Social Isolation in Older Adults: A Qualitative Study on the Social Dimensions of Group Outdoor Health Walks.

Physical distancing practices during the COVID-19 global pandemic contributed to a high degree of social isolation among older adults. To reduce loneliness and other ill effects of social isolation, public health experts recommended outdoor social gathering, with physical distancing. Adopting a case study approach, we explored how social aspects of group outdoor health walks (GOHWs) mitigate social isolation for older adults and improve individual social wellbeing. We used semi-structured interviews to understand the experiences of social isolation and social relationships in nine older (50-80 s) adults participating in a GOHW in Scotland, United Kingdom (UK). Verbatim transcripts were analysed through an iterative process of thematic analysis carried out by an interdisciplinary team of qualitative researchers from environmental psychology, medicine, and geography. Themes provide insight into the social dimensions of GOHWs, the mediating effects of social experiences, and the contribution these make to individual social wellbeing. GOHWs provide opportunities to be part of a group and attend to the needs of inexperienced or physically challenged individuals. Being part of the group walk fosters casual interpersonal interactions through spontaneous mixing during and after the walk. This programmatic structure counters loneliness, engenders pleasurable anticipation of regular contact with others, supports physical activity, and fosters group cohesion. These in turn contribute to individual social wellbeing, including expanding social networks, meaningful relationships, a sense of belonging, and acting on empathy for others. GOWHs may be beneficial for mitigation of social isolation as we emerge from the COVID-19 pandemic. Findings were used to propose a conceptual model to parse social constructs and inform selection or development of quantitative social measures for future studies of nature-based interventions such as GOHWs.

Biodiversity and Health in the Urban Environment.

PURPOSE OF REVIEW: Biodiversity underpins urban ecosystem functions that are essential for human health and well-being. Understanding how biodiversity relates to human health is a developing frontier for science, policy and practice. This article describes the beneficial, as well as harmful, aspects of biodiversity to human health in urban environments. RECENT FINDINGS: Recent research shows that contact with biodiversity of natural environments within towns and cities can be both positive and negative to human physical, mental and social health and well-being. For example, while viruses or pollen can be seriously harmful to human health, biodiverse ecosystems can promote positive health and well-being. On balance, these influences are positive. As biodiversity is declining at an unprecedented rate, research suggests that its loss could threaten the quality of life of all humans. A key research gap is to understand-and evidence-the specific causal pathways through which biodiversity affects human health. A mechanistic understanding of pathways linking biodiversity to human health can facilitate the application of nature-based solutions in public health and influence policy. Research integration as well as cross-sector urban policy and planning development should harness opportunities to better identify linkages between biodiversity, climate and human health. Given its importance for human health, urban biodiversity conservation should be considered as public health investment.

Pathways linking biodiversity to human health: A conceptual framework.

Biodiversity is a cornerstone of human health and well-being. However, while evidence of the contributions of nature to human health is rapidly building, research into how biodiversity relates to human health remains limited in important respects. In particular, a better mechanistic understanding of the range of pathways through which biodiversity can influence human health is needed. These pathways relate to both psychological and social processes as well as biophysical processes. Building on evidence from across the natural, social and health sciences, we present a conceptual framework organizing the pathways linking biodiversity to human health. Four domains of pathways-both beneficial as well as harmful-link biodiversity with human health: (i) reducing harm (e.g. provision of medicines, decreasing exposure to air and noise pollution); (ii) restoring capacities (e.g. attention restoration, stress reduction); (iii) building capacities (e.g. promoting physical activity, transcendent experiences); and (iv) causing harm (e.g. dangerous wildlife, zoonotic diseases, allergens). We discuss how to test components of the biodiversity-health framework with available analytical approaches and existing datasets. In a world with accelerating declines in biodiversity, profound land-use change, and an increase in non-communicable and zoonotic diseases globally, greater understanding of these pathways can reinforce biodiversity conservation as a strategy for the promotion of health for both people and nature. We conclude by identifying research avenues and recommendations for policy and practice to foster biodiversity-focused public health actions.

Addressing behavior in pollinator conservation policies to combat the implementation gap.

Solutions for conserving biodiversity lie in changing people's behavior. Ambitious international and national conservation policies frequently fail to effectively mitigate biodiversity loss because they rarely apply behavior-change theories. We conducted a gap analysis of conservation behavior-change interventions advocated in national conservation strategies with the Behavior Change Wheel (BCW), a comprehensive framework for systematically characterizing and designing behavior-change interventions. Using pollinator conservation as a case study, we classified the conservation actions listed in national pollinator initiatives in relation to intervention functions and policy categories of the BCW. We included all national-level policy documents from the European Union available in March 2019 that focused on conservation of pollinators (n = 8). A total of 610 pollinator conservation actions were coded using in-depth directed content analysis, resulting in the identification of 787 intervention function and 766 policy category codes. Overall, these initiatives did not employ the entire breadth of behavioral interventions. Intervention functions most frequently identified were education (23%) and environmental restructuring (19%). Least frequently identified intervention functions were incentivization (3%), and restriction (2%) and coercion were completely absent (0%). Importantly, 41% of all pollinator conservation actions failed to identify whose behavior was to be changed. Building on these analyses, we suggest that reasons for the serious implementation gap in national and international conservation policies is founded in insufficient understanding of which behavioral interventions to employ for most beneficial impacts on biodiversity and how to clearly specify the intervention targets. We recommend that policy advisors engage with behavior-change theory to design effective behavior-change interventions that underpin successful conservation policies.

Atención al Comportamiento en las Políticas de Conservación de los Polinizadores para Combatir la Brecha de Implementación Resumen Las soluciones para conservar a la biodiversidad se encuentran en el cambio del comportamiento de las personas. Las políticas ambiciosas de conservación nacional e internacional con frecuencia fallan en mitigar efectivamente la pérdida de la biodiversidad porque rara vez aplican teorías de cambios en el comportamiento. Realizamos un análisis de brecha de las intervenciones de cambios en el comportamiento de conservación promovidas en las estrategias de conservación nacional usando la Rueda de Cambios en el Comportamiento (BCW), un marco de trabajo completo para caracterizar y diseñar sistemáticamente las intervenciones de cambios en el comportamiento. Con la conservación de los polinizadores como un estudio de caso, clasificamos las acciones de conservación listadas en las iniciativas nacionales para los polinizadores en relación con las funciones de la intervención y las categorías de las políticas de la BCW. Incluimos todos los documentos de políticas a nivel nacional de la Unión Europea disponibles en marzo de 2019 cuyo enfoque fuera la conservación de los polinizadores (n = 8). Se codificó un total de 610 acciones para la conservación de los polinizadores mediante análisis profundos de contenido dirigidos, lo que resultó en la identificación de 787 códigos de función de la intervención y 766 códigos de categoría de las políticas. En general, estas iniciativas no emplearon la amplitud completa de las intervenciones de comportamiento. Las funciones de la intervención que fueron identificadas con mayor frecuencia fueron la educación (23%) y la reestructuración ambiental (19%); aquellas que fueron identificadas con menor frecuencia fueron la estimulación y el fomento (3%) y la restricción, mientras que la coerción estuvo totalmente ausente (0%). Es importante resaltar que el 41% de todas las acciones por la conservación de los polinizadores falló en la identificación de a quiénes se les debería cambiar el comportamiento. Con base en estos análisis sugerimos que las razones detrás de la brecha severa en la implementación de las políticas de conservación nacionales e internacionales están fundamentadas en el entendimiento insuficiente de cuáles intervenciones de comportamiento emplear para un impacto de mayor beneficio sobre la biodiversidad y cómo especificar claramente los objetivos de las intervenciones. Recomendamos que los asesores políticos se involucren con la teoría del cambio del comportamiento para así diseñar intervenciones efectivas de cambios en el comportamiento que respalden políticas exitosas de conservación.

Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study.

Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) incorporating activity trackers and use of a holistic health and wellbeing measure, the Self-sasessment of Change (SAC) scale. A mixed methods design explored participant recruitment and retention, programme delivery, and measures of physical activity and health and wellbeing. Walker data included: pre-post questionnaires, daily step counts, and interviews. Programme delivery information included: weekly checklists, staff reflections, stakeholder meeting minutes, and a report. Thirteen adults (age 63-81, 76% female) joined and completed the activity tracker GOHW. Activity trackers motivated walkers to join and be more active but complicated programme delivery. Activity trackers allowed the quantification of physical activity and the SAC health and wellbeing measure was easy to use. By week 12, all participants met national physical activity guidelines. Clinically relevant changes on the SAC scale included: sleeping well, experiencing vibrant senses, and feeling energised, focused, joyful, calm and whole. Results illustrate the feasibility of using activity trackers to motivate engagement in and provide a measure of physical activity from GOHWs. The SAC scale offers a promising measure for nature-health research. A conceptual model is provided for the development of future large-scale studies of NBIs, such as group outdoor health walks.

Urban street tree biodiversity and antidepressant prescriptions.

Growing urbanisation is a threat to both mental health and biodiversity. Street trees are an important biodiversity component of urban greenspace, but little is known about their effects on mental health. Here, we analysed the association of street tree density and species richness with antidepressant prescribing for 9751 inhabitants of Leipzig, Germany. We examined spatial scale effects of street trees at different distances around participant's homes, using Euclidean buffers of 100, 300, 500, and 1000 m. Employing generalised additive models, we found a lower rate of antidepressant prescriptions for people living within 100 m of higher density of street trees-although this relationship was marginally significant (p = 0.057) when confounding factors were considered. Density of street trees at further spatial distances, and species richness of street trees at any distance, were not associated with antidepressant prescriptions. However, for individuals with low socio-economic status, high density of street trees at 100 m around the home significantly reduced the probability of being prescribed antidepressants. The study suggests that unintentional daily contact to nature through street trees close to the home may reduce the risk of depression, especially for individuals in deprived groups. This has important implications for urban planning and nature-based health interventions in cities.

Growing Resilience through Interaction with Nature: Can Group Walks in Nature Buffer the Effects of Stressful Life Events on Mental Health?

Nature-based activities have been used as therapeutic interventions for those experiencing stress and mental ill health. This study investigates whether group walks could be a nature-based intervention to foster resilience, by buffering the effects of recent stressful life events on mental health. An observational research design with propensity score-matched samples compared the mental health of individuals who did (Nature Group Walkers, n = 1081) or did not (Non-Group Walkers, n = 435) attend nature group walks. A sub-sample of Frequent Nature Group Walkers (at least once per week, n = 631) was also investigated. Data were analyzed using multiple regression with an interaction term. All analyses were controlled for age, gender, and recent physical activity. Results showed that neither nature group walking, nor doing this frequently, moderated the effects of stressful life events on mental health. Using a main effects model, the positive associations of group walks in nature were at a greater magnitude than the negative associations of stressful life events on depression, positive affect, and mental well-being, suggesting an 'undoing' effect of nature group walks. Group walking schemes in natural environments may be an important public health promotion intervention for mental health.

Addressing "Nature-Deficit Disorder": A Mixed Methods Pilot Study of Young Adults Attending a Wilderness Camp.

Background and Objectives. Rapid urbanization raises concern about chronic human health issues along with less frequent interaction with the natural world. "Nature-deficit disorder," a nonclinical term, describes this potential impact on the well-being of youth. We conducted a mixed methods pilot study of young adults attending a four-week wilderness camp to investigate whether nature-based camp experiences would increase connection to nature and promote multiple dimensions of well-being. Methods. Participants completed precamp (n = 46) and postcamp (n = 36) online questionnaires including nature-related and holistic well-being measures. Differences were investigated using paired t-tests. Interviews (n = 16) explored camp experiences and social relations. Results. All nature-related measures-exposure, knowledge, skills, willingness to lead, perceived safety, sense of place, and nature connection-significantly increased. Well-being outcomes also significantly improved, including perceived stress, relaxation, positive and negative emotions, sense of wholeness, and transcendence. Physical activity and psychological measures showed no change. Interviews described how the wilderness environment facilitated social connections. Conclusion. Findings illustrate the change in nature relations and well-being that wilderness camp experiences can provide. Results can guide future research agendas and suggest that nature immersion experiences could address the risk of "nature-deficit disorder," improve health, and prepare future environmental leaders.

Moving beyond green: exploring the relationship of environment type and indicators of perceived environmental quality on emotional well-being following group walks.

Against the backdrop of increasing interest in the relationship between Nature and health, this study examined the effect of perceived environment type and indicators of perceived environmental quality on short-term emotional well-being following outdoor group walks. Participants (n = 127) of a national group walk program completed pre- and post-walk questionnaires for each walk attended (n = 1009) within a 13-week study period. Multilevel linear modelling was used to examine the main and moderation effects. To isolate the environmental from the physical activity elements, analyses controlled for walk duration and perceived intensity. Analyses revealed that perceived restorativeness and perceived walk intensity predicted greater positive affect and happiness following an outdoor group walk. Perceived restorativeness and perceived bird biodiversity predicted post-walk negative affect. Perceived restorativeness moderated the relationship between perceived naturalness and positive affect. Results suggest that restorative quality of an environment may be an important element for enhancing well-being, and that perceived restorativeness and naturalness of an environment may interact to amplify positive affect. These findings highlight the importance of further research on the contribution of environment type and quality on well-being, and the need to control for effects of physical activity in green exercise research.

Walking for well-being: are group walks in certain types of natural environments better for well-being than group walks in urban environments?

The benefits of walking in natural environments for well-being are increasingly understood. However, less well known are the impacts different types of natural environments have on psychological and emotional well-being. This cross-sectional study investigated whether group walks in specific types of natural environments were associated with greater psychological and emotional well-being compared to group walks in urban environments. Individuals who frequently attended a walking group once a week or more (n = 708) were surveyed on mental well-being (Warwick Edinburgh Mental Well-being Scale), depression (Major Depressive Inventory), perceived stress (Perceived Stress Scale) and emotional well-being (Positive and Negative Affect Schedule). Compared to group walks in urban environments, group walks in farmland were significantly associated with less perceived stress and negative affect, and greater mental well-being. Group walks in green corridors were significantly associated with less perceived stress and negative affect. There were no significant differences between the effect of any environment types on depression or positive affect. Outdoor walking group programs could be endorsed through "green prescriptions" to improve psychological and emotional well-being, as well as physical activity.