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1. Dr Carly Wood University of Essex Nature, Health and Wellbeing What does the research show? 2. Outline Theories linking nature & health a snapshot Green Exercise or Ecotherapy What do the terms mean? Green Exercise Research Grants Ecotherapy: Ecominds Project Implications and Conclusions 3. Our relationship with nature has changed.... 4. Theory Linking Nature and Health an innate sensitivity to and need for other living things as we have co-existed for thousands of generations Hardwired into our genetic makeup Evolved with affiliation for nature, urban settings not part of our genetic history Closeness to nature WB & likelihood of understanding & caring for nature Important resource for human health Wilson (1984) 5. Nature Contributes to Healthy Communities Nature Reduces property crime Violent crime Levels of aggression Provides a sense of belonging Enhances social cohesion Reduces social isolation Improves social networking Encourages intergenerational links Reduces stress Perceived Objective e.g. Cortisol Restores mental fatigue Improves mental health and wellbeing Self-esteem Mood Reduces health inequalities Facilitates activity Improves physical health Lowers BP Increases HRV Reduces obesity 6. Physical Activity Known to have positive effects on physical and mental health Green Exercise To what extent does physical activity in the presence of green space affect mental and physical well-being? Exposure to Nature Known to have positive effects on mental health Green Exercise Green Exercise 7. Ecotherapy or Green Care? Umbrella terms for a range of nature-based interventions for vulnerable groups. Initiatives facilitated, specific intervention, for particular participants, rather than simply an experience in nature for general public. Green Care approaches therapeutic in nature although some (minority) of initiatives also include formal therapy as an integral part of the programme. Recently term Ecotherapy used more generically/ interchangeably with GC 8. Green Exercise Research Grants ESRC Early Career Fellowship (2009-2012) British Heart Foundation Studentship (2010-2014) Series of studies exploring the links between nature and stress in terms of: - Stress recovery - Response to stress 9. Heart Rate Variability Marker of cardiovascular function which is altered by stress High HRV reflects a healthy CV system able to adapt to stimuli from the brain and receptors around the body Reduced HRV is a risk for cardiovascular disease 10. Study 1 Can viewing scenes of nature prior to stress 1. physiological stress response &/or 2. physiological recovery from a stressor? 11. On arrival Participant reads information sheet and signs informed consent Participant fitted with ECG, finger blood pressure cuff, and respiration strap Baseline Participants rested in a semi-supine position for 15 minutes Physiological measures recorded for the final 5 minutes of the rest period Viewing Participants viewed scenes of either a nature or built environment for 10 minutes During Visit 2 participants viewed the set of slides not viewed during Visit 1 Stressor Five minute forward digi-span stressor Buzzer was sounded twice irrespective of incorrect or correct answers given Physiological measures recorded throughout Recovery Physiological measures recorded immediately post-stressor for five minutes 12. Views 13. Results response n = 23 Mean heart rate Mean systolic blood pressure * * 14. Mean ( SD) heart rate variability Results recovery 15. Study 2- Can a walk in nature affect night time HRV? Randomly assigned to walking a 1.8km route around either a built or a natural environment. On the second visit they undertook the other walk. Pace was similar on both walks. Participants wore an RR interval sensor overnight (eMotion sensor, Mega Electronics Ltd) to allow HRV to be examined during sleep. Three 10 minutes segments were selected by a reviewer blinded to type of walk. These segments were 1-2 hours after the participant noted in a diary they had fallen asleep (approx phase 4 of sleep). 16. Results 0 10 20 30 40 50 60 Walk RMSSDms2 Built Nature 17. Summary: Green Exercise Grants Research provides ecologically valid evidence that nature reduces physiological stress and enhances recovery from stress; Physiological effects of Green Exercise may last for more than 12 hours Green Exercise may therefore enhance essential recovery and restoration during night time sleep and improve overall health. 18. Ecotherapy: Ecominds wellbeing evaluation First study of different types of ecotherapy in the UK Longitudinal & acute effect study Recognised outcome measures 3 key themes: i) wellbeing, ii) social inclusion, iii) connection to nature All projects study In-depth study Within group study Between groups study Changes after an Ecominds session Changes over the Ecominds programme Ecominds evaluation Figure 3. Overview of the University of Essex Ecominds evaluation 19. Results All projects study - Significant changes Bragg et al., (2013) Change in mean positivity, nature connection and health scores from beginning to the end of the Ecominds programme * * * * indicates a significant increase in mean score 20. Results In Depth study Significant increase in participant wellbeing over the course of the programme Significant increase in participant self-esteem over the course of the programme 21. Results In Depth study Increased social inclusion Increased connection to nature 22. Summary: Ecotherapy Interventions Encourages PA which impacts on health Self-esteem, mood, WB Connection to nature - (giving back to nature through shaping & restoring NEs) Self-perceived health Environmentally friendly behaviour Facilitate social contact , social exclusion Build resilience & capacity to cope with life stresses Provide sense of place Are multifaceted, promoting good health & WB 23. Implications of Research Nature can improve public health and wellbeing Build resilience for those at risk of developing mental ill-health Preventative measure for the vulnerable And for us all.... Treatment option for those with existing mental health problems Another tool in the tool box for mental healthcare 24. Implications continued. An enjoyable option to help people feel better Efficient multiple outcomes simultaneously wider than clinical outcomes Cost-effective Leaving the diagnosis at the gate Helps reduce social isolation 25. Conclusion NE is an important resource for human health need to actively protect it to ensure access for all Nature public health costs by promoting healthier communities Need to engage commissioners of health & social care services to fund & support Ecotherapy initiatives Promote it to GPs, call upon NICE to consider the evidence & recommend Ecotherapy interventions as treatment options for mental ill-health Need to think of Natural Health Service to complement NHS? 26. DQ has done more for me than I could have imagined, it has released my spirit and I feel completely different Thank you for listeningcjwood@essex.ac.uk www.greenexercise.org