for forest recreation areas to develop strategies for ecological services, encompassing the establishment of restorative environmental management and visitor service management approaches.

Do Mental Health Changes in Nature Co-occur with Changes in Heartrate Variability and Executive Functioning? A Systematic Review

PURPOSE OF REVIEW

Given the global burden of mental health issues, new solutions are needed to promote mental health. Nature exposure represents a promising option to promote mental health, but the mechanisms are poorly understood. Recent frameworks have argued that changes in mental health in nature are caused by activity changes in the vagus nerve, which connects the heart and the brain, and that these changes also improve executive functioning (EF) abilities. This suggests that changes in mental health symptomology in nature should be accompanied by changes in vagus nerve activity, as well as changes in executive functioning. Yet, little work has systematically examined co-variation of these outcomes in empirical studies. The present manuscript systematically examines whether changes in mental health in nature are accompanied by changes in vagus nerve activity (approximated by heartrate variability) and changes in executive functioning.

RECENT FINDINGS

There is compelling evidence that spending time in nature can increase heartrate variability, improve mental health, and improve executive functioning. However, despite strong theoretical claims that these three outcomes should be linked after spending time in nature settings, few studies directly examine such co-occurrence. The study systematically examines whether studies that considered both mental health and executive functioning (n = 6) showed co-occurring effects in response to nature exposure. Similarly, the study also considers if studies examining mental health and heartrate variability (n = 6) showed similarly directional effects following nature exposure. This systematic review concludes with discussion about the limited number of studies (n =1) that include all three measures. We find mixed results of co-occurrence with these variables, suggesting that the relationship between these three constructs in nature may be more nuanced than current theory suggests. Perhaps more importantly, our results demonstrate that there is very little existing work linking changes in mental health to changes in EF and vagal tone. We conclude with justification for why it may be beneficial for researchers to include all three metrics as well as guidance on how to do so.

Medical Nature-Based Rehabilitation Program for Individuals with Exhaustion Syndrome: Changes in Quality of Life, Exhaustion Symptoms and Overall Health

Stress-related health problems have increased sharply over the last two decades and have become a serious issue at all levels of society. In the Jönköping Region in southern Sweden, a nature-based rehabilitation (NBR) program for adults with Exhaustion Syndrome has been developed and then implemented into the Swedish National Healthcare System. The main aim of this study was to investigate the effectiveness of this NBR-program. This was achieved by examining patients' quality of life, exhaustion symptoms and overall health using self-assessment instruments, comparing the results before participation to immediately after, three months after and six months after. With a sample size of 67 participants, the results show a statistically significant improvement for all points. From a public health perspective, and with background knowledge of the nature of the patient group under treatment, the studied program would appear to be effective and economic, having a satisfied patient group as well as a favourable comparison with the outcomes of other research programs. Although the results are promising, as this is a naturalistic field study, there is no control group, and further research is encouraged. We suggest randomised controlled studies, longitudinal studies and investigation of mediators.

Effects of nature on restorative and cognitive benefits in indoor environment

This study investigates the effects of natural exposure in an indoor environment on restorative quality and cognitive ability. Thirty participants were shown nature at three different indoor sites: baseline, indoor (some vegetation), and semi-indoor (a large amount of vegetation and view to sky) for five minutes. After viewing, they completed an assessment of restoration and a cognitive task, and their electroencephalography (EEG) was recorded. Compared to the baseline, the sites with nature resulted in restorative (higher perceived restoration scores) and cognitive (higher working memory performance and lower delta-to-theta ratio (DTR), delta-to-alpha ratio (DAR), theta-to-beta ratio (TBR), and alpha-to-beta ratio (ABR) responses) benefits. These findings further our understanding of the effects of exposure to nature on restorative and cognitive benefits in an indoor environment, and help to build guidance for future research on the effects of nature indoors and designing restorative- and cognitive-enhancing indoor spaces.

The relationship between perceived restorativeness and place attachment for hikers at Jeju Gotjawal Provincial Park in South Korea: the moderating effect of environmental sensitivity

Objectives

Jeju Gotjawal Provincial Park provides visitors with opportunities for outdoor recreation and informs visitors of the environmental significance of the park's ecosystem. This study attempted to examine how the perceived restorativeness of park visitors influenced their place attachment. In addition, the moderating effect of environmental sensitivity on the hypothesized relationship was explored.

Methods

Using the purposive sampling method, 408 surveys were collected at Jeju Gotjawal Provincial Park. The hypotheses were tested by confirmatory factor analysis, path analysis, and invariance tests using Lisrel 8.70.

Results

The results indicated that perceived restorativeness had a positive influence on place attachment (place identity and place dependence). Further, the hypothesized relationship was stronger for the visitors with higher environmental sensitivity, compared to those with weaker environmental sensitivity.

Conclusion

Park managers should consider ways to increase the perceived restorativeness of visitors as they experience the natural environment at the park. Also, since environmental sensitivity played an important role in shaping the perceived restorativeness-place attachment relationship, there is a need for educational programs that can inform visitors of the significance of the natural environment to increase their affection for nature.

In situ psycho-cognitive assessments support self-determined urban green exercise time

Prescribed nature walks frequently yield improvements to mood and cognition as observed in experimental studies. Research that uses real life settings such as self-determined time exercising outdoors for restorative health benefits may more accurately elicit effects than time-specified study protocols. This study examined in situ psycho-cognitive outcomes of routine walks in urban greenspace to test the concept that self-set exposure duration and not context alone is related to magnitude of psycho-cognitive benefit. Pre-post measurements taken on a diverse participant pool of individuals walking in urban parks and recruited on random days over a two-week period found significant associations between outdoor activity duration and cognitive and mood improvements. Greater outdoor walking duration linearly predicted stronger processing speeds but non-linearly in tests of other cognitive domains. Results of fixed effects model for mean mood change following green exercise show outdoor walking influenced mood change at highest levels of significance, even after accounting for individual level variability in duration. Mood improved for all durations of outdoor walking under a random effects model with high significance. Untethering fixed intervals of outdoor exercise from formal study design revealed briefer but more frequent nature engagement aligned with nature affinity. The influence of unmeasured factors, e.g., nature affinity or restorative conditioning, for prescriptive durations of urban green exercise merits further investigation toward designing wellbeing interventions directed at specific urban populations.

Contact with Nature in Social Deprivation during COVID-19: The Positive Impact on Anxiety

The 2019 outbreak of the novel coronavirus disease (COVID-19) had a devastating impact on millions of people worldwide. Following the constantly changing course of the pandemic, the Italian government massively restricted public and private life to prevent the further spread of the virus. Unfortunately, lockdown policies negatively impacted many people's mental and physical health. Numerous studies recognized an essential role of urban green areas in promoting human well-being. The present study aims to evaluate the effect of personal dispositions towards nature, measured using the connectedness to nature scale (CNS) and actual contact with green spaces (CwN) on human well-being (i.e., anxiety) and medicine intake during COVID-19 lockdowns. A total of 637 Italian residents answered a survey aimed at gathering information about the above variables. A series of path analyses were performed. The results showed that the CNS was positively associated with the CwN, and the latter, in turn, was negatively associated with anxiety. Finally, anxiety was positively related to medicine intake. In sum, these results identify the positive role of person-nature relationships for individual well-being during COVID-19 restrictions.

Effects of indoor plants on office workers: a field study in multiple Dutch organizations

In the period 2019-2020, the effect of plants in the workspace on (a) the physical indoor climate, (b) the perception of the workspace by office workers, and (c) their health, well-being and functioning was investigated in nine organizations. This paper reports the outcomes of the latter part. A conceptual model describing the short-term, medium and long-term effect of plants on people was formulated, containing 18 outcome variables. A "Before After Control Impact" quasi-experimental research design was used. A control workspace and an intervention workspace were selected in each of the organizations. A pre-measurement was conducted in both. Correlational analyses, based on the pre-measurements in all organizations and workspaces, confirmed the associations proposed by the conceptual model to a large extent. After placing plants in the intervention workspace, a maximum of two post-intervention measurements were conducted (due to COVID-19 not in all nine organizations), the last one at least 4 months after the introduction of the plants. Overall significant effects were found on complaints about dry air (fewer), the sense of privacy (higher), the attractiveness of the workspace (higher), satisfaction with the workspace (greater) and having a health-related complaint, especially when at work (fewer). The first three effects were already observed in the analyses only including the first post-measurement. The latter two effects only showed up in the analyses including two post-measurements. No direct effect of the plants could be demonstrated on the 13 other outcome variables. The observed effects mainly concern outcome variables that are positioned at the beginning of the proposed causal chain, starting with plants and ending with mental health, absenteeism and job satisfaction.

Visiting nature is associated with lower socioeconomic inequalities in well-being in Wales

Natural environments can promote well-being through multiple mechanisms. Many studies have investigated relationships between residential green/blue space (GBS) and well-being, fewer explore relationships with actual use of GBS. We used a nationally representative survey, the National Survey for Wales, anonymously linked with spatial GBS data to investigate associations of well-being with both residential GBS and time in nature (N = 7631). Both residential GBS and time spent in nature were associated with subjective well-being. Higher green-ness was associated with lower well-being, counter to hypotheses (predicting the Warwick and Edinburgh Mental Well-Being Scale (WEMWBS): Enhanced vegetation index β =  - 1.84, 95% confidence interval (CI) - 3.63, - 0.05) but time spent in nature was associated with higher well-being (four hours a week in nature vs. none β = 3.57, 95% CI 3.02, 4.13). There was no clear association between nearest GBS proximity and well-being. In support of the equigenesis theory, time spent in nature was associated with smaller socioeconomic inequalities in well-being. The difference in WEMWBS (possible range 14-70) between those who did and did not live in material deprivation was 7.7 points for those spending no time in nature, and less at 4.5 points for those spending time in nature up to 1 h per week. Facilitating access and making it easier for people to spend time in nature may be one way to reduce socioeconomic inequalities in well-being.

[Nature experience and mental health in children-theoretical approaches and selected empirical findings]

The widely documented beneficial effects of children's experiences with nature make it plausible to assume that an environment close to nature also has a positive effect on health in childhood, that is, that it can also contribute to health maintenance and prevention. The findings on health-promoting effects of nature are remarkable and are accentuated and theoretically substantiated here with a focus on mental health.The basis is a so-called three-dimensional personality model, according to which mental development is not only a function of the subject's relationship to other people, but also to the world of things, including nature. In addition, three explanatory approaches for the health effects of nature experiences are outlined: (1) the anthropologically based "Stress Recovery Theory," (2) the "Attention Restoration Theory," and (3) the assumption that nature as a symbolic storehouse for self- and world interpretations can accompany the meaning constitution of the subjects ("Therapeutic Landscapes").The health effects of accessible open spaces close to nature are discussed, whereby the state of research for adults is much richer than for children. With regard to mental health or its influencing variables, the following dimensions are elaborated with empirical results: stress reduction, antidepressant and mood enhancing effects, prosocial behavior, attention and ADHD, cognitive development, self-esteem and self-regulation, nature experience, and exercise. From a salutogenetic perspective, nature does not have a deterministic effect on health, but rather, in a sense, an incidental effect when open spaces close to nature are accessible and used. This casualness of the effect of nature experiences has to be considered in possible therapeutic or educational interventions.

Adding virtual plants leads to higher cognitive performance and psychological well-being in virtual reality

Previous research has shown the positive effects of exposure to real and virtual nature. To investigate how such benefits might generalize to ever-more-prevalent virtual workplaces, we examined the effects of the absence or presence of virtual plants in an office environment in Virtual Reality (VR) on users' cognitive performance and psychological well-being. The results of our user study with 39 participants show that in the presence of virtual plants, participants performed significantly better in both short-term memory and creativity tasks. Furthermore, they reported higher psychological well-being scores, including positive affect and attentive coping, whilst reporting lower feelings of anger and aggression after exposure to virtual plants in VR. The virtual office with plants was also perceived as more restorative and induced a higher sense of presence. Overall, these results highlight how the presence of virtual plants in VR can have positive influences on users, and therefore, constitute important design considerations when developing future working and learning spaces.

Using Virtual Reality to Bring Restorative Environments to Employees: An Online Pilot Study

Employees face many demands throughout the workday. Participating in activities can help employees recover from the pressures of work, and physical activity and time spent in nature are among the most beneficial. Simulations of nature offer some of the benefits of actual contact with nature and can address some of the barriers to exercising outdoors that some employees may face. In this pilot study, we examine the influence of physical activity and virtual or actual nature contact on affect, boredom, and satisfaction when experienced during a break from a demanding work task. Twenty-five employed adults participated in an online study in which they completed a problem-solving task, completed a twenty-minute break, and then completed another session of the problem-solving task. During the break, participants were randomized to either a control condition, a physical activity and low-fidelity virtual nature contact condition, a physical activity and high-fidelity virtual nature contact condition, or a physical activity and actual nature contact condition. An examination of the means of affect, boredom, and satisfaction before, during, and after the break revealed that those in high-fidelity virtual nature and actual nature contact conditions seemed to report more positive well-being during the break. The results highlight that to help employees recover from work demands, it could be important to take breaks, be physically active, and have contact with nature, which should be simulated in high fidelity if actual nature contact cannot be achieved.

Psychological impacts of intervention to improve a therapeutic garden for older adults with dementia: a case study conducted at a care facility

Introduction

Exposure to nature is known to support psychological wellbeing, and can support People with Dementia (PwD). Here we describe a case study conducted at a care facility for PwD to examine the effect of their exposure to nature after intervention to renovate an existing Therapeutic Garden (TG). Changes in frequency of attendance and behavior in the TG were examined. A single case was also considered to assess individual benefits.

Materials and methods

Twenty-one PwD participated in the study. Their behavior in the TG was observed for 4 weeks before and after the intervention (using behavioral mapping), and measures of individual characteristics (general cognitive functioning, behavioral/neuropsychiatric symptoms, depression, and quality of life) were administered.

Results

Ten of the 21 PwD visited the TG more often after the intervention, their social behaviors (e.g., talking to others) increased, and their active isolated behavior in the garden (e.g., smelling, touching flowers) tended to increase. The increase in social behavior related to less severe baseline depressive symptoms. Passive isolated behaviors related to more impaired baseline cognitive functioning. The case of Mrs. A extended the findings for the whole sample: although her dementia symptoms (apathy, motor disturbances) worsened, she visited the TG more often after the intervention, her social exchanges and active isolated actions increased, and her agitation and wandering decreased.

Discussion

These results support the benefits of exposure to nature for PwD, and underscore the importance of considering users' profiles to optimize their use of a TG.

Elementary Classroom Views of Nature Are Associated with Lower Child Externalizing Behavior Problems

Exposure to nature views has been associated with diverse mental health and cognitive capacity benefits. Yet, much of this evidence was derived in adult samples and typically only involves residential views of nature. Findings from studies with children suggest that when more greenness is available at home or school, children have higher academic performance and have expedited attention restoration, although most studies utilize coarse or subjective assessments of exposure to nature and largely neglect investigation among young children. Here, we investigated associations between objectively measured visible nature at school and children's behavior problems (attention and externalizing behaviors using the Brief Problem Monitor Parent Form) in a sample of 86 children aged seven to nine years old from 15 classrooms across three schools. Images of classroom windows were used to quantify overall nature views and views of specific nature types (sky, grass, tree, shrub). We fitted separate Tobit regression models to test associations between classroom nature views and attention and externalizing behaviors, accounting for age, sex, race/ethnicity, residential deprivation score, and residential nature views (using Google Street View imagery). We found that higher levels of visible nature from classroom windows were associated with lower externalizing behavior problem scores, after confounder adjustment. This relationship was consistent for visible trees, but not other nature types. No significant associations were detected for attention problems. This initial study suggests that classroom-based exposure to visible nature, particularly trees, could benefit children's mental health, with implications for landscape and school design.

Nature in the Heart and Mind of the Beholder: Psycho-Emotional and EEG Differences in Perception of Virtual Nature Due to Gender

Natural environment experiences in virtual reality (VR) can be a feasible option for people unable to connect with real nature. Existing research mostly focuses on health and emotional advantages of the “virtual nature” therapy, but studies of its neuropsychological effects related to visual perception are rare. In our experiment, 20 subjects watched nature-related video content in VR headsets (3D condition) and on a computer screen (2D condition). In addition to the gender factor, we considered the individual Environmental Identity Index (EID) and collected the self-assessment of the emotional state per the components of Valence, Arousal, and Dominance in each experimental condition. Besides the psychometric data, we also registered brainwave activity (EEG) and analyzed it with the 7 frequency bands. For EID, which was considerably higher in women, we found significant positive correlation with Valence (i.e., beneficial effect of the natural stimuli on the psycho-emotional status). At the same time, the analysis of the EEG data suggests a considerable impact of the VR immersion itself, with higher relaxation alpha effect in 3D vs. 2D condition in men. The novel and most pronounced effect of the gender factor was found in the relation between the EID and the EEG powers in the high-frequency bands—that is, positive correlation of these variables in women (0.64 < Rs < 0.74) but negative correlation in men (−0.66 < Rs < −0.72). Our results imply individually different and gender-dependent effects of the natural stimulus in VR. Correspondingly, the video and VR content development should consider this and aim to provide a user characteristics-tailored experience.

Exposure to greenspace and bluespace and cognitive functioning in children - A systematic review

BACKGROUND

The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic but none of them are specific to cognitive outcomes in the entire age range of children. Moreover, only a few of them have examined the effects of bluespace in addition to greenspace. Also, theses reviews are focused either only on observational studies or experimental studies. Our systematic review focuses on cognitive outcomes in relation to greenspace and bluespace in children and adolescents aged 0-18; it captures both observational and experimental studies. Cognitive outcomes are presented according to an evidence-based taxonomy of human cognitive abilities: the Cattell-Horn-Carroll (CHC) theory.

METHODS

We conducted searches in the PubMed and PsychInfo databases, from their inception dates to 17 December 2021. We used three-text terms related to outcome, exposure, and population as well as MeSH terms for outcome and population. Further, the reference lists and existing reviews were searched ("snowball" search) until 21 April 2022 to detect additional studies. For the results reporting, we followed the updated guidelines of the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). We included observational and experimental studies on greenspace or bluespace exposure in relation to cognitive functioning, published in English, German, or Polish. Two reviewers independently checked study eligibility and extracted data. Two reviewers evaluated the risk of bias according to the Office of Health Assessment and Translation (OHAT) tool. At all stages, discrepancies between the two reviewers were solved via discussion with a third reviewer.

RESULTS

Records identified from PubMed (n = 2030) and PsycINFO (n = 1168) were deduplicated and screened. Twenty one reports were first selected. The "snowball" search revealed 16 additional reports. Altogether, 39 studies (17 experimental and 22 observational) published in 37 reports were qualified. The data extraction showed that the methodology used in the studies was heterogenous and the findings were inconsistent. The majority of the studies investigated attentional functioning, which we subdivided into two categories according to the CHC theory: attentional control and reaction and decision speed (12 studies) and attentional control and processing speed (10 studies). Eleven studies investigated working memory and/or short-term memory that we categorized as CHC working memory capacity. Nine studies investigated intellectual functioning, which we categorized as CHC general ability, fluid reasoning, and comprehension-knowledge. Two studies investigated visual-spatial skills, which we categorized as CHC visual processing and psychomotor speed. One study measured parent-reported attention; two studies examined early childhood/cognitive development; three studies examined decision-making and self-regulation, which can be categorized as several CHC theory abilities.

DISCUSSION

The heterogeneity of the included studies does not permit clear conclusions for our review. In accordance with previous systematic reviews, greenspace and bluespace were not more strongly related to a particular domain of cognitive functioning than other cognitive domains, and no effects of age or type of exposure assessment on the association between nature and cognition were detected. Further research is needed, including state-of-the-art of assessment of cognitive outcomes and diverse exposure assessment methods within both observational and experimental approaches. Expertise will be required in several domains, such as environmental epidemiology, cognitive psychology, and neuropsychology. Systematic review registration number (INPLASY): 202220018.

Residential green space improves cognitive performances in primary schoolchildren independent of traffic-related air pollution exposure

BACKGROUND

Cognitive performances of schoolchildren have been adversely associated with both recent and chronic exposure to ambient air pollution at the residence. In addition, growing evidence indicates that exposure to green space is associated with a wide range of health benefits. Therefore, we aimed to investigate if surrounding green space at the residence improves cognitive performance of primary schoolchildren while taking into account air pollution exposure.

METHODS

Cognitive performance tests were administered repeatedly to a total of 307 primary schoolchildren aged 9-12y, living in Flanders, Belgium (2012-2014). These tests covered three cognitive domains: attention (Stroop and Continuous Performance Tests), short-term memory (Digit Span Forward and Backward Tests), and visual information processing speed (Digit-Symbol and Pattern Comparison Tests). Green space exposure was estimated within several radii around their current residence (50 m to 2000 m), using a aerial photo-derived high-resolution (1 m²) land cover map. Furthermore, air pollution exposure to PM_2.5 and NO₂ during the year before examination was modelled for the child's residence using a spatial-temporal interpolation method.

RESULTS

An improvement of the children's attention was found with more residential green space exposure independent of traffic-related air pollution. For an interquartile range increment (21%) of green space within 100 m of the residence, a significantly lower mean reaction time was observed independent of NO₂ for both the sustained-selective (-9.74 ms, 95% CI: -16.6 to -2.9 ms, p = 0.006) and the selective attention outcomes (-65.90 ms, 95% CI: -117.0 to -14.8 ms, p = 0.01). Moreover, green space exposure within a large radius (2000 m) around the residence was significantly associated with a better performance in short-term memory (Digit-Span Forward Test) and a higher visual information processing speed (Pattern Comparison Test), taking into account traffic-related exposure. However, all associations were attenuated after taking into account long-term residential PM_2.5 exposure.

CONCLUSIONS

Our panel study showed that exposure to residential surrounding green space was associated with better cognitive performances at 9-12 years of age, taking into account traffic-related air pollution exposure. These findings support the necessity to build attractive green spaces in the residential environment to promote healthy cognitive development in children.

Psychological Benefits of Attending Forest School for Preschool Children: a Systematic Review

Forest school is a form of outdoor learning that takes children into regular and repeated learning experiences in natural settings. Being based on a comprehensive experience with nature, it is assumed to be beneficial for learning and to promote restorative effects on cognitive and emotional function in preschool children. This review aimed to examine the available evidence on the benefits of forest school compared to indoor school activities in children aged 3 to 6 years. We searched for studies on forest school for preschool children in PsycInfo, JSTOR, and Scopus, with no restriction on publication year. The risk of bias was assessed using Joanna Briggs’s criteria for quasi-experimental design. Of the 190 articles identified, 16 studies were reviewed (N = 1560). Higher benefits were found in children attending forest school compared to those attending indoor school in various areas of child development: cognitive function, motor coordination and balance, connectedness to nature, and health and well-being outcomes. There is, however, still a shortage of empirical evidence, and the methodological quality of most studies was limited. The literature on forest schools for preschool children in general supports positive effects in a wide range of variables that promote child health and development, but more evidence is needed to assess their effectiveness. Due to the methodological weaknesses of the reviewed studies, one should interpret their findings with caution.

The influence of individual characteristics on perceived restorativeness and benefits associated with exposure to nature in a garden

This study newly explored the relationship between individual characteristics (i.e., connectedness to nature, a preference for natural rather than built environments, personality, visuospatial preferences) with perceived restorativeness, as well as affective and memory-related benefits of exposure to the nature. Eighty adults were individually exposed to nature by walking in a landscape garden. Measures of connectedness to nature, preference for natural environments, personality traits, and visuospatial preferences were administered. Before and after walking in the garden, participants completed measures of affect (positive and negative emotions) and memory (short-term and working memory, and spatial memory). After walking they completed a Perceived Restorativeness scale. Perceived Restorativeness was found to be significantly explained by Extraversion (personality trait) and Connectedness to Nature. There was no significant influence of individual characteristics on benefits to affect and memory measures. Overall, the results showed that perception of the restorative effect of a natural environment is related to connectedness to nature and personality (extraversion trait). Taken together, our findings highlight the importance of considering individual characteristics to better capture restorative/recovery effects of a natural environment in an individual, and to tailor/implement nature-based solutions to ensure a sustainable urban green environment and to promote quality of life for their citizens.

Optimising the effects of physical activity on mental health and wellbeing: A joint consensus statement from Sports Medicine Australia and the Australian Psychological Society

OBJECTIVES

This consensus statement from Sports Medicine Australia and the Australian Psychological Society aims to provide guidance to practitioners on the ways that physical activity can be promoted to maximise benefits to mental health.

METHODS

Following the Clinical Consensus Statement protocol, an expert group comprised of eight members with expertise in physical activity and mental health articulated recommendations regarding five physical activity contextual factors: type, physical environment, delivery, domain, and social environment.

RESULTS

To optimise the mental health benefits of physical activity, we recommend: i) activity selection be guided by factors associated with adherence and enjoyment as opposed to any specific type (type); ii) facilitators (i.e., teachers, coaches, instructors, practitioners) deliver organised physical activity sessions using an instructional style that satisfies individuals' basic needs for autonomy, competence and social connection (delivery); iii) participation in physical activity with others who provide support, facilitate positive interactions, or make people feel valued, so long as it does not undermine a preference to be active alone (social environment); iv) where possible and appropriate, some physical activity should be undertaken outside in pleasant natural environments (physical environment); and, v) at least some physical activity be undertaken during leisure-time or via active travel, where possible prioritising activities one personally chooses to undertake (domain).

CONCLUSIONS

The type, domain, physical and social environment of physical activity, as well as the way in which it is delivered, will determine mental health outcomes. Practitioners can use these recommendations to optimise the effects of physical activity on mental health.

The Association between Physical Environment and Externalising Problems in Typically Developing and Neurodiverse Children and Young People: A Narrative Review

The physical environment is of critical importance to child development. Understanding how exposure to physical environmental domains such as greenspace, urbanicity, air pollution or noise affects aggressive behaviours in typical and neurodiverse children is of particular importance given the significant long-term impact of those problems. In this narrative review, we investigated the evidence for domains of the physical environment that may ameliorate or contribute to the display of aggressive behaviours. We have considered a broad range of study designs that include typically developing and neurodiverse children and young people aged 0-18 years. We used the GRADE system to appraise the evidence. Searches were performed in eight databases in July 2020 and updated in June 2022. Additional articles were further identified by hand-searching reference lists of included papers. The protocol for the review was preregistered with PROSPERO. Results: We retrieved 7174 studies of which 67 are included in this review. The studies reported on green space, environmental noise and music, air pollution, meteorological effects, spatial density, urban or rural setting, and interior home elements (e.g., damp/sensory aspects/colour). They all used well validated parent and child reported measures of aggressive behaviour. Most of the studies were rated as having low or unclear risk of bias. As expected, noise, air pollution, urbanicity, spatial density, colour and humidity appeared to increase the display of aggressive behaviours. There was a dearth of studies on the role of the physical environment in neurodiverse children. The studies were heterogeneous and measured a range of aggressive behaviours from symptoms to full syndromes. Greenspace exposure was the most common domain studied but certainty of evidence for the association between environmental exposures and aggression problems in the child or young person was low across all domains. We found a large knowledge gap in the literature concerning neurodiverse children, which suggests that future studies should focus on these children, who are also more likely to experience adverse early life experiences including living in more deprived environments as well as being highly vulnerable to the onset of mental ill health. Such research should also aim to dis-aggregate the underlying aetiological mechanisms for environmental influences on aggression, the results of which may point to pathways for public health interventions and policy development to address inequities that can be relevant to ill health in neurodiverse young people.

Brief repeated virtual nature contact for three weeks boosts university students' nature connectedness and psychological and physiological health during the COVID-19 pandemic: A pilot study

The COVID-19 pandemic and its associated uncertainties and restrictions have adverse impacts on university students' mental wellbeing. Evidence shows that virtual nature contact has mental health benefits. However, little is known about the potential beneficial health impacts of virtual nature contact during times of social distancing, when access to the natural environment is restricted. This pilot study aimed to examine the effectiveness of a 3-week virtual nature contact in improving nature connectedness and reducing psychophysiological stress. A sample of 56 university students in Hong Kong was randomly assigned to control and nature interventions using 2-D video played for 15 min three times a week for 3 weeks. Nature connectedness, perceived restorativeness and psycho-physiological wellbeing were measured. Our findings show significant changes in psychological stress levels after nature interventions compared with the baseline, including increased happiness and stronger emotions of comfort and relaxation. When compared with the control group, the results show the nature intervention group has significantly higher levels of nature connectedness, happiness, and positive affect, but no significant effects on other psychological and physiological variables (e.g., cardiovascular responses). Our preliminary findings highlight the potential use of virtual nature contacts in bolstering university students' wellbeing at times of pandemic or when in-person visit to the natural environment is not feasible.

Effects of exposure to immersive computer-generated virtual nature and control environments on affect and cognition

Previous research has shown that exposure to immersive virtual nature environments is able to induce positive affective and physiological effects. However, research on the effects on cognitive performance is scarce. Additionally, the effects of virtual nature exposure compared to a virtual control environment with a comparable amount of virtual objects have not been examined so far. Therefore, we conducted an experiment with 27 participants to study the psychological effects of such exposure. The virtual nature consisted of a 3D model of a typical forest environment, whereas the control environment was an abstract replication of the virtual forest environment. In both environments, a virtual wooden cart was used to transport the users from the start to the end of the virtual road. The typical background noise of moving such a cart was integrated into both environments as well. In addition, the virtual nature environment included typical forest sounds in the background, whereas the control condition did not have such background sounds. Both environments were compared with regard to their effects on cognitive performance (using trail making tests (TMTA, TMTB, and TMTB-A) as well as digit span forward and digit span backward tests), perceived restorativeness, mood, stress, sense of presence, and simulator sickness. The results showed that in comparison to the control environment, exposure to the virtual nature resulted in significantly higher cognitive performance, higher perceived restorativeness, higher positive affect, higher sense of presence, lower perceived stress, and lower simulator sickness.

The impact of screen exposure on attention abilities in young children: a systematic review

BACKGROUND

The neurocognitive consequences of exposure to screens in school-aged children have been the subject of multiple studies. However, the relationship between screen exposure and neurocognitive development, especially attentional functions, remains unclear in preschool children. The aim of this systematic review was to evaluate the immediate and long-term impact of screen exposure on attentional functions in preschoolers.

METHODS

Three electronic databases (PubMed, COCHRANE, and SCOPUS) were searched for studies published between January 1, 2000, and November 30, 2020. Two reviewers independently selected studies. Inclusion criteria were observational studies, inclusion of children aged less than seven years with no neurodevelopmental disorders, evaluation of screen time, and evaluation of attentional functions. Data extracted including participants' ages, number of participants, screen exposure time, attention assessment tool, and confounding factors. Study quality was evaluated using the Newcastle-Ottawa Scale.

RESULTS

Five cross-sectional studies were included: all reported significant, positive associations between high levels of screen exposure and attention difficulties. Ten longitudinal studies were included: six found a significant impact of earlier screen exposure on subsequent attentional function and four found no relationship. Eight of the studies included evaluated the direction of the relationship between screen exposure and attentional difficulties: seven suggested the relationship is bidirectional.

CONCLUSIONS

These findings support current guidelines to limit screen time in preschoolers to prevent the development of attention difficulties.

Need and Interest in Nature Prescriptions to Protect Cardiovascular and Mental Health: A Nationally-Representative Study With Insights for Future Randomised Trials

OBJECTIVE

"Nature prescriptions" are increasingly being adopted by health sectors as an adjunct to standard care to attend to health and social needs. We investigated levels of need and interest in nature prescriptions in adults with cardiovascular diseases, psychological distress and concomitants (e.g. physical inactivity, sedentary behaviour, obesity, loneliness, burn-out).

METHODS

A nationally-representative survey of 3,319 adults across all states and territories of Australia was completed in February 2021 (response 84.0%). Participants were classified across 15 target groups using validated health indicators and surveyed on (1) time and frequency of visits to green and blue spaces (nature spaces), (2) interest in a nature prescription, and (3) potential confounders (e.g. age, income). Analyses were done using weighted logistic regressions.

RESULTS

The sample was 50.5% female, 52.0% were aged ≥45 years, 15.2% were living alone and 19.3% were born overseas in non-English-speaking countries. Two-thirds of the sample spent 2 hours or more a week in nature, but these levels were generally lower in target groups (e.g. 57.7% in adults with type 2 diabetes). Most participants (81.9%) were interested in a nature prescription, even among those spending fewer than 2 hours a week in nature (76.4%). For example, 2 hours a week or more in nature was lowest among sedentary adults (36.9%) yet interest in nature prescriptions in this group was still high (74.0%). Lower levels of nature contact in target groups was not explained by differences in access to or preference for local nature spaces.

CONCLUSIONS

High levels of interest in nature prescriptions amid low levels of nature contact in many target health groups provides impetus for developing randomised trials of interventions that enable people to spend more time in nature. These findings can inform intervention co-design processes with a wide range of community stakeholders, end-users in target health groups, and the health professionals who support them.