Mechanisms underlying the associations between different types of nature exposure and sleep duration: An 18-country analysis.

Whilst green space has been linked to healthier sleep outcomes, the roles of specific types of nature exposure, potential underlying mechanisms, and between-country variations in nature-sleep associations have received little attention. Drawing on cross-sectional survey data from an 18-country sample of adults (N = 16,077) the current study examined: 1) the relative associations between six different types of nature exposure (streetscape greenery, blue view from home, green space within 1 km, coast within 1 km, green space visits, blue space visits) and insufficient sleep (<6 h vs. 7-10 h per day); 2) whether these relationships were mediated by better mental wellbeing and/or physical activity; and 3) the consistency of these pathways among the different countries. After controlling for covariates, neighbourhood nature measures (green space, coast within 1 km) were not significantly associated with insufficient sleep; but nature visible from home (streetscape greenery, blue views) and recreational visits to green and blue spaces were each associated with less insufficient sleep. Significant nature-sleep associations were mediated, to varying degrees, by better mental wellbeing, but not self-reported physical activity. Country-level heterogeneity in the strength of nature-sleep associations was observed. Increasing nature visible from the home may represent a promising strategy for promoting healthier sleep duration at the population level, whilst nature-based interventions encouraging individuals to spend time in local green/blue spaces may be an appropriate target to assist individuals affected by insufficient sleep.

Exploring public risk perceptions of microplastics: Findings from a cross-national qualitative interview study among German and Italian citizens.

Microplastics are receiving growing attention in the public debate, while the scientific assessment of risks of microplastics to ecological and human health is still ongoing. Previous studies suggest concerns among the general public with country-specific differences. However, little is known about the reasoning underlying these concerns. By conducting qualitative interviews with German (n = 15) and Italian citizens (n = 15), this study adopted a cross-national perspective to investigate which concepts shape citizens' perceptions of microplastics. A qualitative content analysis was used, with coding categories and subcategories developed inductively. Results showed that interviewees formed assumptions around microplastics despite own uncertainties, transferred knowledge from macro- to microplastics, and used the concepts of accumulation and dose-response relationship to make sense of the topic. Moreover, they saw the domains of human health and the environment as intertwined and expressed helplessness when discussing solutions to the microplastics issue. Many themes on the topic were similar in both samples, but there were also some differences. For instance, whereas Italian participants talked about marine-related microplastics, German participants talked about airborne sources; also, German participants tended to recognize more strongly the actions their country was putting in place to address the problem. These findings underscore the need for proactive risk communication despite remaining gaps in scientific risk assessment. Beyond providing technical information, communicators should consider the reasoning behind risk perception on microplastics and address scientific uncertainty as well as the interconnectedness between the domains of human health and the environment.

Associations of nature contact with emotional ill-being and well-being: the role of emotion regulation.

Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation.

Urban green space and mental health among people living alone: The mediating roles of relational and collective restoration in an 18-country sample.

Rates of living alone, especially in more urbanised areas, are increasing across many industrialised countries, with associated increases in feelings of loneliness and poorer mental health. Recent studies have suggested that access to nature (e.g. parks and green spaces) can reduce the stressors associated with loneliness, partly through providing opportunities to nurture personal relationships (relational restoration) and engage in normative community activities (collective restoration). Such associations might vary across different household compositions and socio-demographic or geographical characteristics, but these have not been thoroughly tested. Using data collected across 18 countries/territories in 2017-2018, we grouped urban respondents into those living alone (n = 2062) and those living with a partner (n = 6218). Using multigroup path modelling, we tested whether the associations between neighbourhood greenspace coverage (1-km-buffer from home) and mental health are sequentially mediated by: (a) visits to greenspace; and subsequently (b) relationship and/or community satisfaction, as operationalisations of relational and collective restoration, respectively. We also tested whether any indirect associations varied among subgroups of respondents living alone. Analyses showed that visiting green space was associated with greater mental well-being and marginally lower odds of using anxiety/depression medication use indirectly, mediated via both relationship and community satisfaction. These indirect associations were equally strong among respondents living alone and those living with a partner. Neighbourhood green space was, additionally, associated with more visits among respondents living with a partner, whereas among those living alone, this was sensitive to the green space metric. Within subgroups of people living alone, few overall differences were found. Some indirect pathways were, nevertheless, stronger in males, under 60-year-olds, those with no financial strain, and residents in warmer climates. In conclusion, supporting those living alone, as well as those living with a partner, to more frequently access their local greenspaces could help improve mental health via promoting relational and collective restoration.

Forest 404: Using a BBC drama series to explore the impact of nature's changing soundscapes on human wellbeing and behavior.

Extensive ecosystem degradation and increasing urbanization are altering human relationships with nature. To explore these trends, we created a transdisciplinary, narrative-led podcast series produced by the BBC, called Forest 404. The series explored the implications of a world without nature. An online experimental component mobilized audience participation (n = 7,596) to assess responses to natural soundscapes with and without abiotic, biotic, and poetic elements across five biomes. Conditions featuring the sounds of wildlife, such as bird song, were perceived to be more psychologically restorative than those without. Participants' personal lived experiences were strongly related to these outcomes; those who had memories triggered by the sounds were more likely to find them psychologically restorative and exhibited a greater motivation to preserve them. Moreover, the effects of both soundscape composition and memories on preservation behavior were partially mediated by restorative potential; respondents were more likely to want to protect the sounds they heard if they thought they might offer therapeutic outcomes. Our findings highlight the value of art-science collaborations and demonstrate how maintaining contact with the natural world can promote wellbeing and foster behaviors that protect planetary health.

Redesigning walking brochures using behaviour change theory: implications for walking intentions in natural environments.

Natural environments can be used to promote health through facilitating recreational walking. However, efforts to encourage this often neglect messages identified in psychological research that are effective at influencing intentions to walk. This is despite the National Institute for Health and Care Excellence stating that promotional efforts should utilize theoretical frameworks of behaviour change and be targeted towards less active adults. As an illustrative example, this experiment compared a prototypical recreational walking brochure with an "enhanced" version including such persuasive messages on people's intentions to walk for recreation in natural environments. The enhanced brochure heightened intentions for inexperienced recreational walkers through our hypothesized mechanisms, but appeared to dissuade already-experienced walkers. Optimal messaging strategies in recreational walking brochures require tailoring to more and less active readerships. Guidelines are provided for authors of recreational walking brochures, though the principles and techniques could easily be extended to other means of outdoor walking promotion.

Blue space, health and well-being: A narrative overview and synthesis of potential benefits.

Research into the potential health and well-being benefits from exposure to green spaces such as parks and woodlands has led to the development of several frameworks linking the different strands of evidence. The current paper builds on these to provide a model of how exposure to aquatic environments, or blue spaces such as rivers, lakes and the coast, in particular, may benefit health and well-being. Although green and blue spaces share many commonalities, there are also important differences. Given the breadth of the research, spanning multiple disciplines and research methodologies, a narrative review approach was adopted which aimed to highlight key issues and processes rather than provide a definitive balance of evidence summary. Novel aspects of our framework included the inclusion of outcomes that are only indirectly good for health through being good for the environment, the addition of nature connectedness as both a trait and state, and feedback loops where actions/interventions to increase exposure are implemented. Limitations of the review and areas for future work, including the need to integrate potential benefits with potential risks, are discussed.

Urban nature and physical activity: Investigating associations using self-reported and accelerometer data and the role of household income.

BACKGROUND: Physical inactivity is a major public health concern. Natural, or semi-natural, environments may encourage physical activity, but the influences of socio-economic factors have been under-researched. METHODS: We explored the associations between meeting physical activity (PA) guidelines and both neighbourhood green (area coverage) and blue (freshwater coverage and coastal proximity) environments for urban adults using data from the Health Survey for England [HSE] (2008/2012). We considered different domains of self-reported PA: walking (n = 18,391), sports and other exercise (n = 18,438), non-recreational (domestic/gardening/occupational; n = 18,446) and all three domains combined (n = 18,447); as well as accelerometer-derived PA data using a subsample (n = 1,774). Relationships were stratified by equivalised household income as an indicator of socio-economic status. RESULTS: After adjusting for covariates, living <5 km from the coast was associated with significantly higher odds of meeting UK 2010 guidelines through self-reported total, walking and non-recreational PA (e.g. total PA, <5 km vs. >20 km, adjusted odds ratio (ORadj) = 1.26; 95% confidence interval (CI) = 1.15-1.39) but unrelated to sports and exercise. Greater neighbourhood greenspace, however, was only associated with significantly higher odds of meeting guidelines through non-recreational PA alone (e.g. 80-100% vs. <20% ORadj = 1.32; 95% CI = 1.12-1.56). Although associations were most consistent in the lowest income quintile, income-related results were mixed. Relationships were not replicated in the smaller accelerometry subsample. CONCLUSION: Our self-report findings for the differing domains of PA as a function of neighbourhood green and blue space broadly replicated previous research, yet the reasons for the observed differences between PA domains and environments remain unclear. We did not observe any associations between environmental variables and accelerometer-measured PA; further research with larger samples is needed.

General health and residential proximity to the coast in Belgium: Results from a cross-sectional health survey.

The health risks of coastal areas have long been researched, but the potential benefits for health are only recently being explored. The present study compared the general health of Belgian citizens a) according to the EU's definition of coastal (<50 km) vs. inland (>50 km), and b) between eight more refined categories of residential proximity to the coast (<5 km to >250 km). Data was drawn from the Belgian Health Interview Survey (n = 60,939) and investigated using linear regression models and mediation analyses on several hypothesized mechanisms. Results indicated that populations living <5 km of the coast reported better general health than populations living at >50-100 km. Four commonly hypothesized mechanisms were considered but no indirect associations were found: scores for mental health, physical activity levels and social contacts were not higher at 0-5 km from the coast, and air pollution (PM10 concentrations) was lower at 0-5 km from the coast but not statistically associated with better health. Results are controlled for typical variables such as age, sex, income, neighbourhood levels of green and freshwater blue space, etc. The spatial urban-rural-nature mosaic at the Belgian coast and alternative explanations are discussed. The positive associations between the ocean and human health observed in this study encourage policy makers to manage coastal areas sustainably to maintain associated public health benefits into the future.

Why don't the British eat locally harvested shellfish? The role of misconceptions and knowledge gaps.

Although the UK consumes a substantial amount of shellfish, most is imported (e.g. prawns), while locally harvested molluscs and crustaceans (e.g. mussels, crab) tend to be exported. This study aimed to investigate whether a low rate of local shellfish consumption in the UK is due to misunderstandings or knowledge gaps about the potential health and environmental risks and benefits of consumption. Following the Mental Models Approach, the present paper reveals: 1) qualitative results from 26 stakeholder/public interviews which identified 10 key misunderstandings and knowledge gaps, including incorrect beliefs about health risks and a lack of knowledge about the relative environmental benefits compared to other foods (key misunderstandings included some parts of a crab are poisonous if eaten, and the majority of UK shellfish is farmed), and 2) quantitative results from a survey (n = 1,433) that explored the degree to which these misunderstandings and knowledge gaps may influence consumption intentions in the wider UK population. Survey results suggested the number of misunderstandings and knowledge gaps significantly predicted shellfish consumption intentions even after controlling for demographics, food related values, and past consumption behaviour. Path analyses revealed their impact on intentions was partially mediated via Theory of Planned Behaviour variables. Results could inform information campaigns supporting consumers to make more informed decisions regarding a group of foods that are potentially both healthy and relatively environmentally friendly.

How do brochures encourage walking in natural environments in the UK? A content analysis.

Although walking for leisure can support health, there has been little systematic attempt to consider how recreational walking is best promoted. In the UK, local authorities create promotional materials for walking networks, but little is known about whether they effectively encourage walking through persuasive messaging. Many of these materials pertain to walks in natural environments which evidence suggests are generally visited less frequently by physically inactive individuals. Consequently the present study explores whether and how recreational walking brochures use persuasive messages in their promotion of walks in natural environments. A coding taxonomy was developed to classify text in recreational walking brochures according to five behavioural content areas and 87 categories of potentially persuasive messages. Reliability of the taxonomy was ascertained and a quantitative content analysis was applied to 26 brochures collected from Devon, UK. Brochures often provided information about an advertised route, highlighted cultural and aesthetic points of interest, and provided directions. Brochures did not use many potentially effective messages. Text seldom prompted behaviour change or built confidence for walking. Social norm related information was rarely provided and there was a general lack of information on physical activity and its benefits for health and well-being. The limited range of message strategies used in recreational walking brochures may not optimally facilitate walking in natural environments for inactive people. Future research should examine the effects of theory-informed brochures on walking intentions and behaviour. The taxonomy could be adapted to suit different media and practices surrounding physical activity in natural environments.

The Soothing Sea: A Virtual Coastal Walk Can Reduce Experienced and Recollected Pain.

Virtual reality (VR) distraction has become increasingly available in health care contexts and is used in acute pain management. However, there has been no systematic exploration of the importance of the content of VR environments. Two studies tested how interacting with nature VR influenced experienced and recollected pain after 1 week. Study 1 (n = 85) used a laboratory pain task (cold pressor), whereas Study 2 (n = 70) was a randomized controlled trial with patients undergoing dental treatment. In Study 1, nature (coastal) VR reduced both experienced and recollected pain compared with no VR. In Study 2, nature (coastal) VR reduced experienced and recalled pain in dental patients, compared with urban VR and standard care. Together, these data show that nature can improve experience of health care procedures through the use of VR, and that the content of the VR matters: Coastal nature is better than urban.

'Green' on the ground but not in the air: Pro-environmental attitudes are related to household behaviours but not discretionary air travel.

The rise in greenhouse gas emissions from air travel could be reduced by individuals voluntarily abstaining from, or reducing, flights for leisure and recreational purposes. In theory, we might expect that people with pro-environmental value orientations and concerns about the risks of climate change, and those who engage in more pro-environmental household behaviours, would also be more likely to abstain from such voluntary air travel, or at least to fly less far. Analysis of two large datasets from the United Kingdom, weighted to be representative of the whole population, tested these associations. Using zero-inflated Poisson regression models, we found that, after accounting for potential confounders, there was no association between individuals' environmental attitudes, concern over climate change, or their routine pro-environmental household behaviours, and either their propensity to take non-work related flights, or the distances flown by those who do so. These findings contrasted with those for pro-environmental household behaviours, where associations with environmental attitudes and concern were observed. Our results offer little encouragement for policies aiming to reduce discretionary air travel through pro-environmental advocacy, or through 'spill-over' from interventions to improve environmental impacts of household routines.

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

Attention Restoration Theory (ART) suggests the ability to concentrate may be restored by exposure to natural environments. Although widely cited, it is unclear as to the quantity of empirical evidence that supports this. A systematic review regarding the impact of exposure to natural environments on attention was conducted. Seven electronic databases were searched. Studies were included if (1) they were natural experiments, randomized investigations, or recorded "before and after" measurements; (2) compared natural and nonnatural/other settings; and (3) used objective measures of attention. Screening of articles for inclusion, data extraction, and quality appraisal were performed by one reviewer and checked by another. Where possible, random effects meta-analysis was used to pool effect sizes. Thirty-one studies were included. Meta-analyses provided some support for ART, with significant positive effects of exposure to natural environments for three measures (Digit Span Forward, Digit Span Backward, and Trail Making Test B). The remaining 10 meta-analyses did not show marked beneficial effects. Meta-analysis was limited by small numbers of investigations, small samples, heterogeneity in reporting of study quality indicators, and heterogeneity of outcomes. This review highlights the diversity of evidence around ART in terms of populations, study design, and outcomes. There is uncertainty regarding which aspects of attention may be affected by exposure to natural environments.

Marine Biota and Psychological Well-Being: A Preliminary Examination of Dose-Response Effects in an Aquarium Setting.

Exposure to natural environments can have calming and stress-reducing effects on humans. Moreover, previous studies suggest that these benefits may be greater in areas with higher species richness. Our study took advantage of a "natural experiment" to examine people's behavioral, physiological, and psychological reactions to increases in levels of marine biota in a large aquarium exhibit during three stages of restocking: Unstocked, Partially stocked, and Fully stocked. We found that increased biota levels were associated with longer spontaneous viewing of the exhibit, greater reductions in heart rate, greater increases in self-reported mood, and higher interest. We suggest that higher biota levels, even in managed settings, may be associated with important well-being and health benefits, particularly for individuals not able to access the natural analogues of managed environments.

Measuring health-related quality of life by experiences: the experience sampling method.

OBJECTIVE: To explore the potential value of obtaining momentary, instead of retrospective, accounts of the description and valuation of a person's own health-related quality of life (HRQOL). METHODS: Momentary HRQOL was examined with the experience sampling method (ESM) in 139 participants from four different samples. The ESM consists of a so-called beep questionnaire that was administered 10 times a day by an electronic device. Feasibility was determined by assessing willingness to participate in the study and by analyzing the percentage of dropouts and the number of completed beep questionnaires. Multilevel analysis was used to investigate the relation between momentary HRQOL and momentary feelings and symptoms. The relation between momentary outcomes and the EuroQol visual analogue scale was investigated with a multiple regression model. RESULTS: The overall participation rate was low, but there were no dropouts and the number of completed beeps was comparable to that in other studies. Multilevel analysis showed that feelings and symptoms were significant predictors of momentary HRQOL. The strength of these relations differed among three patient groups and a population-based sample. The EuroQol visual analogue scale was not predicted by momentary feelings and symptoms. CONCLUSIONS: We can conclude that the use of the ESM to measure accounts of the momentary experience of health in different populations is feasible. Retrospective measures may provide a biased account of the impact of health problems in the daily lives of people who are affected. Moreover, the bias may be different in different conditions.

Beyond greenspace: an ecological study of population general health and indicators of natural environment type and quality.

BACKGROUND: Many studies suggest that exposure to natural environments ('greenspace') enhances human health and wellbeing. Benefits potentially arise via several mechanisms including stress reduction, opportunity and motivation for physical activity, and reduced air pollution exposure. However, the evidence is mixed and sometimes inconclusive. One explanation may be that "greenspace" is typically treated as a homogenous environment type. However, recent research has revealed that different types and qualities of natural environments may influence health and wellbeing to different extents. METHODS: This ecological study explores this issue further using data on land cover type, bird species richness, water quality and protected or designated status to create small-area environmental indicators across Great Britain. Associations between these indicators and age/sex standardised prevalence of both good and bad health from the 2011 Census were assessed using linear regression models. Models were adjusted for indicators of socio-economic deprivation and rurality, and also investigated effect modification by these contextual characteristics. RESULTS: Positive associations were observed between good health prevalence and the density of the greenspace types, "broadleaf woodland", "arable and horticulture", "improved grassland", "saltwater" and "coastal", after adjusting for potential confounders. Inverse associations with bad health prevalence were observed for the same greenspace types, with the exception of "saltwater". Land cover diversity and density of protected/designated areas were also associated with good and bad health in the predicted manner. Bird species richness (an indicator of local biodiversity) was only associated with good health prevalence. Surface water quality, an indicator of general local environmental condition, was associated with good and bad health prevalence contrary to the manner expected, with poorer water quality associated with better population health. Effect modification by income deprivation and urban/rural status was observed for several of the indicators. CONCLUSIONS: The findings indicate that the type, quality and context of 'greenspace' should be considered in the assessment of relationships between greenspace and human health and wellbeing. Opportunities exist to further integrate approaches from ecosystem services and public health perspectives to maximise opportunities to inform policies for health and environmental improvement and protection.

Coastal proximity and physical activity: Is the coast an under-appreciated public health resource?

BACKGROUND: Recent findings suggest that individuals living near the coast are healthier than those living inland. Here we investigated whether this may be related to higher levels of physical activity among coastal dwellers in England, arising in part as a result of more visits to outdoor coastal settings. METHOD: Participants (n=183,755) were drawn from Natural England's Monitor of Engagement with the Natural Environment Survey (2009-2012). Analyses were based on self-reported physical activity for leisure and transport. RESULTS: A small, but significant coastal proximity gradient was seen for the likelihood of achieving recommended guidelines of physical activity a week after adjusting for relevant area and individual level controls. This effect was statistically mediated by the likelihood of having visited the coast in the last seven days. Stratification by region, however, suggested that while the main effect was relatively strong for west coast regions, it was not significant for those in the east. CONCLUSIONS: In general, our findings replicate and extend work from Australia and New Zealand. Further work is needed to explain the marked regional differences in the relationship between coastal proximity and physical activity in England to better understand the coast's potential role as a public health resource.

Longitudinal effects on mental health of moving to greener and less green urban areas.

Despite growing evidence of public health benefits from urban green space there has been little longitudinal analysis. This study used panel data to explore three different hypotheses about how moving to greener or less green areas may affect mental health over time. The samples were participants in the British Household Panel Survey with mental health data (General Health Questionnaire scores) for five consecutive years, and who relocated to a different residential area between the second and third years (n = 1064; observations = 5320). Fixed-effects analyses controlled for time-invariant individual level heterogeneity and other area and individual level effects. Compared to premove mental health scores, individuals who moved to greener areas (n = 594) had significantly better mental health in all three postmove years (P = .015; P = .016; P = .008), supporting a "shifting baseline" hypothesis. Individuals who moved to less green areas (n = 470) showed significantly worse mental health in the year preceding the move (P = .031) but returned to baseline in the postmove years. Moving to greener urban areas was associated with sustained mental health improvements, suggesting that environmental policies to increase urban green space may have sustainable public health benefits.