Rethinking conceptual frameworks and models of health and natural environments.

This article considers conceptual frameworks and models applied in research about the multiple relations between human contact with natural environments (specifically green public spaces), diverse kinds of human activities and uses of those spaces, and effects on physical and mental health. Conceptual frameworks are tools for thinking about such complex subjects. Conceptual models represent the multiple relations between key factors and variables. These models can be used to represent the mutual interactions between the core components of environmental conditions of specific green public spaces, the main kinds of human activities in those settings, and various impacts on health. A literature search showed that the authors of various conceptual models used a metaphor of pathways to represent relations between explanatory variables by linear cause-effect relations. Mutual interaction between key variables and feedback loops between different components of the model are rarely included. Hence, it is argued that these models do not represent the complexity of real world situations. The authors propose a systemic conceptual framework founded on core principles of human ecology. The proposed conceptual framework and model have been formulated during and after an EU 7th Framework project about the ''Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions of Europe."

Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): a study programme protocol.

INTRODUCTION: Growing evidence suggests that close contact with nature brings benefits to human health and well-being, but the proposed mechanisms are still not well understood and the associations with health remain uncertain. The Positive Health Effects of the Natural Outdoor environment in Typical Populations in different regions in Europe (PHENOTYPE) project investigates the interconnections between natural outdoor environments and better human health and well-being. AIMS AND METHODS: The PHENOTYPE project explores the proposed underlying mechanisms at work (stress reduction/restorative function, physical activity, social interaction, exposure to environmental hazards) and examines the associations with health outcomes for different population groups. It implements conventional and new innovative high-tech methods to characterise the natural environment in terms of quality and quantity. Preventive as well as therapeutic effects of contact with the natural environment are being covered. PHENOTYPE further addresses implications for land-use planning and green space management. The main innovative part of the study is the evaluation of possible short-term and long-term associations of green space and health and the possible underlying mechanisms in four different countries (each with quite a different type of green space and a different use), using the same methodology, in one research programme. This type of holistic approach has not been undertaken before. Furthermore there are technological innovations such as the use of remote sensing and smartphones in the assessment of green space. CONCLUSIONS: The project will produce a more robust evidence base on links between exposure to natural outdoor environment and human health and well-being, in addition to a better integration of human health needs into land-use planning and green space management in rural as well as urban areas.