Examining the Psychological Measures and Feasibility of Recreational Trail Rides in Reducing Cravings for Addictive Substances among Veterans: A Replication Pilot Study.

INTRODUCTION: Equine-assisted services have been gaining popularity as complementary therapies for a variety of populations with a diversity of diagnoses. Interventions using equines might benefit the military Veteran population through building therapeutic alliance as well as reducing symptoms. This pilot observational study is primarily aimed to investigate safety, feasibility, and acceptability of equine-assisted services for Veterans with substance abuse disorders. It is the second pilot observational study, the first being completed in 2022. Secondary outcomes included recording the impact of trail riding on psychological measures among Veterans at a large Veterans Administration medical center. METHODS: The study included a total of 32 Veterans who participated in trail riding sessions from May 4, 2022 to August 31, 2022. The study utilized the Positive and Negative Affect Scale, Adult Hope Scale, and Craving Experience Questionnaire to assess changes in positive affect, negative affect, hope components, and substance craving. RESULTS: The results indicated significant reductions in negative affect and substance craving after the first session, with positive effects observed in subsequent sessions. However, demographic and diagnostic variables did not predict significant changes in psychological instruments. CONCLUSION: Overall, the study demonstrated that trail riding was a safe and feasible intervention and may have potential benefits for improving emotional well-being and reducing substance cravings among Veterans. It is recommended that future studies research mechanisms of action, as well as conduct more rigorous investigations, including controlled trials using larger sample sizes and longitudinal research, to best determine lasting effects of these types of complementary therapies.

A Pilot Replication Study of Implementing an Equine-Assisted Services Program Within a VA Residential Substance Use Disorder Treatment Program.

INTRODUCTION: Veterans have high rates of substance use disorders and other mental health conditions including post-traumatic stress disorder. Effective treatments for these conditions exist; however, high attrition rates and residual symptoms after completing treatment are common. Complementary treatment approaches could enhance treatment engagement and/or response among this population. We previously reported a study of one such intervention, an equine-assisted learning, and psychotherapy incorporating horses intervention provided to veterans admitted to a Veterans Health Care Administration residential substance abuse treatment program. The first aim of this study was to replicate the previous study assessing the safety, feasibility, and preliminary outcomes of this intervention. The second aim was to examine the effect of participants attending multiple intervention sessions. MATERIALS AND METHODS: Participants were 94 veterans who participated in one to six sessions of a 3-4-hour program consisting of both equine-assisted learning and psychotherapy incorporating horses. Pre- and post-session administration of the Positive and Negative Affect Scale, State-Trait Anxiety Inventory, and Craving Experience Questionnaire was utilized to assess changes in affect, anxiety, and craving. Wilcoxon signed-rank or paired two-tailed t-tests were utilized for pre- to post-session comparisons of the outcome measures for sessions 1-4. Generalized linear mixed-effects (GLME) models were constructed to determine the impact of dosage. GLME models were constructed to determine the impact of dosage. RESULTS: As with our previous study, the intervention was safe and feasible to utilize for this population. There were statistically significant pre- to post-session improvements, with medium-to-large effect sizes, for sessions 1-3 for negative affect and sessions 1 and 2 for positive affect, anxiety, and craving. The GLME models revealed no statistical significance for any of the predictors. CONCLUSIONS: Taken together, this study and our previous investigation of this equine-assisted services intervention suggest that it is safe and feasible to utilize for veterans admitted to a residential substance abuse treatment program and we have now found short-term benefits in two separate studies. Thus, a randomized controlled trial of this intervention is warranted to demonstrate cause and effect and determine whether longer-term benefits are associated with the intervention. The finding that there was no additional benefit from attendance at more than two intervention sessions suggests that dose-response relationship studies of equine-assisted services interventions for veterans are needed.

A Pilot Observational Study of Implementing an Equine-A ssisted Services Program Within a VA Medical Center Residential Substance Use Disorder Treatment Program.

INTRODUCTION: The aim of this observational pilot study was to assess the safety, feasibility, preliminary outcomes, and predictors of participant response as a result of implementing an equine-assisted intervention within a residential substance abuse treatment program at a large Veterans Administration medical center. A secondary aim was to evaluate psychological instruments for use in future, more rigorous studies. The overarching goal was to complete the necessary work to prepare for a large randomized controlled trial of this intervention for Veterans with addictive disorders. MATERIALS AND METHODS: Participants were 33 Veterans, 29 males and 4 females, who participated in one 4-hour session of combined equine-assisted learning and equine-assisted psychotherapy during an admission to a residential substance abuse treatment program. Preintervention and postintervention instruments were utilized to assess changes in affect, anxiety, and craving. Demographic and diagnostic variables were evaluated for the potential to predict outcomes. RESULTS: The intervention was safe and feasible to utilize as there were no adverse outcomes to patients, staff, or equines. The State-Trait Anxiety Inventory, Craving Experience Questionnaire, and Positive and Negative Affect Scale revealed preliminary findings of significant preintervention to postintervention decreases in anxiety, negative affect, and craving, as well as increased positive affect. Lastly, the presence or absence of a history of suicide attempts and/or suicidal ideation were predictive of some postintervention scores. CONCLUSION: While more rigorous studies are needed, these results indicate that the intervention evaluated in this study is safe and feasible to utilize for Veterans admitted to a residential substance abuse treatment program. Furthermore, preliminary outcomes suggest that this intervention, and perhaps other equine-assisted interventions, has the potential to be beneficial to Veterans with addictive disorders as well as those at risk of suicide. The psychological instruments used in this intervention appear to be appropriate for use in future investigations. Additionally, more rigorous studies are warranted, and this work provides the necessary first steps needed to proceed with those investigations.

A pilot observational study of recreational trail riding for Veterans with addictive disorders.

OBJECTIVES: The aim of study was to assess the safety, feasibility, and preliminary outcomes of recreational trail riding for Veterans with addictive disorders. DESIGN: This was an observational pilot study. SETTING: United States Veterans Health Care Administration Medical Center. Participants were 18 Veterans, 13 males and 5 females All had at least one addictive disorder, with most common being alcohol use disorder. INTERVENTION: A recreational trail ride of approximately two hours duration. MAIN OUTCOME MEASURES: Assessment of safety and pre- and post-intervention instruments, The State-Trait Anxiety Inventory, Craving Experience Questionnaire, Positive and Negative Affect Scale and Conner-Davidson Resilience Scale were utilized to assess changes in anxiety, craving, affect, and resilience, respectively. RESULTS: The intervention was feasible to utilize for the population studied. In addition, it was possible to conduct the rides in such a way as to minimize risk to participants and there were no serious adverse outcomes to patients, staff, or equines. However, there was one incident that had potential to cause injury. There were significant pre- to post-intervention decreases in anxiety, negative affect and craving as well as increased positive affect. There was not a statistically significant increase in resilience. CONCLUSIONS: These results indicate that recreational trail riding is, at least in some settings, feasible to utilize for this population. The safety assessment indicated that this intervention can be conducted in a manner such that risk can be mitigated. However, trail riding is a dangerous activity that can result in serious injury or death to participants. Thus, such activities should only be considered by programs that have the ability to implement stringent safety protocols. Preliminary outcomes suggest that this intervention has the potential to be beneficial to for Veterans with addictive disorders. Additional, more rigorous randomized, controlled studies are warranted.

Greening Blocks: A Conceptual Typology of Practical Design Interventions to Integrate Health and Climate Resilience Co-Benefits.

It is increasingly evident that exposure to green landscape elements benefits human health. Urban green space in cities is also recognized as a crucial adaptation response to changes in climate and its subsequent effects. The exploration of conceptual and practical intersections between human health, green spaces, and climate action is needed. Evidence-based guidance is needed for stakeholders, practitioners, designers, and citizens in order to assess and manage urban green spaces that maximize co-benefits for both human health and climate resilience. This paper proposes interventions that provide strategic green space enhancement at the neighborhood and block scale. We propose eight tangible green space interventions and associated metrics to integrate climate resilience and population health co-benefits into urban green space design and planning: View from within, Plant entrances, Bring nature nearby, Retain the mature, Generate diversity, Create refuge, Connect experiences, and Optimize green infrastructure. These interventions represent a hierarchy of functional design concepts that respond to experiential qualities and physical/psychological dimensions of health, and which enhance resilience at a range of social scales from the individual to the neighborhood. The interventions also reveal additional research needs in green space design, particularly in neighborhood-level contexts.

The ethics of Google Earth: crossing thresholds from spatial data to landscape visualisation.

'Virtual globe' software systems such as Google Earth are growing rapidly in popularity as a way to visualise and share 3D environmental data. Scientists and environmental professionals, many of whom are new to 3D modeling and visual communications, are beginning routinely to use such techniques in their work. While the appeal of these techniques is evident, with unprecedented opportunities for public access to data and collaborative engagement over the web, are there nonetheless risks in their widespread usage when applied in areas of the public interest such as planning and policy-making? This paper argues that the Google Earth phenomenon, which features realistic imagery of places, cannot be dealt with only as a question of spatial data and geographic information science. The virtual globe type of visualisation crosses several key thresholds in communicating scientific and environmental information, taking it well beyond the realm of conventional spatial data and geographic information science, and engaging more complex dimensions of human perception and aesthetic preference. The realism, perspective views, and social meanings of the landscape visualisations embedded in virtual globes invoke not only cognition but also emotional and intuitive responses, with associated issues of uncertainty, credibility, and bias in interpreting the imagery. This paper considers the types of risks as well as benefits that may exist with participatory uses of virtual globes by experts and lay-people. It is illustrated with early examples from practice and relevant themes from the literature in landscape visualisation and related disciplines such as environmental psychology and landscape planning. Existing frameworks and principles for the appropriate use of environmental visualisation methods are applied to the special case of widely accessible, realistic 3D and 4D visualisation systems such as Google Earth, in the context of public awareness-building and agency decision-making on environmental issues. Relevant principles are suggested which lend themselves to much-needed evaluation of risks and benefits of virtual globe systems. Possible approaches for balancing these benefits and risks include codes of ethics, software design, and metadata templates.

The digital workshop: exploring the use of interactive and immersive visualisation tools in participatory planning.

This paper examines the emerging role of digital tools in a collaborative planning process for British Columbia's Bowen Island. The goal of this research was to evaluate the effectiveness of a 'digital workshop', combining the interactive CommunityViz tool with the immersive lab facilities at the Collaborative for Advanced Landscape Planning (CALP). In support of the larger community planning process, two 3-h workshops were held at CALP's Landscape Immersion Lab. To facilitate collaborative exploration, the interactive landscape visualisation and real-time data analysis capabilities of CommunityViz were employed to illustrate the possible outcomes of residential density policies for Bowen Island's Snug Cove community. The community planning workshops were structured to provide the 14 semi-expert participants with the opportunity to explore and discuss the contentious residential density components of the draft Snug Cove Village Plan. The abilities to dynamically explore the visualisations of the planning proposals, and to see real-time changes in indicator metrics were considered particularly informative, and appeared to increase participants' understanding of the plan. Written and verbal responses indicated, however, that there was insufficient time to examine and interact with the information during the workshop, suggesting a need to examine in greater depth how and when these tools might best be employed in collaborative settings. Current and future research relating to this project is discussed.