Evidence map›Paper›PMID 34646931›Full record

ReviewSSM - population health2021

Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis.

Peter A Coventry, JenniferV E Brown, Jodi Pervin, Sally Brabyn, Rachel Pateman, Josefien Breedvelt, Simon Gilbody, Rachel Stancliffe, Rosemary McEachan, PiranC L White

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in SSM - population health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 172 papers, 26 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
172citing papers in PubMed, 26 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

172 citing papers in PubMed, 26 syntheses or guidelines pooled it.

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112 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Peter A CoventryDepartment of Health Sciences, University of York, York, YO10 5DD, UK.
JenniferV E BrownDepartment of Health Sciences, University of York, York, YO10 5DD, UK.
Jodi PervinDepartment of Health Sciences, University of York, York, YO10 5DD, UK.
Sally BrabynDepartment of Health Sciences, University of York, York, YO10 5DD, UK.
Rachel PatemanStockholm Environment Institute, Department of Environment and Geography, University of York, York, YO10 5NG, UK.
Josefien BreedveltNational Centre for Social Research, London, United Kingdom.
Simon GilbodyDepartment of Health Sciences, University of York, York, YO10 5DD, UK.
Rachel StancliffeCentre for Sustainable Healthcare, Oxford, OX2 7JQ, UK.
Rosemary McEachanBradford Institute for Health Research, Bradford, BD9 6RJ, UK.
PiranC L WhiteYork Environmental Sustainability Institute, University of York, York, YO10 5NG, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for community based adults. However, it is unclear which NBIs are most effective, or what format and dose is most efficacious. We systematically reviewed the controlled and uncontrolled evidence for outdoor NBIs. The protocol was registered at PROSPERO (CRD42020163103). Studies that included adults (aged ≥18 years) in community-based settings with or without mental and/or physical health problems were eligible for inclusion. Eligible interventions were structured outdoor activities in green and/or blue space for health and wellbeing. We searched ASSIA, CENTRAL, Embase, Greenfile, MEDLINE, PsycINFO, and Web of Science in October 2019; the search was updated in September 2020. We screened 14,321 records and included 50 studies. Sixteen studies were randomised controlled trials (RCTs); 18 were controlled studies; and 16 were uncontrolled before and after studies. Risk of bias for RCTs was low to moderate; and moderate to high for controlled and uncontrolled studies. Random effects meta-analysis of RCTs showed that NBIs were effective for improving depressive mood -0.64 (95% CI: 1.05 to -0.23), reducing anxiety -0.94 (95% CI: 0.94 to -0.01), improving positive affect 0.95 (95% CI: 0.59 to 1.31), and reducing negative affect -0.52 (95% CI: 0.77 to -0.26). Results from controlled and uncontrolled studies largely reflected findings from RCTs. There was less evidence that NBIs improved physical health. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. NBIs, specifically gardening, green exercise and nature-based therapy, are effective for improving mental health outcomes in adults, including those with pre-existing mental health problems.

Indexed as

BluespaceGreenspaceMental healthNature-based interventionPhysical health

Identifiers

PMID34646931
PMCPMC8498096

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.