Nature-based social interventions to address loneliness among vulnerable populations: a common study protocol for three related randomized controlled trials in Barcelona, Helsinki, and Prague within the RECETAS European project.

BACKGROUND: The negative effects of loneliness on population health and wellbeing requires interventions that transcend the medical system and leverage social, cultural, and public health system resources. Group-based social interventions are a potential method to alleviate loneliness. Moreover, nature, as part of our social and health infrastructure, may be an important part of the solutions that are needed to address loneliness. The RECETAS European project H2020 (Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is an international research project aiming to develop and test the effectiveness of nature-based social interventions to reduce loneliness and increase health-related quality of life. METHODS: This article describes the three related randomized controlled trials (RCTs) that will be implemented: the RECETAS-BCN Trial in Barcelona (Spain) is targeting people 18+ from low socio-economic urban areas; the RECETAS-PRG Trial in Prague (Czech Republic) is addressing community-dwelling older adults over 60 years of age, and the RECETAS-HLSNK trial is reaching older people in assisted living facilities. Each trial will recruit 316 adults suffering from loneliness at least sometimes and randomize them to nature-based social interventions called "Friends in Nature" or to the control group. "Friends in Nature" uses modifications of the "Circle of Friends" methodology based on group processes of peer support and empowerment but including activities in nature. Participants will be assessed at baseline, at post-intervention (3 months), and at 6- and 12-month follow-up after baseline. Primary outcomes are the health-related quality-of-life according to 15D measure and The De Jong Gierveld 11-item loneliness scale. Secondary outcomes are health and psychosocial variables tailored to the specific target population. Nature exposure will be collected throughout the intervention period. Process evaluation will explore context, implementation, and mechanism of impact. Additionally, health economic evaluations will be performed. DISCUSSION: The three RECETAS trials will explore the effectiveness of nature-based social interventions among lonely people from various ages, social, economic, and cultural backgrounds. RECETAS meets the growing need of solid evidence for programs addressing loneliness by harnessing the beneficial impact of nature on enhancing wellbeing and social connections. TRIAL REGISTRATION: Barcelona (Spain) trial: ClinicalTrials.gov, ID: NCT05488496. Registered 29 July 2022. Prague (Czech Republic) trial: ClinicalTrials.gov, ID: NCT05522140. Registered August 25, 2022. Helsinki (Finland) trial: ClinicalTrials.gov, ID: NCT05507684. Registered August 12, 2022.

Thinking Health-related Behaviors in a Climate Change Context: A Narrative Review.

BACKGROUND: Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to, climate change. PURPOSE: This article aims to identify potential bi-directional associations between climate change impacts and health-related behaviors, as well as a set of key actions for the behavioral medicine community. METHODS: We synthesized the existing literature about (i) the impacts of rising temperatures, extreme weather events, air pollution, and rising sea level on individual behaviors (e.g., eating behaviors, physical activity, sleep, substance use, and preventive care) as well as the structural factors related to these behaviors (e.g., the food system); and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change. RESULTS: Based on this literature review, we propose a first conceptual model of climate change and health-related behavior feedback loops. Key actions are proposed, with particular consideration for health equity implications of future behavioral interventions. Actions to bridge the fields of behavioral medicine and climate sciences are also discussed. CONCLUSIONS: We contend that climate change is among the most urgent issues facing all scientists and should become a central priority for the behavioral medicine community.

Understanding Emerging Environmental Health Concerns and Environmental Public Health-Tracking Priorities Among State and Local Professionals in Colorado.

CONTEXT: Colorado is experiencing dramatic changes related to population growth, climate change, and expanded industrial activity. Local and state public health professionals are trying to address a growing array of unique public health issues with stagnant or limited resources. OBJECTIVES: To understand, through perspectives from local and state public health professionals, the alignment of contemporary environmental and community health issues with state and local capacity and state environmental public health-tracking priorities. DESIGN: During 2014-2015, we conducted semistructured interviews which informed the development of a statewide survey of Colorado's professionals from public health, emergency management, forestry, and transportation. SETTING: This work took place in Colorado. PARTICIPANTS: Fifteen professionals from public (n = 9), academic (n = 4), and private (n = 2) sectors were interviewed. Forty-seven professionals, representing 34 counties and 40 public agencies, completed the 25-minute online survey. MAIN OUTCOME MEASURES: Environmental and community health concerns; contributing factors to environmental concerns; strengths and limitations of capacity to respond to issues; and frequency of community engagement activities. RESULTS: Top environmental health concerns were indoor air pollution (eg, radon), outdoor air pollution, and waste management. Transportation, extreme weather (eg, wildfires), and oil and gas development were most frequently reported as major contributing factors to concerns. Obesity, physical inactivity, and mental illness were the top community health concerns. To remain prepared for emerging challenges, professionals cited a need for more spatiotemporal-refined data related to their top concerns in the environmental public health-tracking database, and support from local, state, and federal agencies, in addition to personnel and funding. To address concerns, participants reported frequently working with government officials, advisory committees, and media outlets. CONCLUSIONS: This project illuminates opportunities to strengthen connections between the state's environmental public health-tracking priorities and local-level capacity related to professionals' top concerns. It also suggests reinforcing and broadening partnerships to improve data infrastructure and inform environmental public health priorities.

Improving lifestyles sustainability through community gardening: results and lessons learnt from the JArDinS quasi-experimental study.

BACKGROUND: Despite an increasing number of studies highlighting the health benefits of community gardening, the literature is limited by cross-sectional designs. The "JArDinS" quasi-experimental study aimed to assess the impact of community garden participation on the adoption of more sustainable lifestyles among French adults. METHODS: Individuals entering a community garden in Montpellier (France) in 2018 (n = 66) were compared with pairwise matched individuals with no experience in community gardening (n = 66). Nutritional quality, environmental impact and cost of monthly household food supplies, level of physical activity measured by accelerometers, as well as mental and social well-being, sensitivity to food waste, and connection with nature were evaluated at baseline (t0) and 12 months later (t1) to explore sustainability of lifestyles in social/health, environmental and economic dimensions. Linear mixed models were used to determine the independent effect of community gardening on investigated lifestyles components. In-depth interviews were conducted at t1 with 15 gardeners to better understand changes that may have occurred in gardeners' lives during the first year of gardening. RESULTS: At t0, gardeners had lower education level, lower BMI and their household reported lower percentage of meals consumed outside of the home compared to non-gardeners (p <  0.05). Participating in the community garden had no significant impact, in spite of sufficient statistical power, on fruit and vegetables supplies (main outcome), nor on physical activity parameters, nor on others of the social/health, environmental and economic lifestyles components investigated. Qualitative interviews suggested the existence of pre-established health and environmental consciousness in some gardeners and revealed several barriers to the participation such as lack of time, lack of gardening knowledge, physical difficulty of gardening, health problems and conflicts with other gardeners. CONCLUSIONS: The health benefits of community gardening previously reported by cross-sectional studies might be confounded by selection bias. The JArDinS study highlights the need to identify solutions to overcome barriers related to community garden participation when designing relevant public health interventions for the promotion of sustainable lifestyles. TRIAL REGISTRATION: The study was registered at clinicaltrials.gov as NCT03694782 . Date of registration: 3rd October 2018, retrospectively registered.

How to Identify Success Among Networks That Promote Active Living.

OBJECTIVES: We evaluated organization- and network-level factors that influence organizations' perceived success. This is important for managing interorganizational networks, which can mobilize communities to address complex health issues such as physical activity, and for achieving change. METHODS: In 2011, we used structured interview and network survey data from 22 states in the United States to estimate multilevel random-intercept models to understand organization- and network-level factors that explain perceived network success. RESULTS: A total of 53 of 59 "whole networks" met the criteria for inclusion in the analysis (89.8%). Coordinators identified 559 organizations, with 3 to 12 organizations from each network taking the online survey (response rate = 69.7%; range = 33%-100%). Occupying a leadership position (P < .01), the amount of time with the network (P < .05), and support from community leaders (P < .05) emerged as correlates of perceived success. CONCLUSIONS: Organizations' perceptions of success can influence decisions about continuing involvement and investment in networks designed to promote environment and policy change for active living. Understanding these factors can help leaders manage complex networks that involve diverse memberships, varied interests, and competing community-level priorities.

A process evaluation of a randomized-controlled trial of community gardening to improve health behaviors and reduce stress and anxiety.

As part of the Community Activation for Prevention (CAPS) randomized controlled trial (RCT) of community gardening, we conducted a process evaluation to assess the implementation of a community gardening intervention over nine months, as measured by reach, fidelity (delivery, receipt, enactment), and acceptability. Evaluation instruments included repeated semi-structured interviews with study participants, direct observation of community garden sites, and an exit survey of participants. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were stress and anxiety. The CAPS trial included 291 participants (19% non-white; 34% Hispanic/Latino; 35% without a college degree; 58% with income < $50,000 per year). Intervention delivery and receipt were high for environmental supports. Garden social events were offered by 73% of gardens, although only 48% of intervention participants reported attending these events. Of the 145 participants assigned to the gardening intervention, 97 (67%) reported gardening the entire season and reported visiting the community garden a median of 90 min per week (range: 0-840). Of the participants who completed the exit survey (48%), 89% were highly satisfied with the overall garden experience. The CAPS trial was favorably received and implemented with high fidelity, supporting the validity of the trial outcomes. These findings suggest that community gardens are a viable health promotion strategy that can be successfully implemented among new gardeners from diverse backgrounds. Strategies that engage new gardeners in the social aspects of the garden environment and connect gardeners with garden "mentors" or "buddies" to ensure new gardeners achieve success in their first years of gardening are recommended.Trial registration: NCT03089177. Registered 24 March 2017, https://clinicaltrials.gov/study/NCT03089177 .

In-depth interviews with state public health practitioners on the United States National Physical Activity Plan.

BACKGROUND: The United States National Physical Activity Plan (NPAP; 2010), the country's first national plan for physical activity, provides strategies to increase population-level physical activity to complement the 2008 physical activity guidelines. This study examined state public health practitioner awareness, dissemination, use, challenges, and recommendations for the NPAP. METHODS: In 2011-2012, we interviewed 27 state practitioners from 25 states. Interviews were recorded and transcribed verbatim. Transcripts were coded using a standard protocol, verified and reconciled by an independent coder, and input into qualitative software to facilitate development of common themes. RESULTS: NPAP awareness was high among state practitioners; dissemination to local constituents varied. Development of state-level strategies and goals was the most frequently reported use of the NPAP. Some respondents noted the usefulness of the NPAP for coalitions and local practitioners. Challenges to the plan included implementation cost, complexity, and consistency with other policies. The most frequent recommendation made was to directly link examples of implementation activities to the plan. CONCLUSIONS: These results provide early evidence of NPAP dissemination and use, along with challenges encountered and suggestions for future iterations. Public health is one of eight sectors in the NPAP. Further efforts are needed to understand uptake and use by other sectors, as well as to monitor long-term relevance, progress, and collaboration across sectors.

Local Wellness Policy 5 years later: is it making a difference for students in low-income, rural Colorado elementary schools?

INTRODUCTION: The federally mandated Local Wellness Policy (LWP) was intended to promote student health in schools. This study assesses the 5-year effects of the LWP on the health practices of rural elementary schools in Colorado. METHODS: One year before and 5 years after the LWP mandate, a survey was administered to a random sample of principals, physical education (PE) teachers, and food-service managers in 45 rural, low-income elementary schools in Colorado. Response rates were 71% in 2005 and 89% in 2011. RESULTS: Minutes for PE and recess did not increase, nor did offerings of fresh fruits and vegetables. More schools adopted policies prohibiting teachers from taking recess away as punishment (9.7% in 2005 vs 38.5% in 2011, P = .02) or for making up missed instructional time, class work, or tests in other subjects (3.2% in 2005 vs 28.2% in 2011, P = .03). More schools scheduled recess before lunch (22.6% in 2005 vs 46.2% in 2011, P = .04) and developed policies for vending machines (42.9% in 2005 vs 85.7% in 2011, P = .01) and parties (21.4% in 2005 vs 57.9% in 2011, P = .004). CONCLUSION: Changes in school practices are modest, and arguably the important school practices such as increased PE and recess time and increased offerings of fruits and vegetables in the lunch line have not changed in the 5 years since the mandate went into effect. Further investigation is needed to identify the knowledge, skills, and attitudes as well as financial and physical resources required for school administrators to make changes in school practices.

Active living collaboratives in the United States: understanding characteristics, activities, and achievement of environmental and policy change.

INTRODUCTION: Changing the built environment to promote active lifestyles requires collaboration among diverse sectors. Multisectoral collaborative groups in the United States promote active lifestyles through environmental and policy changes. The objective of this study was to examine the characteristics of these collaborative groups and the extent to which they have achieved change. METHODS: We identified, recruited, and interviewed the coordinators of active living collaborative groups in the United States. We used descriptive statistics to characterize groups by composition, stakeholder engagement, and the extent of environmental and policy change in 8 strategic areas. RESULTS: Fifty-nine groups from 22 states participated in the study. Most groups had a diverse set of partners and used a range of activities to advance their agendas. Most groups achieved some form of environmental or policy change. On average, groups reported working on 5 strategy areas; parks and recreation (86%) and Safe Routes to School (85%) were named most frequently. More than half of groups reported their environmental initiatives as either in progress or completed. Groups reported the most success in changing policy for public plazas, street improvements, streetscaping, and parks, open space, and recreation. Complete Streets policy and zoning ordinances were the most frequently cited policy types. Engaging in media activities and the policy-making process in addition to engaging stakeholders appear to influence success in achieving change. CONCLUSION: Although many groups successfully worked on parks and recreation improvements, opportunities remain in other areas, including transit and infill and redevelopment. Additional time and resources may be critical to realizing these types of changes.

Lessons in promoting active living: the collaborative perspective.

CONTEXT: Collaborative groups are integral in health promotion and disease prevention and use an ecological approach to address complex health conditions in community settings. Little is known about collaborative efforts to promote active living. OBJECTIVE: The objective of this analysis is to explore successes and challenges of collaborative groups in promoting active living in their communities. DESIGN/SETTING: One-time, structured telephone interviews were conducted to assess the composition tactics and activities and approaches used by collaboratives to promote active living. PARTICIPANTS: Collaborative groups were referred by Physical Activity Policy Research Network members or found through online searches. Interviews were conducted with coordinators of 59 collaborative groups. MAIN OUTCOME MEASURE(S): Analysis focused on successes and challenges of collaborative groups' policies, programs, and/or projects as described by collaborative group coordinators. We used the Grounded Theory method approach to code and abstract themes from 2 open-ended response sets. RESULTS: Collaboratives' most successful projects centered on strategies using environmental (41%) or policy (31%) approaches to promote active living. While 80% of groups reported that their most successful project was funded, funding was also identified as a primary challenge for 71% of the collaboratives. Personnel issues were a common challenge for 54%. Opposition to successful projects ranged from community issues to collaborative member issues, although more than half the groups experienced no opposition. CONCLUSIONS: Groups that aligned goals, strategies, and funding to advance changes to the built environment were likely to identify their projects as successful. Perceptions of opposition and attitudes toward success may be important precursors to project outcomes of active living collaboratives and warrant further investigation. Lessons from these active living collaborative groups can provide guidance for other groups planning for environmental and policy change.

Policy, systems, and environmental approaches for obesity prevention: a framework to inform local and state action.

The public health literature has not fully explored the complexities of the policy process as they relate to public health practice and obesity prevention. We conducted a review of the literature across the policy science and public health fields, distilled key theories of policy making, and developed a framework to inform policy, systems, and environmental change efforts on obesity prevention. Beginning with a conceptual description, we focus on understanding three domains of the policy process: the problem domain, the policy domain, and the political domain. We identify key activities in the policy process including the following: (a) assessing the social and political environment; (b) engaging, educating and collaborating with key individuals and groups; (c) identifying and framing the problem; (d) utilizing available evidence; (e) identifying policy solutions; and (f) building public support and political will. The article provides policy change resources and case studies to guide and support local and state efforts around obesity prevention.

Municipal officials' perceived barriers to consideration of physical activity in community design decision making.

CONTEXT: Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. OBJECTIVE: This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. DESIGN: A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. PARTICIPANTS: A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. MAIN OUTCOME MEASURES: Five barriers to consideration of physical activity in community design and layout were assessed. RESULTS: The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. CONCLUSIONS: Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing constraints and perceived lack of collaboration with relevant departments such as planning and public works/transportation.

Advancing environmental and policy change through active living collaboratives: compositional and stakeholder engagement correlates of group effectiveness.

OBJECTIVE: This study aims to evaluate compositional factors, including collaborative age and size, and community, policy, and political engagement activities that may influence collaboratives' effectiveness in advancing environmental improvements and policies for active living. DESIGN/PARTICIPANTS/SETTING: Structured interviews were conducted with collaboratives' coordinators. Survey items included organizational composition, community, policy, and political engagement activities and reported environmental improvements and policy change. Descriptive statistics and multivariate models were used to investigate these relationships. MAIN OUTCOME MEASURE(S): Environmental improvement and policy change scores reflecting level of collaborative effectiveness across 8 strategy areas (eg, parks and recreation, transit, streetscaping, and land redevelopment). RESULTS: Fifty-nine collaborative groups participated in the interview, representing 22 states. Groups have made progress in identifying areas for environmental improvements and in many instances have received funding to support these changes. Results from multivariate models indicate that engagement in media communication and advocacy was statistically correlated with higher levels of environmental improvement, after adjusting for age of group and area poverty levels (P < .01). Groups that frequently solicited endorsements from community leaders and offered testimony in policy or legal hearings reported significantly more policy change, after adjusting for age of group and area poverty levels (P < .01 for both). CONCLUSIONS: Active living collaboratives are translating the evidence on environmental and policy approaches to promote active living from research to practice. Investing in community and policy engagement activities may represent important levers for achieving structural and policy changes to the built environment.

Effects of a community gardening intervention on diet, physical activity, and anthropometry outcomes in the USA (CAPS): an observer-blind, randomised controlled trial.

BACKGROUND: Unhealthy diet, physical inactivity, and social disconnection are important modifiable risk factors for non-communicable and other chronic diseases, which might be alleviated through nature-based community interventions. We tested whether a community gardening intervention could reduce these common health risks in an adult population that is diverse in terms of age, ethnicity, and socioeconomic status. METHODS: In this observer-blind, randomised, controlled trial, we recruited individuals who were on Denver Urban Garden waiting lists for community gardens in Denver and Aurora (CO, USA), aged 18 years or older, and had not gardened in the past 2 years. Participants were randomly assigned (1:1), using a randomised block design in block sizes of two, four, or six, to receive a community garden plot (intervention group) or remain on a waiting list and not garden (control group). Researchers were masked to group allocation. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were perceived stress and anxiety. During spring (April to early June, before randomisation; timepoint 1 [T1]), autumn (late August to October; timepoint 2 [T2]), and winter (January to March, after the intervention; timepoint 3 [T3]), participants completed three diet recalls, 7-day accelerometry, surveys, and anthropometry. Analyses were done using the intention-to-treat principle (ie, including all participants randomly assigned to groups, and assessed as randomised). We used mixed models to test time-by-intervention hypotheses at an α level of 0·04, with T2 and T3 intervention effects at an α level of 0·005 (99·5% CI). Due to potential effects of the COVID-19 pandemic on outcomes, we excluded all participant data collected after Feb 1, 2020. This study is registered with ClinicalTrials.gov, NCT03089177, and data collection is now complete. FINDINGS: Between Jan 1, 2017, and June 15, 2019, 493 adults were screened and 291 completed baseline measures and were randomly assigned to the intervention (n=145) or control (n=146) groups. Mean age was 41·5 years (SD 13·5), 238 (82%) of 291 participants were female, 52 (18%) were male, 99 (34%) identified as Hispanic, and 191 (66%) identified as non-Hispanic. 237 (81%) completed measurements before the beginning of the COVID-19 pandemic. One (<1%) participant in the intervention group had an adverse allergic event in the garden. Significant time-by-intervention effects were observed for fibre intake (p=0·034), with mean between-group difference (intervention minus control) at T2 of 1·41 g per day (99·5% CI -2·09 to 4·92), and for moderate-to-vigorous physical activity (p=0·012), with mean between-group difference of 5·80 min per day (99·5% CI -4·44 to 16·05). We found no significant time-by-intervention interactions for combined fruit and vegetable intake, Healthy Eating Index (measured using Healthy Eating Index-2010), sedentary time, BMI, and waist circumference (all p>0·04). Difference score models showed greater reductions between T1 and T2 in perceived stress and anxiety among participants in the intervention group than among those in the control group. INTERPRETATION: Community gardening can provide a nature-based solution, accessible to a diverse population including new gardeners, to improve wellbeing and important behavioural risk factors for non-communicable and chronic diseases. FUNDING: American Cancer Society, University of Colorado Cancer Centre, University of Colorado Boulder, National Institutes of Health, US Department of Agriculture National Institute of Food and Agriculture, Michigan AgBioResearch Hatch projects.

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.

Safety practices in relation to home ownership among urban Mexican immigrant families.

UNLABELLED: We examined home safety hazards, comparing renter- to owner-occupied housing among urban, immigrant Mexican families. METHODS: Interviews and home inspections were conducted among urban, Spanish-speaking immigrant families with children. We estimated weighted hazard prevalence and used logistic regression to compare owner- and renter-occupied homes. Of 313 eligible households, 250 (80%) enrolled. Respondents were predominantly Mexican-born (99%), low income (72.6%) and lower education (92.3%). Most homes had fire, burn, fall, poisoning, electrocution and fire escape hazards, including high tap water temperatures (76.4%; 95% CI: 69.0, 83.7%), no working smoke alarms (60.0%; 51.3, 68.8%), slippery bathtub/shower surfaces (58.7%; 49.9, 67.5%), blocked fire escape routes (55.9%; 47.2, 64.5%) and child-accessible medications (71.0%; 60.1, 81.3%). After adjustment for sociodemographics, fire escape (OR = 8.8; 95% CI: 2.8, 27.7), carbon monoxide poisoning (OR = 2.9; 1.4, 6.2) and drowning (OR = 3.5; 1.3, 9.4) hazards were more likely in owner- than renter-occupied homes. Housing age and type explained most differences. Many urban, immigrant Spanish-speaking families live in unsafe homes. For this population, housing safety programs should be targeted based on housing age and type rather than tenure.

Rationale, Feasibility, and Acceptability of the Meeting in Nature Together (MINT) Program: A Novel Nature-Based Social Intervention for Loneliness Reduction with Teen Parents and Their Peers.

Recently, there has been an increase in feelings of loneliness and mental health conditions among adolescents. Within this population, parenting teens are at an increased risk for these conditions. Outdoor experiences are shown to be an antidote to loneliness and a way to promote social connectedness by amplifying the processes for supporting social relationships. In 2020-2021, we piloted the 8-week Meeting in Nature Together program (MINT) at a charter school for pregnant and parenting teenagers in Colorado, USA. MINT aimed to promote relatedness and nature connection for students ages 14 to 19. MINT included online and in-person group meetings with educational content, creative activities, discussion, park excursions, mindfulness activities, journaling, and nature photography. Here, we ask, can a school-level nature-based social intervention reduce loneliness among pregnant and parenting teens by promoting and sustaining social connections? How acceptable is MINT to participants? Methods included audiovisual recording transcriptions, surveys, and observation field notes. Results suggest that MINT fostered social connections through a tailored nature-based intervention delivered to a typically isolated community in culturally sensitive, developmentally appropriate ways. MINT proved feasible and effective as participants reported high levels of satisfaction and interest in continuing to engage in activities promoted in MINT.

The influence of social involvement, neighborhood aesthetics, and community garden participation on fruit and vegetable consumption.

OBJECTIVES: We considered the relationship between an urban adult population's fruit and vegetable consumption and several selected social and psychological processes, beneficial aesthetic experiences, and garden participation. METHODS: We conducted a population-based survey representing 436 residents across 58 block groups in Denver, Colorado, from 2006 to 2007. We used multilevel statistical models to evaluate the survey data. RESULTS: Neighborhood aesthetics, social involvement, and community garden participation were significantly associated with fruit and vegetable intake. Community gardeners consumed fruits and vegetables 5.7 times per day, compared with home gardeners (4.6 times per day) and nongardeners (3.9 times per day). Moreover, 56% of community gardeners met national recommendations to consume fruits and vegetables at least 5 times per day, compared with 37% of home gardeners and 25% of nongardeners. CONCLUSIONS: Our study results shed light on neighborhood processes that affect food-related behaviors and provides insights about the potential of community gardens to affect these behaviors. The qualities intrinsic to community gardens make them a unique intervention that can narrow the divide between people and the places where food is grown and increase local opportunities to eat better.

Feasibility of collection and analysis of microbiome data in a longitudinal randomized trial of community gardening.

Aim: We explored the feasibility of collecting and analyzing human microbiome data in a longitudinal randomized controlled trial of community gardening. Methods & materials: Participants were randomly assigned to gardening (N = 8) or control (N = 8). Participants provided stool, mouth, hand and forehead microbiome samples at six timepoints. Analyses combined mixed models with Qiita output. Results: Participant satisfaction was high, with 75% of participants completing evaluations. While no microbial effects were statistically significant due to small sample size, the analysis pipeline utility was tested. Conclusion: Longitudinal collection and analysis of microbiome data in a community gardening randomized controlled trial is feasible. The analysis pipeline will be useful in larger studies for assessment of the pathway between microbiota, gardening and health outcomes.