Article

Gardening as a mental health intervention: A review

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Abstract

Purpose - The number of gardening-based mental health interventions is increasing, yet when the literature was last reviewed in 2003, limited evidence of their effectiveness was identified. The aim of this review was to evaluate the current evidence-base for gardening-based mental health interventions and projects through examining their reported benefits and the quality of research in this field. Design/methodology/approach - Studies evaluating the benefits of gardening-based interventions for adults experiencing mental health difficulties were identified through an electronic database search. Information on the content and theoretical foundations of the interventions, the identified benefits of the interventions and the study methodology was extracted and synthesised. Findings - Ten papers published since 2003 met the inclusion criteria. All reported positive effects of gardening as a mental health intervention for service users, including reduced symptoms of depression and anxiety. Participants described a range of benefits across emotional, social, vocational, physical and spiritual domains. Overall the research was of a considerably higher quality than that reviewed in 2003, providing more convincing evidence in support of gardening-based interventions. However, none of the studies employed a randomised controlled trial design. Research limitations/implications - There is a need for further high-quality research in this field. It is important that adequate outcome measures are in place to evaluate existing gardening-based mental health interventions / projects effectively. Originality/value - This paper provides an up-to-date critique of the evidence for gardening-based mental health interventions, highlighting their potential clinical value.

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... Notably, in the literature concerning alternative and complementary treatments is a discussion about the value of nature-based practices. Indeed, despite the fact that most research concerning effective treatment of PTSD focuses on evidenced-based treatments, there is a growing body of research that suggests for some, being in nature and activity therein is of benefit (Annerstedt & Währborg, 2011;Caddick & Smith, 2014;Cipriani et al., 2017;Clatworthy, Hinds & Camic, 2013;Frumkin et al., 2017). There is also a body of research that suggests that interacting with nature is beneficial for veterans specifically (Atkinson, 2009;Caddick & Smith, 2014;Dustin, Bricker, Arave, Wall & West, 2011;Duvall & Kaplan, 2014;Mowatt & Bennett, 2011;Poulsen, Stigsdotter & Refshage, 2015;Wise, 2015). ...
... Though this modality is extremely versatile and has a wide variety of potential applications, studies of its efficacy are limited and research concerning therapeutic horticulture's efficacy with respect to US veterans is lacking. Part of the challenge of assessing therapeutic horticulture -while also clearly one of the great advantages of the modality -lies in the fact that it can be offered in so many ways and under so many different circumstances, rendering its "success" particularly difficult to rigorously measure (Cipriani et al., 2017;Clatworthy et al., 2013;Kamioka et al., 2014). An additional challenge in terms of assessing therapeutic horticulture's efficacy with respect to veterans lies in the fact that the VA does not currently consider the modality a best practice and/or a practice that facilities would benefit from employing, though more than a few VA facilities currently facilitate some type of gardening program. ...
... In addition to Sempik, Aldridge and Becker's analysis, a fairly small group of other researchers have considered the modality but have offered some valuable observations. Chief among these is the finding that even if not rigorously evaluated, people who have participated in therapeutic horticulture report improvement in their symptoms ("symptoms" in this instance is used very broadly to include a range of both physical and mental health conditions) (Cipriani et al., 2017;Clatworthy et al., 2013;Detweiler et al., 2015;Sempik et al., 2003;Sempik, Rickhuss & Beeston, 2014). Cipriani et al. and Clatworthy et al.'s analyses detailed these improvements, noting meaningful findings including: decreases in depression and anxiety; positive advances with respect to selfesteem, social behavior, and personal relationships; improvements with respect to affect/agitation; progress with respect to mental well-being with specific improvements regarding paranoia, suspicion, depression, and anxiety; advancements in behavior/engagement, and cognitive functioning; decreases in stress and increases in ability to cope with life challenges; and enhancements in sleep (Cipriani et al., 2017;Clatworthy et al., 2013). ...
Article
The Department of Veterans Affairs (VA) faces a plethora of challenges as it daily encounters and treats veterans. With a great prevalence of co-occurring diagnoses, veterans’ needs today are significant and arguably more complex than ever before (Clark, Bair, Buckenmaier, Gironda & Walker, 2007; Phillips et al., 2016). The following two papers seek to build a justification for reconsidering how post-traumatic stress disorder (PTSD) is treated given the illness’ prevalence and the efficacy of current treatments. The first paper reviews the literature and includes: a chronology of the PTSD diagnosis; an examination of current treatments offered by the VA and consideration of their effectiveness; a discussion of current and alternative treatments offered for PTSD; and an exploration of therapeutic horticulture as a healing modality for veterans coping with PTSD. After reviewing the historical and theoretical foundation for this research, the second paper details a mixed method study designed to better understand the depth and breadth of therapeutic horticulture programs that have been operationalized at VA facilities. Using survey and interviews of VA personnel, the author elicited information about VA therapeutic horticulture programs and was able to deduce themes related to the genesis of programs, details of programs’ operationalization and facilitation, and the impact on veterans. The author concludes the study with recommendations for those VA facilities considering implementing a therapeutic horticulture program along with an appeal that the VA begins to more earnestly consider the increasing body of evidence concerning the efficacy of therapeutic horticulture.
... The paper was influenced by the distinct lack of studies embracing an ethnographic methodology in understanding the specific impacts of green exercise therapeutic interventions. Hitherto, research has largely focused upon the use of quantitative or less context-sensitive qualitative methodologies; pertinently, prior studies have typically underemphasised the mediating and moderating influences underpinning reported positive outcomes from green exercise (Rogersen et al, 2020;Clatworthy et al, 2013;Gladwell et al, 2013;Okvat & Zutra, 2011). ...
... Well-cited primary studies have hitherto outlined innovative interventions in a variety of settings, using a range of occupational GE modalities including allotment work (Genter, Roberts, Richardson & Sheaff, 2015;Page, 2008), gardening (Rappe et al, 2008;Soderback et al, 2004) and horticulture (Christie et al, 2016;Parkinson et al 2011;Kim & Park, 2018;Wichrowski et al, 2005). Moreover, a number of instructive systematic reviews have concluded that such interventions and natural settings have clear facility in improving mental health and wellbeing (Cipriani et al, 2017;Clatworthy et al, 2013;Kamioka et al, 2014;Bowler et al, 2010). ...
... It was also influenced by the relative lack of ethnographic methodology in understanding the impacts of gardening and horticultural-based therapeutic intervention studies, despite a rich tradition of ethnography within broader health research (Cook, 2005). One recent notable exception in respect of GE modes was by Joyce et al (2016), a novel approach in a field hitherto dominated by the use of questionnaires and controlled trials (Clatworthy et al, 2013 promoting research innovation and with the desired intent of informing future practice, the researchers added the extra methodological layer of the TA approach within the broader ethnographic methodology adopted (as noted previously). ...
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Critical evaluation of a novel 'think aloud' method within an ethnographic fieldwork research design - reflections on its utility for investigating the impact of a green exercise therapeutic horticulture initiative for people recovering from mental ill-health.
... Originally developed by Block et al. (2011), the food well-being (FWB) framework highlights the role of food to improve well-being for both individuals and society and uses a holistic approach to well-being (i.e., it includes for example spiritual and emotional dimensions in addition to nutritional health) [9,10]. However, this framework has largely been focused on food consumption activities, although a large body of literature shows the connection between growing food activities and well-being [3,7,[11][12][13]. Additionally, a growing body of literature has shown a positive relationship between sustainability or sustainable development and well-being [14][15][16][17][18][19][20], especially how environmentally sustainable practices can help support ecosystems services which have direct impact on human well-being [21,22], but also how prosocial behaviors and connection to nature are key elements of sustainable practices and directly enhance human well-being [23,24]. ...
... Previous research indicates that there is a strong connection between gardening and well-being. Studies have been conducted amongst people above 60 [38], school children [39,40], people with mental health [11], and leisure gardeners [8]. Some results indicate that gardening has positive impacts on mental health, reducing symptoms of depression and anxiety [11]. ...
... Studies have been conducted amongst people above 60 [38], school children [39,40], people with mental health [11], and leisure gardeners [8]. Some results indicate that gardening has positive impacts on mental health, reducing symptoms of depression and anxiety [11]. Some also linked gardening practices to an increased sense of connection to nature, or what is known as biophilia. ...
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“Life, Liberty and Pursuit of Happiness”, is what millions of Americans strive for. The onset of COVID-19 has highlighted the disparities that exist among Black, Indigenous and People of Color (BIPOC) communities, which are facing food access inequities. In this paper, we argue that engaging in growing food sustainably can improve food access, support food justice and enhance sense of purpose and well-being. We expand the notion of Food Well-Being (FWB) to include food producers—especially gardeners—and hypothesize that gardening has the potential to enhance FWB, regardless of the racial and socio-economic background. However, without policies tackling social and racial justice issues, structural barriers may hinder this potential. We use three studies to draw a rich profile of sustainable food gardeners in Arizona, USA and their well-being: (a) the children and teachers engaged in school gardens in the Phoenix metropolitan area; (b) sustainable gardeners and farmers in Phoenix and Tucson; (c) Arizona gardeners during the pandemic. The results show a connection between sustainable gardening and eudemonic well-being, and an impact on the five FWB dimensions (physical, intellectual, spiritual, emotional and social). However, without appropriate policies, funding and infrastructure, the impact might remain minimal, volatile and subject to tokenism
... 'After we started implementing gardening classes, the children learned to work in a team, and started to build friendships.' Clatworthy et al. (2013) undertook a systematic literature review of studies evaluating the benefits of gardening interventions with people experiencing a range of mental-health difficulties. Their study looked at 10 in-depth studies but cited a huge increase in the use of horticultural interventions for vulnerable people in the preceding 10 years, as well as a revived interest over the former five years in the connection between nature, green spaces and Gardening in Displacement 5 ...
... However, among refugees and displaced populations in the Middle East, this connection is not so much lost as momentarily removed, as the majority of residents in Domiz and in other similar camps have had recent and vivid experiences of gardens at home. Clatworthy et al. (2013) uses two dominant theories to explain the impact of gardening on mental health: attention-restoration theory (Kaplan and Kaplan 1989;Kaplan 1995) and psycho-physiological stress-reduction theory (Ulrich 1983). Both are based on the idea that humans have an innate need to affiliate with the natural environment within which they have evolved. ...
... Many of these themes re-emerged among interviews with refugees and IDPs in Domiz Camp, where they also cited the importance of nature, of connecting with a broader new network of people, of the potential for developing work and employment-related skills and business, and a deeper sense of peace and wellbeing in very difficult circumstances. Clatworthy (2013) suggests the need for further research into the components of gardening that people find beneficial and the different contexts in which it might be used. This study both responds to this call and reaffirms the need for more in-depth systematic research. ...
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While the benefits of gardening to mental health and trauma recovery are well documented, and a number of voluntary organizations have been involved in developing gardens with refugees, as yet there is no clear mandate to allow and mainstream gardening in large-scale refugee camps. This article argues for the importance of this in the planning of camps on the basis that many crises are indeed protracted, that refugees often stay in camps for tens of years rather than months and that gardening has significant environmental, psychological and social benefits, as well as contributing to food sovereignty and sustainable drainage. Drawing on interviews with residents of a refugee camp in northern Iraq, all participants in a camp-based garden competition in 2016 and 2017, this article illustrates the benefits of gardening and argues for their sustained inclusion in camp design.
... Ecotherapeutic areas located on the outer and peripheral parts of an urban area include various natural areas and landscapes, of which forests [23,24,30,31,[40][41][42][43] and wilderness areas [23,25,32,36,44,45] are the most prominent types. Ecotherapeutic areas located in inner urban areas include many public and private green areas; urban parks [24][25][26][30][31][32][33]36,38,[41][42][43]46,47] and private gardens [23,26,36,43,[48][49][50] are the most prominent examples of this type. These results reveal the need for natural spaces and urban greeneries in the urban texture because of their ecotherapy benefits. ...
... The benefits of therapeutic environments on human psychology comprise two categories: (1) mental and emotional benefits and (2) advancement in self-placement and perception. The most prominent mental and emotional benefits are relaxation [24,26,27,36,51], improvement in attention [24,28,30,34,39,41,48,52], concentration [26,31,34,53], and mood [23,26,29,34,48,51], and declines in stress [23,24,26,[28][29][30][31]33,34,36,43,48,51,52], anxiety, depression [25,28,30,33,39,48], and anger [39,41]; better self-esteem is the most prominent manifestation of advancement in self-placement and perception [25][26][27][28]34,39,48,54]. These results demonstrate that spending time in natural areas helps people to cope with mental problems and gains importance in tandem with the growing negative impacts of urban areas on human mental health. ...
... The benefits of therapeutic environments on human psychology comprise two categories: (1) mental and emotional benefits and (2) advancement in self-placement and perception. The most prominent mental and emotional benefits are relaxation [24,26,27,36,51], improvement in attention [24,28,30,34,39,41,48,52], concentration [26,31,34,53], and mood [23,26,29,34,48,51], and declines in stress [23,24,26,[28][29][30][31]33,34,36,43,48,51,52], anxiety, depression [25,28,30,33,39,48], and anger [39,41]; better self-esteem is the most prominent manifestation of advancement in self-placement and perception [25][26][27][28]34,39,48,54]. These results demonstrate that spending time in natural areas helps people to cope with mental problems and gains importance in tandem with the growing negative impacts of urban areas on human mental health. ...
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The impacts of problems related to dense, unplanned, and irregular urbanization on the natural environment, urban areas, and humankind have been discussed in many disciplines for decades. Because of the circular relationship between humans and their environment, human health and psychology have become both agents and patients in interactions with nature. The field of ecopsychology investigates within this reciprocal context the relationship between human psychology and ecological issues and the roles of human psychology and society in environmental problems based on deteriorated nature–human relationships in urbanized areas. This approach has given rise to ecotherapy, which takes a systemic approach to repairing this disturbed nature–human relationship. This study aims to uncover the relationship between the physical attributes of urban green areas and their potential for providing ecotherapy service to users, first by determining the characteristics of ecotherapeutic urban space and urban green areas given in studies in the ecopsychology and ecotherapy literature, and then by conducting a case study in two urban parks from the Beylikdüzü District of the Istanbul Metropolitan Area. The impacts of these parks’ changing physical characteristics on user experiences are determined through a comparison of their physical attributes and the user experiences related to their ecotherapy services.
... Interactions with the natural environment, especially gardening, have long been associated with well-being (Heliker et al., 2001;Wilson, 2004). Research on community garden participation has shown that it facilitates community and individual wellbeing (Wakefield et al., 2007), offering restorative benefits that enhance health and well-being for people with mental health issues (Clatworthy et al., 2013). Community gardening refers to social and physical activities that individuals do to maintain and manage the development of plants in a publicly accessible green space (Okvat & Zautra, 2011). ...
... The theme Cultivating Positive Feelings Through Doing offers robust evidence for community gardening's contribution to well-being, adding to findings from other studies. A critical review identified evidence of increased self-esteem and emotional well-being from gardening; however, researchers criticized the lack of robust randomized controlled trials (RCTs) and long-term outcomes (Clatworthy et al., 2013). Significant gains in affect, well-being, and engagement were found in a systematic review of RCT or cohort horticultural therapy studies (Cipriani et al., 2017, p. 65). ...
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Background Sustaining well-being challenges people with serious mental health issues. Community gardening is an occupation used to promote clients’ well-being, yet there is limited evidence to support this intervention. Purpose This paper examines how facilitated community gardening programs changed the subjective well-being and social connectedness of people living with mental health issues. Method A community-based participatory research approach and qualitative methods were used with 23 adults living in supported housing and participating in supported community gardening programs. A constructivist approach guided inductive data analysis. Findings Participation in community gardening programs enhanced well-being through welcoming places, a sense of belonging, and developing positive feelings through doing. The connection to living things and responsibility for plants grounded participants in the present and offered a unique venue for learning about gardening and themselves. Implications Practitioners and service-users should collaborate to develop leadership, programs, places, and processes within community gardens to enhance well-being.
... A growing body of empirical evidence has revealed that exposure to and engagement in the natural environment, provides psychological benefits, including, "reduced stress and anxiety, improvements to mood, increased perceived wellbeing, improved concentration and attention and cognitive restoration. [5][6][7][8][9] " These findings support the notion that exposure to natural environments, when used as a coping tool, may be a source of attention restoration and relief from mental fatigue and illness. 10 But the question arises whether this form of therapy might address very serious, chronic and often intransigent symptoms in disabled veterans, many of whom have multiple comorbid medical and mental health conditions and significant socioeconomic challenges. ...
... HT has been shown to increase feelings of well-being, decrease depression, decrease loneliness, 25 in which individuals who participated in gardening-based interventions experienced significant improvements in self-esteem, interpersonal relationships, and social behavior. 7 Similarly, in the present pilot study we found significant reduction in loneliness in our at-risk veterans following HT. ...
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Objectives: Novel approaches to mental health and suicide prevention are lacking. Converging evidence has shown the effectiveness of horticultural therapy (HT) in improving mental health symptoms, but whether it would reduce suicide risk and contributing risk factors is unknown. Design: Using a cohort model, HT was delivered 3.5 hours over four weekly, sessions administered by a registered horticultural therapist to veterans with history of suicide ideation or attempt who felt isolated and experienced ongoing environmental stressors with interest in learning new coping strategies. Setting: HT delivery occurred in an urban garden, through a community partnership between the VA (Veterans Administration) and the New York Botanical Garden. Guided by principles of biophilia, participating veterans took part in nature walks, self-reflection and journaling, and planting activities. Outcome measures: Stress, mood, pain, and social isolation levels were measured weekly pre-post HT sessions using thermometer scales, with concordant validity to validated clinical instruments. Results: Of the 20 men and women with a history of suicide attempts/ideation, HT demonstrated immediate improvements after each session across all symptom domains in magnitude of reduction in stress, pain, mood, and loneliness. The effect sizes were in medium to large range (Cohen's d>.5). Additionally, a single HT session showed a sustained effect over subsequent 2-to-4 weeks as observed by the significantly decreased pre-session thermometer scores in subsequent weeks. Reductions in mood symptoms correlated with decline in suicidal ideation (rs = 0.63). Conclusion: HT intervention maybe a promising therapeutic modality for improving overall wellness in suicide prevention in at-risk veteran populations.
... Moreover, Alipour et al. (2020) determined the relevance between the QOL and horticultural therapy due to aging, and reported that horticultural therapy is a noninvasive method that is useful in promoting the quality of elderly life. Other studies are also reporting that horticultural therapy reduces psychological pain by relieving depression that is one of the major mental and behavioral disorders, as well as anxiety, stress and negative emotions (Clatworthy et al., 2013;Gonzalez et al., 2011;Kamioka et al., 2014;Soga et al., 2017). ...
... Gonzalez et al. (2011) also proved that the horticultural therapy program alleviates depression, anxiety, stress and negative emotions of adults diagnosed with depression and improves positive emotions, thereby reducing psychological pain. Moreover, according to literature reviews on horticultural therapy performed on subjects with mental and behavior disorders or problematic symptoms, horticultural therapy had positive effects on depression, which is one of the major symptoms of mental and behavior disorders(Clatworthy et al., 2013;Kamioka et al., 2014;Soga et al., 2017).Unlike the results of previous studies in which horticultural therapy is found effective in alleviating depressive symptoms, this study did not show a significant level of positive change as a result of the statistical testing. This may be firstly due to the fact that the number of subjects ...
... It also contributes to reducing stress, anger, fatigue, depression, and anxiety (25). Consequently, the commitment to gardening is increasingly recognized not only as a profitable health intervention (26), but also as a therapy for people with psychological health problems, the so-called "horticultural therapy" (27). ...
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Background and aim of the work: The ongoing pandemic of COVID-19 is a strong reminder that the lockdown period has changed the way that people and communities live, work, and interact, and it's necessary to make resilient the built environment, both outdoor and mainly the indoor spaces: housing, workplaces, public buildings, and entertainment facilities. How can we re-design the concept of Well-being and Public Health in relation to the living places of the future? Methods: According to the previous statements and scenario, this paper aims to integrate the building hygiene and well-being, focusing the possible responses, both existing and for the new buildings, taking home a strong message from this "period" of physical distancing. Results: The Well-being and Public Health recommendations for a healthy, safe, and sustainable housing are framed into the following key points: 1. Visible and accessible green elements and spaces; 2. Flexibility, adaptability, sharing, and crowding of living spaces, and compliant functions located into the buildings; 3. Re-appropriation of the basic principles and archetypes of sustainable architecture, thermal comfort and Indoor Air Quality (IAQ); 4. Water consumption and Wastewater Management; 5. Urban Solid Waste Management; 6. Housing automation and electromagnetic fields; 7. Indoor building and finishing materials. Conclusions: The Well-being and Public Health recommendations for a healthy, safe and sustainable housing may provide a useful basis for Designers, Policy Makers (fostering tax incentives for building renewal), Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform living places in healthier and Salutogenic spaces.
... The findings show that gardeners rated gardening as a valuable means by which to spend time, relax, and gain a sense of accomplishment. Subsequently, gardening activities have been widely studied as potential methods of restoration from stress and negative mood, or as therapeutic interventions (e.g., horticultural therapy) for people suffering mental health-related difficulties (e.g., [38][39][40]). Significant reductions in stress, fatigue and depressive symptoms in the context of gardening activities have also been reported [41,42]. ...
Article
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The financial and health burdens of stress associated with increased urbanization have led to a demand for mental health enhancement strategies. While some extant literature details mental health benefits of community gardening, a coherent narrative on the construct of resilience and its relationship with the mental health benefits of community gardening is lacking. The present study examined the relationship between community gardening and a number of mental health benefits, in the forms of subjective well-being, stress, resilience potentials, and resilience factors (self-esteem, optimism, and openness). A total of 111 residents in Singapore completed a survey. Results from Multivariate Analysis of Covariance (MANCOVA) and Pearson's correlation analyses show that, after controlling for age and levels of connection to nature, community gardeners reported significantly higher levels of subjective well-being than individual/home gardeners and non-gardeners, indicating that engagement in community gardening may be superior to individual/home gardening or non-gardening outdoor activities. Community gardeners reported higher levels of resilience and optimism than the non-gardening control group. These novel results indicate some potential for mental health benefits in urban environments, specifically in terms of subjective well-being and resilience. These findings have implications for future research in clinical psychology, mental health promotion, and policy.
... There is emerging evidence that social prescribing activities can support people's mental health, with activities such as arts classes, gardening, and exercise schemes leading to increased empowerment, self-esteem, confidence, improved mental health outcomes and cognitive functioning, and lowered feelings of social exclusion and isolation [15][16][17]. Another social prescribing study found reductions in isolation and improvements in health-related behaviours and management of long-term conditions [18]. ...
Article
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Background: There is growing evidence for the use of social prescribing as a means to improve the mental health of patients. However, there are gaps in understanding the barriers and enablers faced by General Practitioners (GPs) when engaging in social prescribing for patients with mental health problems. Methods: This study uses a qualitative approach involving one-to-one interviews with GPs from across the UK. The COM-B model was used to elucidate barriers and enablers, and the Theoretical Domains Framework (TDF) and a Behaviour Change Theory and Techniques tool was used to identify interventions that could address these. Results: GPs recognised the utility of social prescribing in addressing the high levels of psychosocial need they saw in their patient population, and expressed the need to de-medicalise certain patient problems. GPs were driven by a desire to help patients, and so they benefited from regular positive feedback to reinforce the value of their social prescribing referrals. They also discussed the importance of developing more robust evidence on social prescribing, but acknowledged the challenges of conducting rigorous research in community settings. GPs lacked the capacity, and formal training, to effectively engage with community groups for patients with mental health problems. Link workers, when available to GPs, were of fundamental importance in bridging the gap between the GP and community. The formation of trusting relationships was crucial at different points of the social prescribing pathway, with patients needing to trust GPs in order for them to agree to see a link worker or attend a community activity, and GPs requiring a range of strong inter-personal skills in order to gain patients' trust and motivate them. Conclusion: This study elucidates the barriers and enablers to social prescribing for patients with mental health problems, from the perspectives of GPs. Recommended interventions include a more systematic feedback structure for GPs and more formal training around social prescribing and developing the relevant inter-personal skills. This study provides insight for GPs and other practice staff, commissioners, managers, providers and community groups, to help design and deliver future social prescribing services.
... ■ Love of/affinity for/connectedness with nature (biophilia); concern for nature; seasonality; weather conditions wellbeing, as well as positive impacts regarding their sense of personal agency, and increased social capital. Undertaking the gardening activities embedded in GM therefore appeared to bestow wide-ranging physical (Nicklett, Anderson & Yen, 2016;Soga, Cox, Yamaura, Gaston, Kurisu & Hanaki, 2017) and psycho-social benefits (Clatworthy, Hinds & Camic, 2013;Guerlain & Campbell, 2016). The latter, in particular, was an artefact of undertaking GE as part of a group, whereby the inherent social interactions fostered motivated further engagement, and helped the participating individuals develop new networks of personal value -in short, they built social capital (Putnam, 1995;Somerville, 2011;Yotti, Townsend & Townsend, 2006). ...
... However, the long-term usage of antipsychotic drugs poses some risks, such as metabolic syndrome, manifested in weight gain and diabetes [5]. Recent evidence has demonstrated that non-pharmacological therapies are more desirable to alleviate symptoms of schizophrenia without producing side effects [6,7]. Horticultural therapy has received increasing attention as an effective and non-pharmacological intervention [8]. ...
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Horticultural therapy is increasingly being used in the non-pharmacological treatment of patients with schizophrenia, with previous studies demonstrating its therapeutic effects. The healing outcomes are positively correlated with the settings of the intervention. This review aimed to evaluate the effectiveness of horticultural therapy on the symptoms, rehabilitation outcomes, quality of life, and social functioning in people with schizophrenia, and the different effectiveness in hospital and non-hospital environments. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We researched studies through PubMed, Embase, the Cochrane Library, Science Direct, and the China National Knowledge Infrastructure. We included randomized controlled trials (RCTs) and quasi-experimental studies about horticultural therapy for people with schizophrenia, from January 2000 to December 2020, with a total of 23 studies involving 2024 people with schizophrenia included in this systematic review. This study provided evidence supporting the positive effect of horticultural therapy. This review demonstrated that non-hospital environments have a better therapeutic effect on all indicators than hospital environments. The results also demonstrated the effectiveness of horticultural therapy on symptoms, rehabilitation outcomes, quality of life, and social functioning in patients in hospital and non-hospital environments, providing further evidence-based support for landscape design.
... Ultimately, the goal must be for society at large to tackle the shocking stigma and discrimination that people with complex needs experience daily, and to develop more inclusive, holistic practices as a way of life. However, as an immediate pragmatic step, at an individual level, therapeutic approaches have been shown to provide: psychological enhancement, coping strategies to withstand challenges, and development of self-esteem to encourage participation in society and to pursue the right to be employed (Bragg et al., 2013;Clatworthy et al., 2013). Besides therapeutic help, it is essential that people with complex needs have educational qualifications, to enter the labour market with a greater likelihood of being employed (Dixon, 2006). ...
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Youth unemployment rates in the United Kingdom are almost triple that of adults (11.3% and vs. 4%, respectively), particularly impacting the employability of young people with complex needs, of whom 61.8% are unemployed. Interventions facilitating transition into work can operate at individual, community and government levels. The main objectives of this review were to explore current practices, identify factors affecting and strategies used to improve employability, and classify strategies at multi-levels. Findings suggest that collaborative strategies covering training, work practices, therapeutic support and creating appropriate work environments, with active involvement of young people, are key in supporting young people with complex needs into employment. Classification of factors indicated four categories: skills-based approaches, job/work experience accessing approaches, therapeutic interventions, and supportive working environments.
... Community gardens usually refer to plots of land collectively gardened by a group of people living in an urban area in diverse settings such as schools, neighborhoods, nursing homes or hospitals [6,7]. Beyond evidence drawn from community gardening within institutions such as schools or health care settings [8][9][10][11], several studies have investigated the potential health effects of community gardening on urban residents. Increased intake of fruits and vegetables, increased physical activity and better social and mental health ndings have been reported in several qualitative studies [12,13]. ...
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Background: Despite the increasing number of studies on gardening and health, evidence of health benefits of community gardening is limited by cross-sectional design. The “JArDinS” quasi-experimental study aimed to assess the impact of community garden participation on the adoption of more sustainable lifestyles in French adults. Methods: Individuals starting gardening in community gardens in Montpellier (France) in 2018 (N=66) were compared to pairwise matched individuals with no experience in community gardening (N=66). Monthly household food supplies, physical activity measured by accelerometers and questionnaires on physical, mental and social well-being, sensitivity to food waste, and connection with nature were used to explore sustainability of lifestyles in social/health, environmental and economic dimensions. Data were collected at baseline (t0) and 12 months later (t1). 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 reported lower percentage of meals consumed outside of the home in total household meals compared to non-gardeners (p<0.05). At t1, the mean weight of fruit and vegetables harvested from the garden was 19.5g/d/p. Participating in the community garden had no significant impact on any of the social/health, environmental and economic lifestyle 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, difficulty of gardening, health problems and conflicts with other gardeners. Conclusions: Using a longitudinal design allowing causality assessment, no impact was observed of the first year of community gardening on lifestyle sustainability. The pre-established sensitivity to sustainability and the various barriers encountered by new gardeners might explain the absence of community gardening impact. Further rigorous longitudinal studies are needed to determine whether or not community gardening is a relevant public health tool. Trial registration: The study was registered at clinicaltrials.gov as NCT03694782. Date of registration: 3rd October 2018, retrospectively registered.
... Gardens provide gentle, but powerful metaphors for challenging life events such as death and personal growth (Clatworthy, Hinds, & Camic, 2013). For example, an intervention for refugees utilised metaphors of being uprooted and growing new shoots to parallel the trauma and growth participants had experienced (Linden and Grut, 2002 Beyond offering temporary respite, gardening was a place for Bridget to practice home-making on her own terms (Li, Hodgetts, & Ho, 2010). ...
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Aotearoa's rate of reported intimate partner violence (IPV) is among the highest in the OECD. Surviving IPV requires considerable strength and resilience. There is a large body of work exploring women's resistance to violence. However, this is often framed within a victim and agent dichotomy, which can obscure the variability of women's everyday experiences. In addition to understanding the more overt forms of resistance women enact against IPV, there is a need to focus on the everyday ways in which violence manifests and the subtle, imperfect ways in which women respond as they carry out their daily routines and practices. This thesis draws on both feminist research and literature on the conduct of everyday life from social psychology to explore how women navigate their daily lives and reproduce gendered relations within the constraints of IPV. Particular attention is paid to moments of adaptation, agency and resistance. Working with the support of Te Whakakruruhau (Māori Women's Refuge), I conducted semi-structured interviews with eight women, four staff members and four former clients, to explore their experiences of day-today IPV. My participants' experiences revealed how deeply enmeshed IPV can become within everyday practices, from making breakfast to going to the toilet. While my participants' lives were characterised by chronic anxiety and constraint, they adopted novel tactics to get through dangerous everyday situations such as going to bed or doing the dishes. They drew on simple routines such as making coffee or working in the garden in order to create a sense of routine that aided them in 'getting by'. Further, they demonstrated remarkable creativity, flexibility and agency in creating novel enclaves of care within otherwise inhospitable settings. These findings have implications for how IPV is characterised and how agencies can identify and support women within the constraints of violent relationships. ii Acknowledgements
... In our study, women with access to a garden, patio, or terrace had better HRQoL and resilience than those without such access. This agrees with other studies that have found a positive association between gardening and various health outcomes such as depression [30,31]. In this regard, poor HRQoL could be related to poor quality housing [32]. ...
Article
Objective To assess the impact of confinement due to the coronavirus (Covid-19) pandemic on health-related quality of life (HRQoL) and resilience in peri- and postmenopausal women. Material and Methods We used an online questionnaire which was sent between April 30th and May 13th, 2020 to women aged 40–70 years who were peri- or postmenopausal according to STRAW criteria. We used the 16-item Cervantes short-form scale (Cervantes-SF) to measure HRQoL, and the 14-item Wagnild and Young Resilience Scale (RS-14) to measure resilience. High scores on the Cervantes-SF indicate low HRQoL and high scores on the RS-14 indicate high levels of resilience. Covid-19 status, sociodemographic descriptors, and lifestyle variables were also evaluated. Results We included 2430 peri- and postmenopausal women with valid questionnaires. All items of the Cervantes-SF were completed in 2151 cases, whilst the RS-14 was completed in 2413 cases. There was a negative correlation between scores on the Cervantes-SF and RS-14 scales (Rho -0.350; p < 0.0001). Multiple linear regression analysis revealed a statistically significant association between Cervantes-SF scores and living with others (β-coefficient -10.2; p < 0.001), use of antidepressants (β 9.3; p < 0.001), physical activity (β -8.6; p < 0.001) and sexual activity (β -2.7; p < 0.001). Resilience was associated with the use of antidepressants (β -5.9; p < 0.001), physical activity (β 3.2; p < 0.001) and sexual activity (β 1.7; p = 0.005). According to the multivariate analysis, there were no associations between either Covid-19 or menopausal status and HRQoL or resilience scores. Conclusions During the period of mandatory Covid-19 confinement, peri- and postmenopausal women who engaged in physical and sexual activity had higher HRQoL and higher levels of resilience, whilst women who were using antidepressants had lower HRQoL and lower levels of resilience. HRQoL was greater in women who lived with others.
... The benefits of gardening for mental health are consistently reported in other research so these findings come as no surprise. 24 What was surprising were the moving stories gardeners shared, reflecting on how gardening helped them cope with profound grief or personal crisis. ...
Research
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In this report, we lay out an action agenda to create more edible towns and cities in Australia. Based on findings from the first-ever national Pandemic Gardening Survey, the report reflects the voices of over 9,000 gardeners from urban, regional and remote communities across Australia who shared how edible gardening is good for the mind, body and soul. Edible gardening has immense power to do good. The survey findings reveal it was particularly important to low-income households and those living with mental illness and chronic conditions. As a gardener from regional Victoria shared, “I suffer from PTSD resulting from my firefighting career, so gardening has become a balm for my soul.” A Canberra gardener living with cancer explained that “my garden keeps me alive, especially on the bad days.” Nearly 20% of respondents said they could not have made it through the pandemic without their garden. Another 62% said the garden meant a great deal to them during the pandemic. Along with their substantial mental health benefits, edible gardens have the power to create greener cities, reduce household waste, strengthen community connectedness, enhance food security and encourage fresh produce consumption. “There are very few initiatives that fall within the remit of local and state governments that so powerfully support so many aspects of wellbeing at once,” said Dr Kelly Donati, founding Chairperson of Sustain and lecturer in food studies at William Angliss Institute. Despite its documented benefits for ecological, mental and physical wellbeing, edible gardening currently receives limited government support. “The estimated costs of dietary-related ill health and mental illness in Australia are a staggering $200 billion every year. With COVID-19 and the climate emergency, we need more innovative policy strategies for mitigating these costs,” noted Dr Nick Rose, Executive Director of Sustain. Sustain is calling for the establishment of a $500 million national Edible Gardening Fund to be co-financed by federal and state/territory governments to drive a mass expansion of urban food production across Australia. “For a tiny fraction of our current annual health expenditure, the return on investment would be enormous,” said Dr Rose. This bold call builds on the views of many survey respondents, including this health care practitioner from NSW Central Coast: “I fully endorse edible gardening as an intervention that would improve public and climate health. I would view any government support—federal, state or local—a very good and wise use of my taxes and rates.” “Respondents said they want councils to remove roadblocks and unlock vacant land,” added Dr Rose. “They want food gardens on verges and in every new development, and community gardens in every suburb. This needs to be networked, coordinated and supported at every level with policy commitments and targets. Now is the time for action.” Online link: https://sustain.org.au/projects/pandemic-gardening-survey-report
... In recent years an increasing body of literature has suggested that gardening could address various public health concerns through its positive effects on nutrition, physical activity, social cohesion, quality of life, stress and depression [1]. Beyond evidence drawn from gardening programs within institutions such as schools or health care settings [2][3][4][5], less is known about the potential health effects of urban collective gardening on free-living adults. Collective gardens, defined as cultivated spaces managed collaboratively by groups of gardeners located at a distant place from gardeners' homes, generally take the form of community or allotment gardens [6]. ...
Article
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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.
... Studies conducted in other social services and clinical settings have shown an association between programming participation (e.g., art therapy, gardening-based interventions, music therapy) and improved housing, psychiatric and substance-use outcomes (Clatworthy et al., 2013;Dingle et al., 2008;Slayton et al., 2010). However, only one empirical study to date has explored the implementation of resident-driven programming in a Housing First setting: the life-enhancing alcohol-management program (LEAP; Clifasefi et al., 2020). ...
Article
Aims This secondary study characterized components of and engagement in the life‐enhancing alcohol‐management program (LEAP), which is resident‐driven housing first programming. Methods We used a process akin to conventional content analysis to operationalize the LEAP according to its component activities. We used generalized linear modeling to identify predictors of LEAP activity participation and to predict alcohol and quality‐of‐life outcomes from participation in specific LEAP activities categories. Results Overall, 86% of participants attended at least one LEAP activity, which comprised three categories: administrative leadership opportunities, meaningful activities, and pathways to recovery. Employment status alone predicted LEAP activity attendance: Employed residents attended 88% fewer LEAP activities than unemployed residents. Participants who sought out more pathways to recovery activities were more likely daily drinkers and more impacted by alcohol‐related harm. Those engaging in administrative leadership opportunities were overall less impacted by alcohol use and had a higher quality of life generally, and their alcohol outcomes further improved over time. Conclusions Programming developed with Housing First residents was well‐attended but could be made more inclusive by including evening programming to accommodate residents employed full time and engaging more severely impacted participants in administrative leadership activities, where the greatest benefits of programming were seen.
... Previous reviews have focused on the health impacts of "nature-assisted" [20] gardening [21] and horticultural therapies [22], and green exercise [23][24][25]. While all of these therapies involve the connection between nature and human health, they each do so in different ways. ...
Article
Full-text available
Nature prescription programs have emerged to address the high burden of chronic disease and increasingly sedentary and screen-based lifestyles. This study examines the base of evidence regarding such programs. We conducted a narrative review of published literature using four electronic databases. We included case studies, research design articles, and empirical studies that discussed any type of outdoor exposure or activities initiated by a health-care provider from an outpatient clinic. We examined articles for information on target populations, health outcomes, and structural and procedural elements. We also summarized evidence of the effectiveness of nature prescription programs, and discussed needs and challenges for both practice and research. Eleven studies, including eight empirical studies, have evaluated nature prescription programs with either structured or unstructured formats, referring patients either to nearby parks or to formal outdoor activity programs. Empirical studies evaluate a wide variety of health behaviors and outcomes among the most at-risk children and families. Research is too sparse to draw patterns in health outcome responses. Studies largely tested program structures to increase adherence, or patient follow-through, however findings were mixed. Three published studies explore providers' perspectives. More research is necessary to understand how to measure and increase patient adherence, short and long-term health outcomes for patients and their families, and determinants of provider participation and participation impacts on providers' own health.
... Bridging ties are between people of different types in a wider community, e.g. by ethnicity, class or health condition. They tend to be more inclusive and encompass people across social groups (Gittell & Vidal, 1998 (Bruggen et al., 2020;Clatworthy et al., 2013;Soga et al., 2016). ...
Article
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Around 246 million people globally suffer from depression. Physical activity (PA) can reduce the risk of depression by 30% and is recognised as an effective treatment for mild-to-moderate depression (MMD). However, a high proportion of patients with MMD are currently inactive and the implementation of PA as an adherent treatment for MMD is not well understood. This study contributes to a growing body of research exploring how to support people who are experiencing MMD to increase their PA levels (i.e. initiation and maintenance). It investigated which factors individuals with MMD perceived to be important for integrating PA into the treatment of depression in adults. In-depth interviews were carried out with individuals with MMD (N = 6), and data were analysed using thematic analysis. Two main theories of social capital that of Bourdieu and Putnam informed the discussion of findings. The initiation and maintenance of PA were linked to individual factors including health (i.e. nature of depression; comorbidities); abilities and tastes; socioeconomic status (e.g. financial position) and positive encouragement. In addition, maintenance emerged as dependent upon the choice, enjoyment, and meaningfulness of PA itself, and, for those who engaged in group PA, on social capital. PA interventions need to be per-sonalised. This goes beyond a simple exercise prescription based on functional ability , but instead takes into account the needs, desires and capabilities of the whole person. The nature of MMD, the wider physical and socioeconomic context and the social capital that is available to the individual also need to be harnessed. K E Y W O R D S depression, phenomenology, physical activity, qualitative research, social capital
... ity for people experiencing mental health difficulties; as early as the 1800s, psychiatric institutions in the United States and Europe used horticultural activities as a form of therapy for their patients.52 A metaanalysis bySoga et al. 53 in 2016 looked at 22 studies examining the effects of gardening on health. ...
Article
Full-text available
There are a range of lifestyle factors which can negatively affect both a person's physical and mental health, and there is increasing evidence that therapeutic lifestyle change can be useful for the prevention and treatment of depression and anxiety disorders. The six core features of lifestyle medicine—regular physical activity, a whole food and plant predominant diet, restorative sleep, stress management, avoidance of substance abuse, and positive social connection—are important foci for mental health providers trying to help patients make meaningful lifestyle changes to improve their well‐being. Alongside these elements, there are likely many other aspects of lifestyle important to mental health. The aim of this paper is to provide an overview of five potential lifestyle targets which may play a role in the development and treatment of depression and anxiety, including financial stability, time in nature, pet ownership, materialistic values, and the use of social media. The paper will explore the evidence that these factors contribute to the burden of depression and anxiety in the modern world and will review the potential mechanisms of these effects and clinical implications of interventions targeting these factors.
... Mediation variables could intervene, such as physical activity carried out in private green spaces that would lead to relevant mental health benefits (Dadvand et al., 2016). Likewise, we did not consider the potential mediating effect of gardening activities in private green spaces, which has been proven to generate benefits on health and well-being (Clatworthy et al., 2013;Spano et al., 2020b;Yeo et al., 2020). Further studies addressing these matters are strongly recommended. ...
Article
Exposure to public green spaces was shown to be associated with psychological health. Nonetheless, evidence is lacking on the role of different green features within and/or surrounding the home environment when public green spaces are inaccessible or not usable. The overarching goal of this study is to shed light on the associations between the presence of greenness within the home and in the surrounding environment and the detrimental effects of quarantine on psychological health during the COVID-19 pandemic lockdown in Italy. A cross-sectional nationwide study involving an online survey was conducted of an Italian population-based sample of 3886 respondents on the association of indoor and outdoor green features (i.e., presence of plant pots, sunlight, green view and accessibility of private green space and natural outdoor environment) with self-reported increases in anxiety, anger, fear, confusion, moodiness, boredom, irritability, recurrent thoughts and/or dreams, poor concentration and sleep disturbance during the COVID-19 lockdown. Single-exposure regression models were performed to estimate associations between single green features and each psychological health outcome adjusted for relevant covariates. In the adjusted models, the presence of plant pots at home was associated with a lower self-reported increase in anxiety, anger, fear, irritability, and sleep disturbance. A greater amount of sunlight in the home was associated with a lower increase in anger, fear, confusion, moodiness, boredom, irritability, poor concentration, and sleep disturbance. A greater amount of green view and access to private green spaces were both associated with a lower increase in each of the psychological health outcomes except for green view and recurrent thought and/or dreams. Natural outdoor environment was associated with anxiety, fear, boredom, irritability, and sleep disturbance. Significant associations remained robust when adjusted for number of confirmed COVID-19 cases. Insights on future investigations are provided.
... Research has linked gardening to facilitation of health and wellbeing (Clatworthy, Hinds, & Camic, 2013). A recent systematic review found benefits from plant-based interventions across a variety of settings, mental health conditions, and gender, which encompassed the areas of stress and coping, mental wellbeing, cognitive functioning, self-esteem, and interpersonal relationships (Cipriani et al., 2017). ...
As significant numbers of university students report high levels of stress, post-secondary institutions are seeking accessible mental health and wellness supports. The outreach program presented integrates therapy dogs, therapeutic horticulture, and art making interventions. Over 170 participants completed questionnaires surveying demographic variables, frequency of attendance and engagement, and self-reported reductions in stress and anxiety. Open-ended questions explored students’ program experience, their explanations for stress reductions, and recommendations for the program. The vast majority of participants reported a considerable decrease in stress and indicated that the program helped them destress, feel calmer and more relaxed, reduced their anxiety, and helped them feel more in control of their emotions. Participant recommendations included investing in expansion, further development and adequate resourcing of the program. Findings highlight the potential of integrated wellness initiatives to support large and diverse groups of students while decreasing support stigma and contributing to healthy campus goals.
... In the field of garden and landscape design, therapeutic studies have already shown effectiveness (Clatworthy et al., 2013). In the field of diagnostics, however, there were so far only rudimentary approaches to record corresponding movement and behavior patterns. ...
Conference Paper
Movement, actions, and intentions are important psychological skills in human behavior. Studies have shown correlations between movement activity and a variety of mental disorders. In this context, planning and designing of gardens and outdoor spaces as an intentional activity might play an important role as a marker for mental health. Thus, in this study, 16 subjects (8 female) aged between 19 and 60 were asked to do a gardening task in an experimentally constructed environment while their movement activity was recorded with a camera from a fixed viewpoint. Movement heatmaps and entropy then was calculated and correlated with mental state measured via the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI-18) questionnaire. After finding an optimal grid size of the heatmaps, we were able to find a moderate negative correlation of r = -0.463 between these quantities in an overall of both genders, explaining 21.4 % of variance. After considering the gender of the test group, a noticeable gender effect could be revealed. We found a significant interaction effect of entropy with gender meaning that a lower movement entropy in a gardening task correlates with a higher mental distress for men, but lower for women. Multivariate regression found that this model explained 77.44 % of variance (R = 0.88). Despite of these promising results, further investigations in this area should overcome some limitations in this pilot study in the field of position tracking and movement feature extraction.
... However, restorative experiences in waterside environments and extensively managed natural settings (mainly urban woodlands) are stronger compared to favorite places in built urban settings or green spaces of urban settings (mostly parks) [76]. "Psycho-physiological stress reduction theory" and "Attention Restoration Theory" provide the theoretical basis for such a restorative effect of interaction with natural environment as well as urban greenery [77] (Figure 5). "Psychophysiological stress reduction theory" proposes that contact with nature (e.g., views of natural settings) can have a positive effect for those with high levels of stress, by shifting them to a more positive emotional state [78,79]. ...
Article
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More than 150 cities around the world have expanded emergency cycling and walking infrastructure to increase their resilience in the face of the COVID 19 pandemic. This tendency toward walking has led it to becoming the predominant daily mode of transport that also contributes to significant changes in the relationships between the hierarchy of walking needs and walking behaviour. These changes need to be addressed in order to increase the resilience of walking environments in the face of such a pandemic. This study was designed as a theoretical and empirical literature review seeking to improve the walking behaviour in relation to the hierarchy of walking needs within the current context of COVID-19. Accordingly, the interrelationship between the main aspects relating to walking-in the context of the pandemic- and the different levels in the hierarchy of walking needs were discussed. Results are presented in five sections of “density, crowding and stress during walking”, “sense of comfort/discomfort and stress in regard to crowded spaces during walking experiences”, “crowded spaces as insecure public spaces and the contribution of the type of urban configuration”, “role of motivational/restorative factors during walking trips to reduce the overload of stress and improve mental health”, and “urban design interventions on arrangement of visual sequences during walking”.
... The stockpile is enabling new soil layer emplacement at high volumes and rates that were not previously feasible. In addition to limiting Pb exposure, many of these experiments revolving around new soil construction generate multiple cobenefits associated with urban gardening and agriculture, including increased food access and fresh produce intake (Alaimo et al., 2008;Metcalf and Widener, 2011;Saha and Eckelman, 2017), food justice and food sovereignty (Alkon, 2014;Jarosz, 2014;Horst et al., 2017), a range of health benefits (McCormack et al., 2010;Van Den Berg and Custers, 2011;Clatworthy et al., 2013;Subica et al., 2015), and enhanced community well-being (Hung, 2004;Saldivar-Tanaka and Krasny, 2004;Kingsley and Townsend, 2006;Okvat and Zautra, 2011). Ecological benefits include reduced waste , reduced stormwater runoff (Gittleman et al., 2017), increased biodiversity and habitat (Goddard et al., 2010;Yadav et al., 2012;McPhearson et al., 2014;Carlet et al., 2017), and greenhouse gas sequestration (Pouyat et al., 2002;Beesley, 2012;Vasenev et al., 2014). ...
Article
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The knowledge of unsustainable human and Earth system interactions is widespread, especially in light of systemic environmental injustices. Systems science has enabled complex and rigorous understandings of human and Earth system dynamics, particularly relating to pollution of Earth’s land, water, air, and organisms. Given that many of these systems are not functioning sustainably or optimally, how might this field enable both rigorous understanding of the issues and experiments aimed at alternative outcomes? Here, we put forth a novel, multiscale systems science approach with three steps: (1) understanding the systemic issues at hand, (2) identifying systemic interventions, and (3) applying experiments to study the efficacy of such interventions. We illustrate this framework through the ubiquitous and yet frequently underrecognized issue of soil lead (Pb). First, we describe the systemic interactions of humans and soil Pb at micro-, meso-, and macroscales in time and space. We then discuss interventions for mitigating soil Pb exposure at each scale. Finally, we provide examples of applied and participatory experiments to mitigate exposure at different scales currently being conducted in New York City, NY, USA. We put forth this framework to be flexibly applied to contamination issues in other regions and to other pressing environmental issues of our time.
... On the positive side, gardening can be physically and psychologically very healthy. There is a lot of literature that stresses the positive physical and mental effects of gardening and green [31][32][33][34]. This can be used as leverage for getting pavement removed. ...
Article
Full-text available
The Steenbreek program is a private Dutch program which aims to involve citizens, municipalities and other stakeholders in replacing pavement with vegetation in private gardens. The Dutch approach is characterized by minimal governmental incentives or policy, which leaves a niche for private initiatives like Steenbreek, that mainly work on behavioural change. The aim of this paper is to build a model based on theory that can be used to improve and better evaluate depaving actions that are based on behavioural change. We tested this garden greening behaviour model in the Steenbreek program. The main result is that the model provides an understanding of the ‘how and why’ of the Steenbreek initiatives. Based on this we are able to provide recommendations for the improvement of future initiatives. Steenbreek covers a wide range of projects that together, in very different ways, take into account elements of the theoretical framework; either more on information factors, or on supporting factors, sometimes taking all elements together in a single action. This focus is sometimes understandable when just one element is needed (e.g., support), sometimes more elements could be taken into account to be more effective. If a certain element of the framework is lacking, the change of behaviour will not (or will only partly) take place. The model also gives insight into a more specific approach aimed at the people most susceptible to changing their behaviour, which would make actions more effective.
... Studies from high-income countries have suggested mental health benefits accruing from involvement in various forms of gardening (Barton and Rogerson, 2017;Clatworthy et al., 2013;Gonzalez et al., 2011Gonzalez et al., , 2009Kam and Siu, 2010;Stepney and Davis, 2005). A metaanalysis of the health effects of gardening and horticulture revealed a wide range of health benefits, including reductions in depression, anxiety, and body mass index, and increases in life satisfaction, quality of life, and self-esteem (Soga et al., 2017). ...
Article
Full-text available
Evidence from high-income settings suggests that gardening is associated with reductions in depression, anxiety, and stress. The benefits of gardening are less well understood by mental health practitioners and researchers from low- and middle-income countries. Our study estimated the association between participation in gardening and symptoms of depression, anxiety, and stress among caregivers of people living with dementia in rural, southwestern Uganda. In a cross-sectional study, we interviewed 242 family caregivers of people with dementia to elicit their gardening activities; symptoms of depression, anxiety, and stress (Depression Anxiety Stress Scales); and caregiving burden (Zarit Burden Interview). Linear multivariable regression models estimated the association between participation in gardening and symptoms of depression, anxiety, and stress. Out of 242 participants, 131 (54%) caregivers were involved in gardening. Severe to extremely severe symptoms of depression were less prevalent among those who were involved in gardening compared with those who were not (0 [0%] vs. 105 [95%], P<0.001), as were severe to extremely severe symptoms of anxiety (36 [27%] vs. 110 [99%], P<0.001) and stress (2 [2%] vs. 94 [85%], P<0.001). In regression models adjusting for covariates,we found statistically significant associations between participation in gardening and symptoms of depression (b = -18.4; 95% CI, 20.5 to -16.3), anxiety (b=-16.6; 95% CI, -18.6 to –14.6), and stress (b=-18.6; 95% CI, -20.6 to –16.6). Caregivers of people with dementia who participate in gardening have lower symptoms of depression, anxiety, and stress. Gardening interventions in this at-risk population may ameliorate symptoms of depression, anxiety, and stress.
... Sie werden in vielen Studien, aber auch in den Materialien der Öffentlichkeitsarbeit entsprechender Institutionen wiederholt aufgegriffen.Ulrich et al. (1991) sowieBrascamp und Kidd (2004) stellten fest, dass bereits die passive Betrachtung von Gärten und Grünanlagen oder das Lauschen von Naturgeräuschen das Wohlbefinden steigert und eine schnellere Genesung von Krankheiten zur Folge haben konnte. AuchClatworthy et al. (2013), Van den Berg/Custers (2011) sowieHartig et al. (2003) verzeichneten eine stressreduzierende Wirkung allein durch den Aufenthalt in einem Garten.Detweiler et al. (2012) beschreiben in ihrer Studie, dass ein Garten einen erweiterten Erlebnisraum für Heimbewohner darstellt, in dem sie nicht nur körperlich aktiv sein, sondern auch vielfältige Sinneserfahrungen machen können. Die Aufenthaltsdauer und Aktivität im Freien und damit die Lebensqualität älterer Menschen werden durch Gartentherapie erhöht (Schneiter-Ulmann 2010).Die Situation alter Menschen wird in der Forschung zu naturnahen Umgebungen insbesondere in Zusammenhang mit Demenzerkrankungen untersucht.Whear et al. (2014) sowieGonzalez & Kirkevold (2014) analysierten themenspezifische Publikationen zu Demenzgärten und deren Wirkungen. ...
Technical Report
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In Europa werden vermehrt soziale Dienstleistungen auf landwirtschaftlichen Betrieben angeboten. Seit einigen Jahren gibt es erste Ideen, solche Angebote auch für alte Menschen zu schaffen. Damit könnten Lücken der Daseinsvorsorge in kleinen Siedlungseinheiten geschlossen werden und (kleinere) landwirtschaftliche Betriebe bekämen eventuell zusätzliche Einkommensmöglichkeiten. Die Aufrechterhaltung einer vielfältigen Agrarstruktur ist von besonderem gesellschaftlichem Interesse, weil sie sowohl Auswirkungen auf Landschaftsstrukturen und damit Biodiversität hat als auch als Ressource der Versorgung mit Nahrungsmitteln besonders schützenswert ist. Zumindest in Deutschland sind jedoch sowohl das Sozial- als auch das Gesundheitssystem in jeder Hinsicht von der Agrarstruktur getrennt. Die sektorübergreifende Entwicklung von innovativen Konzepten kann somit zu Problemen in der Passung führen und es muss geprüft werden, inwieweit diese zunächst pragmatische erscheinende Idee einer Kombination von Landwirtschaft und Vorsorgeeinrichtungen für alte Menschen in die Realität umgesetzt werden kann. Im Rahmen des F-&E-Vorhabens „Lebensabend im Dorf. Seniorenangebote auf landwirtschaftlichen Betrieben“ (VivAge, 2016-2019) untersuchten Wissenschaftlerinnen und Wissenschaftler der HAWK Hochschule Hildesheim/Holzminden/Göttingen daher, welche Chancen sich aus Angeboten landwirtschaftlicher Betriebe ergeben. Dabei wurden drei Perspektiven eingenommen und jeweils spezifische Fragen entwickelt: 1. Perspektive der Landwirtinnen und Landwirte: Wie können soziale Angebote wirtschaftlich rentabel gestaltet werden? Welche (bürokratischen) Hindernisse gibt es und welche Unterstützungs- oder Beratungsangebote brauchen Landwirtinnen und Landwirte? 2. Perspektive der Seniorinnen und Senioren: Wie kann eine hohe Qualität der Dienstleistungen sichergestellt werden? Verleiht die Anbindung an einen landwirtschaftlichen Betrieb den Dienstleistungen eine Qualität, die an anderer Stelle nicht in dieser Ausformung erreicht werden kann? 3. Perspektive der ländlichen Entwicklung und Daseinsvorsorge: Sind soziale Dienstleistungen auf landwirtschaftlichen Betrieben eine Möglichkeit, den Versorgungsbedarf älterer Dorfbewohnerinnen und Dorfbewohner zu decken? Um diese Fragen zu beantworten, wurde eine systematische Recherche durchgeführt. Dabei wurde zum einen über Online-Materialien und Gesprächen mit Expertinnen und Experten erarbeitet, wie viele Angebote es in Deutschland gibt, die auf landwirtschaftlichen Betrieben mit der Zielgruppe Seniorinnen und Senioren stattfinden. Um die Rahmenbedingungen für andere Strukturen erarbeiten zu können, wurde diese Recherche um Informationen zu anderen europäischen Ländern ergänzt, in denen Angebote für Seniorinnen und Senioren auf landwirtschaftlichen Betrieben zum Zeitpunkt der Antragstellung für das F-&E-Vorhaben VivAge bekannt waren. Zudem wurde wissenschaftliche Literatur gesichtet, die für die Fragestellung von Interesse war. Die intensiven Recherchen wurden um eine methodengeleitete Analyse von acht bestehenden Angeboten in Deutschland ergänzt. Dazu dienten Betriebsbesuche, bei denen neben Teilnehmenden Beobachtungen Interviews mit Seniorinnen, Senioren, Landwirtinnen und Landwirten durchgeführt wurden. Die zuvor genannten Arbeitsschritte dienten als Grundlage für die Entwicklung von vier theoretischen Modelle, aus denen heraus abschließend Leitfäden zur Umsetzung entwickelt wurden.
Article
Background Obesity is a well-known risk factor for public health. Recent studies found that greenness exposure may protect against obesity. However, the accumulated evidence on associations of greenness-obesity are inconsistent and most of them are from developed countries. Objectives This study aimed to evaluate the associations of greenness exposure with indicators of peripheral and central obesity. Methods This cross-sectional study was based on a Chinese national Sub-Clinical Outcomes of Polluted Air (SCOPA) prospective cohort across 15 provinces, and 5849 participants with average age of 64.7 were included. Surrounding greenness was estimated with the Enhanced Vegetation Index (EVI), which was calculated at each participant’s residential addresses within a 250 m buffer. Weight, height and waist circumference (WC) were measured, and body mass index (BMI) and the waist-to-height ratio% (WHtR%) were calculated based on those measurements. The relationships between EVI and obese outcomes were explored using multiple linear regression and logistic regression models. Results Non-linear associations were observed between EVI and obese indicators. Participants in Quartile 3 benefited more than in Quartile 4 compared to the lowest quartile of greenness. For peripheral obesity, participants in Quartile 3 of EVI250m had 0.86 kg/m² (β -0.86, 95% CI: -1.10, -0.61) lower BMI, and 46% (OR 0.54, 95% CI: 0.44-0.66) lower odds of peripheral obesity than in the lowest quartile (Quartile 1). For central obesity, participants in Quartile 3 of EVI250m had 1.85 cm (β -1.85, 95% CI: -2.54, -1.15) lower waist circumference, 1.12% (β -1.12, 95% CI: -1.56, -0.67) lower waist-to-height ratio% (WHtR%), and 33% (OR 0.67, 95% CI:0.57-0.78) lower odds of central obesity than in the lowest quartile of EVI250m. Conclusions Higher levels of greenness were statistically significant associated with lower obesity risk.
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Gardens are culturally shaped environments in which natural processes can be experienced. Thus, they offer insights into the relation people have with these processes and the biophysical domain. This includes soils and plants, as these are the natural materials gardeners work with regularly. A cultural ecosystem service (CES) perspective might help to understand interactions between the gardeners and the environment, for example, soils. This could provide insights for scientists, public stakeholders and non‐governmental organizations to raise awareness for ecosystem services (ES) of soils. Understanding how gardens are created and used, requires studies from the natural sciences but also from the humanities and social sciences. The natural sciences provide insights into soil properties, biodiversity, plant requirements and the water cycle, while the humanities and social sciences are needed to understand identity formation, social and cultural practices, belief systems and psychological aspects connected to gardening. Inter‐ and transdisciplinary research can then inform scientists, gardeners, policy makers and educators as well as the general public about CES. This can be used to develop educational programs and measures to protect these valuable CES as well as the general ES of gardens and soils. A free Plain Language Summary can be found within the Supporting Information of this article.
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In the Foreword to Gerard Robinson and Elizabeth English Smith's Education for Liberation volume on educational initiatives in prison, Newt Gingrich and Van Jones note that educational programs “do something powerful: they give hope and dignity to the incarcerated.” The authors wholeheartedly agree and while they recognize the importance of higher education programs that confer degrees and therefore credentials out in the free world, they find that education can be broadly understood in prison in ways that greatly enhance the hope and dignity of the incarcerated. In this chapter, they explore the creation of a Japanese-style healing garden at the Oregon State Penitentiary (OSP), a maximum security, 2,000-person male prison in Salem, Oregon. This prisoner-led initiative was a resounding success, despite all the odds against it, because it was animated by a philosophy of transformative justice that both prison administration and prisoners could believe in, and it embraced the need for meaningful and inclusive community partnerships.
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The COVID‐19 pandemic has highlighted the need to adapt to and rebound from unexpected change and uncertainty. The increasing climate chaos of the Anthropocene additionally underscores the necessity of resilient societies and individuals. Individuals able to problem‐solve in emergent situations are integral to a resilient society, and science education can develop these competencies both individually and collectively. We use the concept of resiliency to argue for science education that enables learners to adapt and respond in the face of disruption, unrest, and disaster. We focus specifically on the ways in which learning how to grow plants indoors can develop resilience on multiple levels while authentically facilitating science and engineering principles. This study seeks to explore how indoor agriculture might support science education for resiliency. We examine a higher‐education project, the “Grow Pod,” involving shipping container agriculture with first‐year undergraduates. We argue that inclusion of indoor agriculture within science education has the potential to support both learning for and as resiliency. In our analysis, we note how the Grow Pod project supports a science education for resiliency through collective learning that helps learners understand plant basics and how to grow food, and a science education as resiliency which includes learning through and rebounding from challenges/mistakes, learning resourcefulness, and experiencing restorative benefits of working with plants.
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Background: Mental health of adolescents have been exposing to risk factors associated with stress from a variety of sources. Previous studies identified that green space exposure might be effective for promoting mental health and reduction of stress. However, previous literature focused on adults, and for those which studied children and adolescents, the effects of planting and similar green activities remain to be explored. The aim of this study was to investigate the effects of a pioneer school-based program on green space use and satisfaction, and mental wellbeing indicators, among early adolescent students. Methods: This was a feasibility quasi-experiment in which intervention and control groups were studied sequentially. Three secondary schools and 55 grade 7-8 students were sampled conveniently. In the intervention school, the green space program consists of learning hydroponic planting and group practice in creating green areas at school. In the two control schools, the activities consisted of a standardized stress management program including relaxation exercise such as stretching, extension and massage. Both groups learned green diet, tasting and had green living activity, stress awareness games and learned stress coping. The activity schedule for each group (intervention and control) consisted of three one-hour sessions, each was conducted two to three weeks apart. Key outcomes were assessed with questionnaires at baseline and one month after the completion of the activity period as for each school. Data were fit with mixed model applying GEE. Results: At baseline, students were not sure whether they know how to plant herbs or prepare herbal tea. Control group at posttest had lower frequencies of using green facilities in the community and using school gardening facilities in the previous four weeks compared with intervention group and pretest. Females at posttest were associated with higher confidence in planting, and higher level of enjoyment from green activities. Other moderate to small but non-significant effects were also identified. Conclusions: In this study, the school-based green space programme was found feasible for early adolescent students with statistically supported results. Limitations have also been identified and future study with larger scale, more frequent intervention, longer follow-up and RCT design are required.
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Objective To systematically identify and describe studies that have evaluated the impact of gardens and gardening on health and well-being. A secondary objective was to use this evidence to build evidence-based logic models to guide health strategy decision making about gardens and gardening as a non-medical, social prescription. Design Scoping review of the impact of gardens and gardening on health and well-being. Gardens include private spaces and those open to the public or part of hospitals, care homes, hospices or third sector organisations. Data sources A range of biomedical and health management journals was searched including Medline, CINAHL, Psychinfo, Web of Knowledge, ASSIA, Cochrane, Joanna Briggs, Greenfile, Environment Complete and a number of indicative websites were searched to locate context-specific data and grey literature. We searched from 1990 to November 2019. Eligibility criteria We included research studies (including systematic reviews) that assessed the effect, value or impact of any garden that met the gardening definition. Data extraction and synthesis Three reviewers jointly screened 50 records by titles and abstracts to ensure calibration. Each record title was screened independently by 2 out of 3 members of the project team and each abstract was screened by 1 member of a team of 3. Random checks on abstract and full-text screening were conducted by a fourth member of the team and any discrepancies were resolved through double-checking and discussion. Results From the 8896 papers located, a total of 77 * studies was included. Over 35 validated health, well-being and functional biometric outcome measures were reported. Interventions ranged from viewing gardens, taking part in gardening or undertaking therapeutic activities. The findings demonstrated links between gardens and improved mental well-being, increased physical activity and a reduction in social isolation enabling the development of 2 logic models. Conclusions Gardens and gardening can improve the health and well-being for people with a range of health and social needs. The benefits of gardens and gardening could be used as a ‘social prescription’ globally, for people with long-term conditions (LTCs). Our logic models provide an evidence-based illustration that can guide health strategy decision making about the referral of people with LTCs to socially prescribed, non-medical interventions involving gardens and gardening.
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Background: It is important to identify valid and acceptable outcome measures so that interventions evaluating common mental health problems can be assessed appropriately. Some advocate the use of generic preference-based measures claimed to be applicable for all health interventions, but others argue that they are insensitive for common mental health problems. The aim of this paper is to evaluate the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), to be used in cost-effectiveness studies in people with common mental health problems. Method: The CORE-OM measure was tested for completeness, acceptability and responsiveness in a pilot study. Analyses for missing data, distribution of scores, and standardised response means (SRMs) were calculated. Results: Missing data did not exceed 5% for any of the CORE-6D items both at baseline and follow-up. The overall comprehension rate was high, and only 19 participants (14%) requested clarifications to complete the questionnaire. As expected in a feasibility study, there was a small and non-significant SRM. Conclusion: CORE-OM is a valid and acceptable instrument to evaluate quality of life for people with common mental health problems. More research is needed with larger sample sizes to compare CORE-6D with other condition specific quality of life instruments.
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Objectives To explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic. Design This was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding. Participants This study involved 25 participants from a range of frontline professions in health and social care. Setting Interviews were conducted over the phone or video call, depending on participant preference. Results From the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life. Conclusions This study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.
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This study examines the relationship of living place perception and nature relatedness with the psychological resiliency levels of adults, who are residents of Turkey. The population of the study consists of 431 adults who completed the scales which were published through social media. The participants are from different cities and they stated the size of their locality on the sociodemographic form. Three reliable scales were used in this study along with the sociodemographic form prepared by the researcher. These three scales are; the Resilience Scale for Adults in order to measure psychological resilience, the Living Place Perception Scale in order to measure living place perception and the Nature Relatedness Scale in order to measure the relationship with nature. Data analysis findings indicate that adults who perceive their locality positively have higher psychological resiliency levels. It was found that adults who spend more time in the nature perceive their locality more positively and the adults who are connected to nature express higher psychological resiliency. The discussed findings support previous researches; the psychological resilience increases with age and the perception of the self and the future are more positive among adults who are over 40, compared to adults who are between the ages of 20 and 29. The data shows that adults with low psychological resilience levels are seeking more psychological support than the adults who have higher psychological resilience levels. The results of this study were discussed in the light of literature. As individuals' psychological resilience will ultimately determine community health; it is hoped that this research contributes to the mental health, community health and urban planning disciplines with its findings.
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Social Prescribing (SP) is the referral of patients to non-clinical services for practical, physical or psychosocial support. Recent guidelines from the National Health Service England mean that SP will become commonplace for people with complex healthcare needs. Autistic adults make up over 1% of the population and commonly have co-existing physical and mental health conditions, therefore they are likely to be referred to SP services. As yet, no studies have examined the efficacy of SP for autistic adults. In this letter, we review the existing literature examining the efficacy of SP in the general population. We further examine the factors that should be considered when offering SP to autistic adults in order to optimise outcomes for physical and mental well-being.
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This chapter derives from a qualitative evaluation on the impact of a prisons-based horticulture and environmental programme concerning the health and well-being of participants selected from four UK prisons. The primary research approach used was the biographic-narrative interpretive method (BNIM). The chapter explores some of the strengths and challenges with regard to conducting BNIM interviews with people in prison in order to build individual case studies. One such case study, with a participant serving a life sentence, is used to illustrate the challenges and benefits of understanding the stories of people in prison, including notions such as rehabilitation of the participant when the criminal act for which they are serving their sentence is consciously avoided in their story.
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Urban agriculture is often advanced as a sustainable solution to feed a growing urban population, offering a number of benefits: improved fresh food access, CO2 absorption, social justice and social cohesion among others. Going beyond these direct tangible/objective benefits from urban agriculture, in this paper we ask: How can growing food in the cities teach us about taking care of each other and the natural environment? We use the example of urban food autonomy movements to discuss the transformative potential of a grassroots-led initiative promoting permaculture, which is anchored in three “ethics”: care for the earth, care for the people, and fair share. Through examining the philosophical underpinnings of “autonomy” and “care”, we explore how urban food autonomy initiatives can enable the development of an ethics of care, especially using permaculture inspirations. Our theoretical review and case analysis reveal that “autonomy” can never be achieved without “care” and that these are co-dependent outcomes. The urban food autonomy initiatives are directly relevant for the achievement of the three of the UN’s 17 Sustainable Development Goals: “Zero Hunger,” “Life on Land” and “Climate Action”, and contribute to a culture of care. Indeed, urban agriculture can act as a powerful education platform for the engagement of diverse stakeholders while also supporting a collective transformation of values.
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For residents of Finnish Lapland, snow frames outdoor and indoor activities during the entire year, both in its presence and in its absence. This article focuses on people’s social and aesthetic perspectives on what is commonly referred to as “snow work”, lumityö . In ethnographic tradition, the aim is to understand “doing living with snow” in contemporary urban society – with snow that falls and, unlike other forms of precipitation, stays around for many months to come, thus creating physical, mouldable obstacles that have mental, social and environmental consequences. The shovelling of snow is considered an important physical activity that allows people to practice their individual expert knowledge and lets them socialise during long annual periods of potential isolation. Hence, apart from its restricting features, snow and ice enhance the meaning of homeowners’ dwelling in the open. In this context, aesthetic and creative concepts are essential where they draw on people’s gardening and artistic skills, and bring satisfaction to those engaging with this mundane and unavoidable activity.
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Intervention meint das Eingreifen in eine Situation oder einen Handlungszusammenhang, aber auch Unterbrechung, Provokation und Vermittlung. Interventionen sind aus systemischer Sicht notwendig, um Veränderungen im Sinne der Eröffnung neuer Entwicklungsperspektiven in sozialen Systemen anzuregen (Luhmann, 1994). Dadurch werden relevante Voraussetzungen für Veränderungen von beispielsweise Kommunikations- und Interaktionsformen im System geschaffen (Willke, 2005). Für das Gelingen von Interventionen als förderliche Irritation oder stimulierende Anregung ist bedeutsam, dass Kommunikation als „Unterschied, der einen Unterschied macht“ (Bateson, 1995) wahrgenommen und entsprechend genutzt werden. Ausgangspunkt ist ein weit gefasstes Verständnis von Interventionen mit künstlerischen Mitteln im Hinblick auf verschiedene Formate, Qualitäten, Einsatzmöglichkeiten und Anwendungsfelder. Es umschließt erweiternd verschiedene Formen von Kunst im öffentlichen Raum (Installation, Skulptur, Tanz, Performances etc.) und Formen des Theaters als spezielle künstlerische Intervention in Organisationsstrukturen. Der Band zeigt die vielschichtige Verwendung des Interventionsbegriffs aus künstlerischen und wissenschaftlichen Perspektiven der Autor*innen: Fabian Chyle & Martin Dornberg - Intervention, Verkörperung und Bedeutung Hannes Egger - Vom Sehen und Gesehen werden: Das Publikum als performativer Körper Alexandra Modesta Hopf - Kunsttherapeutische Interventionen: Von der Notwendigkeit des Eingreifens Christina Niedermann & Thomas Ostermann - Zur Bedeutung von Gartengestaltung für die Erfassung mentaler Gesundheit: Konzeptentwurf eines Pilotprojekts Tim Raupach - Serious Games und Serious Gaming: Computerspiele als Lern- und Therapieinstrument Petra Straß - Experimentier- und Kommunikationsraum Bühne: Ausgewählte Projektskizzen Fotografische Collagen: Hannah Licia Hansen Santana Fotografisches Bildmaterial für Collagen: Stephanie Lange und Paulina Lapp Editorialdesign: Denise Tobinski Die Publikation erscheint im Rahmen des Forschungsschwerpunkts Künstlerische Interventionen in Gesundheitsförderung und Prävention an der Hochschule für Künste im Sozialen Ottersberg. Der Forschungsschwerpunkt einschließlich der Publikation wird gefördert durch die VolkswagenStiftung und das Niedersächsische Ministerium für Wissenschaft und Kultur.
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(For the interactive e-book, see: https://www.unep.org/resources/geo-6-youth) GEO-6 for Youth is a one-stop-shop for a young person to understand the state of the environment, what they can do every day to drive markets to adopt environmentally sustainable products and services and how to develop their skills and choose environmentally sustainable careers. The report provides background to help understand the issues, but most importantly shows how youth have the power to bring about transformative change for the environment. GEO-6 for Youth is UNEP’s first fully interactive e-publication and provides engaging multimedia content and interactive features to inform, engage, educate, and lead to youth action. Several case studies and interviews appear in the report, including small-scale, community-led projects and individual guides to developing the appropriate skills for green jobs and daily sustainable actions. A gender and geographically balanced team of 28 young authors from across the world worked on the report using the GEO’s co-creation model. The report aims to: 1) Translate high-level, scientific messages on the state of the environment for a youth audience (ages 15 to 24); 2) Define how youth can bring about transformational change by creating and accessing environmentally sustainable jobs, and 3) Identify daily sustainability actions that can change market dynamics to achieve an environmentally sustainable world by 2050.
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Refugees and the displaced experience challenges which can lead to mental health illnesses, including depression. In this study, the effectiveness of gardening in reducing depression and improving the lives of displaced Syrian women in Lebanon was explored. Considering that the displaced had limited outdoor space and no access to land, vertical gardening units were used. Forty-four participants residing in four displaced communities in North Lebanon joined the 6-months gardening programme, which was designed as a quasi-experimental exploratory study. Data on depression scores were collected at the preparatory phase and at 24 weeks post-intervention using the Beck Depression Inventory (BDI-II) and analysed using a paired t-test. Results revealed that participants were less depressed at the end of the gardening programme, with depression scores significantly lower than preparatory phase scores. Group interviews were also conducted to assess women’s perception of gardening halfway through the intervention phase. Women’s engagement in gardening activities was also reflected by estimating yields. Participants indicated that they joined the programme because they saw it as a stress relief activity, they were interested to learn about vertical gardening, they enjoyed the aesthetic value of plants, they wanted to produce food and they felt that gardening provided an opportunity to socialise. Our findings suggest that aid organisations may consider vertical gardening as a therapeutic and social activity in situations where displaced women are confined to limited open spaces.
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Objective To investigate the effect of applying horticulture activity on stress, work performance and quality of life in persons with psychiatric illness. Methods This study was a single-blinded randomized controlled trial. Using convenience sampling, 24 participants with psychiatric illness were recruited to participate in a horticultural programme and were randomly assigned to experimental and control groups. Two participants dropped out from experimental groups after assignment. Ten participants in the experimental group attended 10 horticultural sessions within 2 weeks, while 12 participants in the control group continued to receive conventional sheltered workshop training. Participants were assessed before and after programme using Chinese version of the Depression Anxiety Stress Scale (DASS21) and the Personal Wellbeing Index (PWI-C), and the Work Behavior Assessment. Results There was a significant difference in change scores of the DASS21 (p = .01) between experimental and control group. There were no significant differences in change scores of the PWI-C between the two groups. Conclusion Horticultural therapy is effective in decreasing the levels of anxiety, depression and stress among participants in this pilot study, but the impact of the programme on work behavior and quality of life will need further exploration.
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Aims and method Mental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals. Results Mental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed. Clinical implications Recovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.
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Introduction Physical exercise has been proven to benefit the general population in terms of mental health and wellbeing. However, there is little research investigating the impact of exercise on mental health and quality of life for people who experience a severe and enduring mental illness. Method This review aims to describe the effect of physical exercise intervention on the mental health and quality of life of people with severe mental illness. Quantitative and qualitative articles published between 1998–2009 were sourced using electronic databases. Articles were included if the study intervention involved exercise and the outcome measure included mental health or quality of life. Sixteen articles were analysed for common themes and appraised critically. Findings The findings show that exercise can contribute to improvements in symptoms, including mood, alertness, concentration, sleep patterns and psychotic symptoms. Exercise can also contribute to improved quality of life through social interaction, meaningful use of time, purposeful activity and empowerment. Implications Future research is warranted to describe the way exercise can meet the unique needs of this population. Studies with a focus on psychological outcome measures would provide greater evidence for its use in therapy.
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Purpose The occupation of gardening has historically generated a wealth of literature. Although espousing its positive impact on wellbeing, evidence is typically anecdotal in nature, with only one major synthesis of reliable evidence to date. This study sought to explore people's experiences and personal meanings of gardening within the literature, from 2003–2010, in order to present a concise body of evidence and to inform occupational therapy practice. Procedures A meta-ethnography was used in gathering high quality qualitative studies, synthesising through a process of translations, rather than aggregation, in order to preserve meanings from within a range of culturally specific contexts. Four papers, out of 214 initially identified, met the inclusion criteria employed. Findings This study has identified processes within the occupation of gardening in a natural environment, which offer satisfying and meaningful methods of recovery for people who are marginalised within society. This has been shown on an individual and a community health level. Conclusion This study has highlighted fundamental links between gardening and wellbeing, and how occupational therapists can broaden practice and have an impact upon health at a community level.
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A sense of belonging is a key element in enabling social inclusion through meaningful occupations. This is evident in occupational science and social and therapeutic horticulture (STH) literature. How these theories interact in practice was explored at Thrive's STH project in Battersea in London. A workshop conducted with Thrive Battersea's therapists examined how gardening may facilitate health and wellbeing through belonging. The authors reflect on themes of belonging from the workshop. The implications for occupational therapy from this apparently rich synergy of occupational science, STH and social inclusion are considered.
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Argues that evolutionary heritage underlies humans' consistent preference for stimuli from the natural environment and that research on affective and aesthetic responses is needed to understand human interaction with the environment. It is noted that the rapidly expanding empirical record concerning aesthetic and affective responses to natural environments is in need of a well-developed theoretical foundation. An integrated conceptual framework to address this theoretical lack, drawing on recent theory and research on emotion, is proposed. This framework explains how affects arise in the natural environment; postulates their functions; and links them to cognition, activity in physiological systems, and behavior. The present author, in developing the framework, questions the view that feelings result from cognitive processes, asserting that feelings (not thoughts) are the initial response in environmental encounters. The observer's initial feeling reaction shapes subsequent cognitive events. The relative sequence of feeling and thinking in environmental encounters represents a fundamental issue in understanding human interaction with the environment. (98 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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An engaged lifestyle is seen as an important component of successful ageing. Many older adults with high participation in social and leisure activities report positive wellbeing, a fact that fuelled the original activity theory and that continues to influence researchers, theorists and practitioners. This study's purpose is to review the conceptualisation and measurement of activity among older adults and the associations reported in the gerontological literature between specific dimensions of activity and wellbeing. We searched published studies that focused on social and leisure activity and wellbeing, and found 42 studies in 44 articles published between 1995 and 2009. They reported from one to 13 activity domains, the majority reporting two or three, such as informal, formal and solitary, or productive versus leisure. Domains associated with subjective wellbeing, health or survival included social, leisure, productive, physical, intellectual, service and solitary activities. Informal social activity has accumulated the most evidence of an influence on wellbeing. Individual descriptors such as gender or physical functioning sometimes moderate these associations, while contextual variables such as choice, meaning or perceived quality play intervening roles. Differences in definitions and measurement make it difficult to draw inferences about this body of evidence on the associations between activity and wellbeing. Activity theory serves as shorthand for these associations, but gerontology must better integrate developmental and psychological constructs into a refined, comprehensive activity theory.
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Between-group outcome research is a scientific approach to evaluating the effectiveness of psychotherapy and the mechanisms of change associated with those treatments for psychological disorders. This area of research is replete with important methodological issues that need to be considered in order for investigators to draw the strongest, most specific cause-and-effect conclusions about the active components of treatments, human behavior, and the effectiveness of therapeutic interventions. In this chapter, we present the various methodological considerations associated with these experiments. The chapter begins with a description of the different experimental designs from which investigators may choose in designing a therapy outcome study. These designs include the no-treatment and common factors comparison designs, as well as the dismantling, additive, catalytic, and parametric designs. We also present the methodological, client/participant, and therapist concerns that must be taken into account in the design stage of a treatment outcome investigation. Following this, we discuss the measurement of change, starting with the considerations surrounding dependent variables and ending with methods of analyzing data and assessing clinically significant change. Finally, after a presentation on small-N experimental designs, we discuss the importance of scientific research in naturalistic settings. Keywords: design; methodology; naturalistic; outcome; psychotherapy; therapy
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The need to document the efficacy of nature-based therapeutic modalities is of concern to all who support and encourage this field of endeavour. While a relatively large body of information is available very few of the articles are published in clinical and medical journals that provide the underlying basis for academic, programmatic and policy decisions, and little of it is based on the high level of rigorous research needed to gain respect as a contributing part of health-care science. In addition, the difficulties in forming a coherent profession go beyond the lack of adequate and appropriate research to the core problem of uniform terminology in the field and coherent theoretical framework to guide the research and implementation of treatment. With that conclusion in mind, the majority of this paper will look at models (either as text or diagrams) that have been put forth, as a starting point for establishing effective theories of human-nature interaction in a therapeutic or treatment setting to guide future research in horticultural therapy (HT), animal-assisted therapy (AAT) and Agriculture in Healthcare programs. Based on the experiences discussed relevant to HT, recommendations for future action are given.
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The point of departure of this chapter is to view nature-based settings as an important asset for improvement and promotion of health. During the last decades the concepts of healthy nature-based settings and accompanying treatment programs have been referred to by many names, making the subject difficult to interpret. Here the development of the theoretical framework and the research area are described. The second part of the chapter focuses on the structure of a therapy program and the health design of the nature-based setting. From the theories and experiences, including both research as well as best practice presented, the chapter ends with recommendations for future aims of research projects within this area.
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Different conceptual perspectives converge to predict that if individuals are stressed, an encounter with most unthreatening natural environments will have a stress reducing or restorative influence, whereas many urban environments will hamper recuperation. Hypotheses regarding emotional, attentional and physiological aspects of stress reducing influences of nature are derived from a psycho-evolutionary theory. To investigate these hypotheses, 120 subjects first viewed a stressful movie, and then were exposed to color/sound videotapes of one of six different natural and urban settings. Data concerning stress recovery during the environmental presentations were obtained from self-ratings of affective states and a battery of physiological measures: heart period, muscle tension, skin conductance and pulse transit time, a non-invasive measure that correlates with systolic blood pressure. Findings from the physiological and verbal measures converged to indicate that recovery was faster and more complete when subjects were exposed to natural rather than urban environments. The pattern of physiological findings raised the possibility that responses to nature had a salient parasympathetic nervous system component; however, there was no evidence of pronounced parasympathetic involvement in responses to the urban settings. There were directional differences in cardiac responses to the natural vs urban settings, suggesting that attention/intake was higher during the natural exposures. However, both the stressor film and the nature settings elicited high levels of involuntary or automatic attention, which contradicts the notion that restorative influences of nature stem from involuntary attention or fascination. Findings were consistent with the predictions of the psycho-evolutionary theory that restorative influences of nature involve a shift towards a more positively-toned emotional state, positive changes in physiological activity levels, and that these changes are accompanied by sustained attention/intake. Content differences in terms of natural vs human-made properties appeared decisive in accounting for the differences in recuperation and perceptual intake.
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This study aimed to assess changes in psychological distress and social participation in adults diagnosed with clinical depression during and after participating in a therapeutic horticulture programme, and to investigate if the changes covaried with levels of group cohesiveness during the intervention. An intervention with a single-group design was repeated with different samples in successive years (pooled n = 46). In each year, five groups of 3-7 participants went through the intervention. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, as well as at 3-months' follow up. Mental health assessments included the Beck Depression Inventory, the State Subscale of Spielberger State-Trait Anxiety Inventory, the Positive Affect Scale from the Positive and Negative Affect Scale, the Perceived Stress Scale, and the Therapeutic Factors Inventory-Cohesiveness Scale. The analysis of the pooled data confirmed significant beneficial change in all mental health variables during the intervention. Change from baseline in depression severity persisted at 3-months' follow up. Increased social activity after the intervention was reported for 38% of the participants. The groups quickly established strong cohesiveness, and this continued to increase during the intervention. The average level of group cohesiveness correlated positively, but not significantly, with change in all mental health outcome variables.
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Two studies with single-group design (Study 1 N = 18, Study 2 N = 28) addressed whether horticultural activities ameliorate depression severity and existential issues. Measures were obtained before and after a 12-week therapeutic horticulture program and at 3-month follow-up. In both studies, depression severity declined significantly during the intervention and remained low at the follow-up. In both studies the existential outcomes did not change significantly; however, the change that did occur during the intervention correlated (rho > .43) with change in depression severity. Participants' open-ended accounts described the therapeutic horticulture experience as meaningful and influential for their view of life.
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This paper is a report of a study conducted to assess change in depression severity, perceived attentional capacity and rumination (brooding) in individuals with clinical depression during a therapeutic horticulture programme and to investigate if the changes were mediated by experiences of being away and fascination. Individuals with clinical depression suffer from distortion of attention and rumination. Interventions can help to disrupt maladaptive rumination and promote restoration of depleted attentional capacity. A single-group study was conducted with a convenience sample of 28 people with clinical depression in 2009. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, and at 3-month follow-up. Assessment instruments were the Beck Depression Inventory, Attentional Function Index, Brooding Scale, and Being Away and Fascination subscales from the Perceived Restorativeness Scale. Mean Beck Depression Inventory scores declined by 4.5 points during the intervention (F = 5.49, P = 0.002). The decline was clinically relevant for 50% of participants. Attentional Function Index scores increased (F = 4.14, P = 0.009), while Brooding scores decreased (F = 4.51, P = 0.015). The changes in Beck Depression Inventory and Attentional Function Index scores were mediated by increases in Being Away and Fascination, and decline in Beck Depression Inventory scores was also mediated by decline in Brooding. Participants maintained their improvements in Beck Depression Inventory scores at 3-month follow-up. Being away and fascination appear to work as active components in a therapeutic horticulture intervention for clinical depression.
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Ecotherapy is an umbrella term for a gathering of techniques and practices that lead to circles of mutual healing between the human mind and the natural world from which it evolved. It includes horticultural therapy, wilderness excursion work, time stress management, and certain kinds of animal-assisted therapy. This article provides an overview of research into ecotherapy's treatment efficacy and argues for a psychology of place designed to reconnect people psychologically with the world a place at a time.
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In most cases, therapy is addressed as an indoor, verbal, and cognitive activ- ity, with the relationship between therapist and client at its center (McLeod, 2003). This article presents an alternative approach to therapy, conducted in creative ways in nature, addressing the environment not merely as a setting but as a partner in the process. The article includes examples of work that took place with different clients, in varied settings. It aims at presenting basic con- cepts from this young framework that will inspire other practitioners to "open the doors" and explore these ideas with their clients in nature.
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Introduction The use of horticulture in mental health settings is widespread. Moreover, its effectiveness is supported by a body of qualitative evidence. Aims The investigators in this research study sought to determine those aspects of their horticultural projects that conferred the greatest therapeutic benefit to their clients. They used outcome measures to rate the responses of participants, paying particular attention to the participants' expressed motivation. Method Qualitative and quantitative methods were used to evaluate six horticultural projects. Ten participants were interviewed, using an adapted version of the Work Environment Impact Scale (WEIS) to rate factors that supported their motivation. Fifty participants were assessed, using the Volitional Questionnaire (VQ) to observe and rate the extent of their motivation. Findings The therapeutic value of horticulture arose from a complex interplay of personal factors, including gender-based preferences, individual interests and social needs. Conclusion The benefits of engaging in horticultural activity are not automatic. The external environment provides challenges, which can be graded by the facilitators to maximise the therapeutic benefit.
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The needs of people with serious mental health problems are frequently not met by services and service users' difficulties are further compounded by social isolation and exclusion. Clients attending a community mental health team horticultural allotment group described the importance that they attached to social contact in the group. This study aimed to develop an understanding of how this experience came about so that it could be harnessed more effectively. A qualitative approach was used to explore the subjective experience of meaning that had underpinned regular attendance by nine group members. Qualitative interviews and a focus group generated data, which were examined in the light of concepts drawn from the literature on therapeutic horticulture, social networking and meaning in occupation. The participants described the restorativeness of the allotment setting, a resurgent destigmatised identity and attachment to a highly valued social network. The study concludes that there are particular qualities of the plant-person relationship that promote people's interaction with their environment and hence their health, functional level and subjective wellbeing. The embeddedness of allotments within communities means that they have great potential as media for occupational therapy and as mechanisms for social inclusion.
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ABSTRACT– A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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Directed attention plays an important role in human information processing; its fatigue, in turn, has far-reaching consequences. Attention Restoration Theory provides an analysis of the kinds of experiences that lead to recovery from such fatigue. Natural environments turn out to be particularly rich in the characteristics necessary for restorative experiences. An integrative framework is proposed that places both directed attention and stress in the larger context of human-environment relationships.
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Nature's potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.
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Including exercise for the prevention and treatment of mental disorders is a promising area of research for exercise scientists since data indicate that many of these disorders are not treated at all, and there is a significant delay in treatment. This review provides an appraisal of the recent use of exercise to prevent and treat specific mental disorders and provides a recommended framework for future progress of this research. More research is needed to overcome methodological issues to demonstrate the efficacy and effectiveness of exercise and to integrate mental and physical healthcare for widespread dissemination.
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Clinically depressed persons suffer from impaired mood and distortion of cognition. This study assessed changes in depression severity and perceived attentional capacity of clinically depressed adults (N=18) during a 12-week therapeutic horticulture program. The Beck Depression Inventory (BDI) and Attentional Function Index (AFI) were administered at baseline, twice during (4 and 8 weeks), and immediately after the intervention (12 weeks), and at a 3-month follow-up. Experiences of being away and fascination related to the intervention were measured at 4, 8, and 12 weeks. The mean BDI score declined 9.7 points from pretest (27.3) to posttest (p < .001) and were clinically relevant (deltaBDI > or =6) for 72% of the cases. The mean AFI score increased 10.2 points from pretest (68.8) to posttest (p = .06). The greatest change in BDI and AFI scores occurred in the initial weeks of the intervention. The reduction in BDI scores remained significant and clinically relevant at the 3-month follow-up (N=16). The decline in depression severity during the intervention correlated strongly with the degree to which the participants found that it captured their attention. Therapeutic horticulture may decrease depression severity and improve perceived attentional capacity by engaging effortless attention and interrupting rumination.
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A summary of the main findings of a review of the literature on social and therapeutic horticulture – the use of horticulture and gardening to promote health, well-being and social inclusion among vulnerable people.
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This evidence paper summarises the findings of the third and final phase of the Growing Together study of the use of social and therapeutic horticulture (STH) as a form of health and social care provision for vulnerable adults. The first phase of the research, a review of the literature, has already been published (Sempik et al, 2003) and summarised in Evidence Issue 6. The second phase, findings from a survey of STH projects showing the level of activity and participation in the UK were summarised in Evidence Issue 8. Full details of these findings have recently been published (Sempik et al, 2005). In order to study the effects of participation in STH, 24 garden ‘projects’ were examined in depth. Interviews were recorded with 137 clients, 88 project staff and carers, and 11 health professionals. The findings show that STH is an effective form of social care which promotes social inclusion and well-being for people with a wide range of social, mental and physical problems, including those with mental ill health, learning difficulties, challenging behaviour, physical disabilities and others.
While institution-bound programs in horticulture therapy were appropriate for the era in which long-term hospitalization was the primary mode of psychiatric treatment, the supported employment paradigm updates this mode of treatment for the current era of community psychiatry.