Mental Health Wellness 1NCT05276245
Nature-based Intervention to Enhance Well-being
A study testing Structured Protocol of Nature Contact in people with Mental Health Wellness 1 and Health Behavior, run by Education University of Hong Kong at 1 site in China.
Trial summary
The aim of the present study is to investigate the effectiveness of a nature-based intervention on adaptive psychological functioning. We compared a structured protocol with a high level of nature engagement and involvement of multiple sensory processes with a waitlist control group. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Mental Health Wellness 1, Health Behavior, Environmental Exposure
- What is being tested?
- Structured Protocol of Nature Contact
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteChina
- Study dates
- 9 Dec 2019to 30 Jun 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- 18 years or older
- Cantonese speaking
- Full-time employment of The Education University of Hong Kong
Who cannot join
- NA
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Testing a New Protocol of Nature-based Intervention to Enhance Well-being: A Randomized Control Trial
The aim of the present study is to investigate the effectiveness of a nature-based intervention on adaptive psychological functioning. We compared a structured protocol with a high level of nature engagement and involvement of multiple sensory processes with a waitlist control group. We expected that participants in the structured protocol of nature contact will report higher levels of mental health and more positive work-related functioning immediately and three months after the interventions.
Read the detailed description
This study aims to test the associations of nature contact with multiple dimensions of psychological functioning. A total of 90 university employees were randomly assigned to spend their lunch breaks on a (1) 30-minute structured protocol of nature contact and a (2) control group for 10 consecutive weekdays. Psychological distress, psychological well-being, and work-related psychological outcomes were assessed at baseline (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
- Being tested
- Structured Protocol of Nature Contact
- Keywords
- nature-based intervention, restorative environments, psychological well-being, health promotion, lunch break
- Medical subject headings
- Health Behavior, Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Structured Protocol of Nature ContactBehavioural
This structured protocol was a 10-day nature-based program with high level of nature engagement and involvement of multiple sensory processes. The program was held in lunch breaks between 12:00 noon and 2:00 p.m. Each session consisted of 30 minutes in the Eco Garden of The Education University of Hong Kong. Activities of this program included walking, ecological photography, sketching butterflies, planting vegetables, drinking herbal tea, observing birds, and taking a nap in nature. Each activity corresponded to specific sensory pathways. For example, butterfly sketching is focused on the use of visual sense, whereas drinking herbal tea involved sense of taste, smell, and touch. Trainers with master's degrees in environmental education and rich experience in guiding ecological tours provided instructions and guidance to participants during the activities. Participants were also asked to pay attention to their surroundings and focus on their five senses during participation.
| Study group | Role | What they receive |
|---|---|---|
| Program Group | Experimental | This structured protocol was a 10-day nature-based program with high level of nature engagement and involvement of multiple sensory processes. The program was held in lunch breaks between 12:00 noon and 2:00 p.m. Each session consisted of 30 minutes in the Eco Garden of The Education University of Hong Kong. Activities of this program included walking, ecological photography, sketching butterflies, planting vegetables, drinking herbal tea, observing birds, and taking a nap in nature. Each activity corresponded to specific sensory pathways. For example, butterfly sketching is focused on the use of visual sense, whereas drinking herbal tea involved sense of taste, smell, and touch. Trainers with master's degrees in environmental education and rich experience in guiding ecological tours provided instructions and guidance to participants during the activities. Participants were also asked to pay attention to their surroundings and focus on their five senses during participation. Receives: Behavioral: Structured Protocol of Nature Contact |
| Waitlist control group | No intervention | Participants who were randomly assigned to the waitlist control group were instructed to spend their usual half-hour lunch break in the office for consecutive 10 weekdays. Also, the waitlist control group was told to wait for at least three months before they took part in the structured protocol of nature contact. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from baseline (T1) anxiety symptoms to post intervention (T2) and follow up (T3)
The Chinese version of the 7-item Generalized Anxiety Disorder (GAD-7) was used to measure anxiety symptoms at all time points. Participants rated each item on a 4-point scale ranging from 0 (not at all) to 3 (nearly every day) based on their experience in the past two weeks. Higher scores indicated greater severity of anxiety symptoms (range = 0-21).
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) depressive symptoms to post intervention (T2) and follow up (T3)
Depressive symptoms were measured using the Chinese version of the Patient Health Questionnaire-9 (PHQ-9) at T1, T2, and T3, respectively. Participants rated each item on a 4-point scale as in GAD-7. Higher scores indicate the greatest severity of the depressive symptoms (range 0-27).
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) perceived stress to post intervention (T2) and follow up (T3)
Perceived stress was assessed at all time points using the Chinese version of the 10-item Perceived Stress Scale (PSS-10). Participants reported their subjective stress in the past two weeks on a 5-point scale (0 = never, 4 = very often). Total scores ranged from 0 to 40, with higher scores indicating higher levels of perceived stress.
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) subjective well-being to post intervention (T2) and follow up (T3)
The WHO-Five Well-being Index (WHO-5) consisted of five positively worded items. Participants were asked to report the presence of the five positive mental states in the past 2 weeks on a 6-point scale ranging from 0 (at no time) to 5 (all of the time).
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) satisfaction with life to post intervention (T2) and follow up (T3)
Satisfaction with Life Scale (SWLS) was used to assess participants' well-being with regard to satisfaction and fulfillment of their current state on a 4-point scale (1 = strongly disagree, 4 = strongly agree). The five items were summed, with higher scores indicating higher life satisfaction (range = 5-20).
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) positive affect to post intervention (T2) and follow up (T3)
The 10-item positive affect subscale of Chinese Affect Scale (CAS-PA) assessed frequency of positive emotional experience in the past 2 weeks on a 5-point scale (0 = not at all, 4 = all the time).
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) burnout to post intervention (T2) and follow up (T3)
Burnout was measured using the Chinese version of the 14-item Maslach Burnout Inventory-General Survey (MBI-GS) at all time points. Participants rated how often they had different experiences of burnout in the past two weeks on a 7-point scale (0 = never, 6 = always). The scale consisted of five questions on emotional exhaustion, four on cynicism, and five on professional efficacy.
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Change from baseline (T1) work engagement to post intervention (T2) and follow up (T3)
The Chinese version of the 17-item Utrecht Work Engagement Scale (UWES) was used to assess vigor, dedication, and absorption at work at all time points. Participants indicated the frequency of these experiences at work in the past two weeks on a 7-point scale (0 = never, 6 = always).
Measured: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Mar 2022
- Study start9 Dec 2019
- Primary completion30 Jun 2021
- Study completion30 Jun 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mental Health Wellness 1Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 90 participants (actual)
Sponsor and investigators
- Lead sponsor
- Education University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hou Wai Kai, Education University of Hong Kong
- Investigators
- Wai Kai Hou, PhD, Principal investigator, The Education University of Hong Kong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05276245
- Sponsor's protocol ID
- 04465
- Other IDs
- 2019-2020-0191
- Status last verified
- Mar 2022
- First submitted
- 22 Feb 2022
- Last updated
- 11 Mar 2022
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) will be available on request.
Study at a glance
From the registry record, last updated by the sponsor on 11 Mar 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Testing a New Protocol of Nature-based Intervention to Enhance Well-being: A Randomized Control Trial
- ClinicalTrials.gov ID
- NCT05276245
- Acronym / sponsor ID
- 04465
- Keywords
- nature-based intervention, restorative environments, psychological well-being, health promotion, lunch break
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 90 participants (actual)
- Lead sponsor
- Education University of Hong KongUniversity, hospital or other
- Study start
- 9 Dec 2019 (actual)
- Primary completion
- 30 Jun 2021 (actual)
- Study completion
- 30 Jun 2021 (actual)
- First posted
- 11 Mar 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of the present study is to investigate the effectiveness of a nature-based intervention on adaptive psychological functioning. We compared a structured protocol with a high level of nature engagement and involvement of multiple sensory processes with a waitlist control group. We expected that participants in the structured protocol of nature contact will report higher levels of mental health and more positive work-related functioning immediately and three months after the interventions.
Detailed description
This study aims to test the associations of nature contact with multiple dimensions of psychological functioning. A total of 90 university employees were randomly assigned to spend their lunch breaks on a (1) 30-minute structured protocol of nature contact and a (2) control group for 10 consecutive weekdays. Psychological distress, psychological well-being, and work-related psychological outcomes were assessed at baseline (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Program Group | Experimental | Behavioral: Structured Protocol of Nature ContactThis structured protocol was a 10-day nature-based program with high level of nature engagement and involvement of multiple sensory processes. The program was held in lunch breaks between 12:00 noon and 2:00 p.m. Each session consisted of 30 minutes in the Eco Garden of The Education University of Hong Kong. Activities of this program included walking, ecological photography, sketching butterflies, planting vegetables, drinking herbal tea, observing birds, and taking a nap in nature. Each activity corresponded to specific sensory pathways. For example, butterfly sketching is focused on the use of visual sense, whereas drinking herbal tea involved sense of taste, smell, and touch. Trainers with master's degrees in environmental education and rich experience in guiding ecological tours provided instructions and guidance to participants during the activities. Participants were also asked to pay attention to their surroundings and focus on their five senses during participation. |
| Waitlist control group | No intervention | –Participants who were randomly assigned to the waitlist control group were instructed to spend their usual half-hour lunch break in the office for consecutive 10 weekdays. Also, the waitlist control group was told to wait for at least three months before they took part in the structured protocol of nature contact. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 18 years or older
- Cantonese speaking
- Full-time employment of The Education University of Hong Kong
Key exclusion criteria (1 listed)
- NA
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Structured Protocol of Nature ContactThis structured protocol was a 10-day nature-based program with high level of nature engagement and involvement of multiple sensory processes. The program was held in lunch breaks between 12:00 noon and 2:00 p.m. Each session consisted of 30 minutes in the Eco Garden of The Education University of Hong Kong. Activities of this program included walking, ecological photography, sketching butterflies, planting vegetables, drinking herbal tea, observing birds, and taking a nap in nature. Each activity corresponded to specific sensory pathways. For example, butterfly sketching is focused on the use of visual sense, whereas drinking herbal tea involved sense of taste, smell, and touch. Trainers with master's degrees in environmental education and rich experience in guiding ecological tours provided instructions and guidance to participants during the activities. Participants were also asked to pay attention to their surroundings and focus on their five senses during participation. | Behavioural | Program Group |
Primary outcome
Change from baseline (T1) anxiety symptoms to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
The Chinese version of the 7-item Generalized Anxiety Disorder (GAD-7) was used to measure anxiety symptoms at all time points. Participants rated each item on a 4-point scale ranging from 0 (not at all) to 3 (nearly every day) based on their experience in the past two weeks. Higher scores indicated greater severity of anxiety symptoms (range = 0-21).
Change from baseline (T1) depressive symptoms to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Depressive symptoms were measured using the Chinese version of the Patient Health Questionnaire-9 (PHQ-9) at T1, T2, and T3, respectively. Participants rated each item on a 4-point scale as in GAD-7. Higher scores indicate the greatest severity of the depressive symptoms (range 0-27).
Change from baseline (T1) perceived stress to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Perceived stress was assessed at all time points using the Chinese version of the 10-item Perceived Stress Scale (PSS-10). Participants reported their subjective stress in the past two weeks on a 5-point scale (0 = never, 4 = very often). Total scores ranged from 0 to 40, with higher scores indicating higher levels of perceived stress.
Change from baseline (T1) subjective well-being to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
The WHO-Five Well-being Index (WHO-5) consisted of five positively worded items. Participants were asked to report the presence of the five positive mental states in the past 2 weeks on a 6-point scale ranging from 0 (at no time) to 5 (all of the time).
Change from baseline (T1) satisfaction with life to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Satisfaction with Life Scale (SWLS) was used to assess participants' well-being with regard to satisfaction and fulfillment of their current state on a 4-point scale (1 = strongly disagree, 4 = strongly agree). The five items were summed, with higher scores indicating higher life satisfaction (range = 5-20).
Change from baseline (T1) positive affect to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
The 10-item positive affect subscale of Chinese Affect Scale (CAS-PA) assessed frequency of positive emotional experience in the past 2 weeks on a 5-point scale (0 = not at all, 4 = all the time).
Change from baseline (T1) burnout to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
Burnout was measured using the Chinese version of the 14-item Maslach Burnout Inventory-General Survey (MBI-GS) at all time points. Participants rated how often they had different experiences of burnout in the past two weeks on a 7-point scale (0 = never, 6 = always). The scale consisted of five questions on emotional exhaustion, four on cynicism, and five on professional efficacy.
Change from baseline (T1) work engagement to post intervention (T2) and follow up (T3)
Time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).
The Chinese version of the 17-item Utrecht Work Engagement Scale (UWES) was used to assess vigor, dedication, and absorption at work at all time points. Participants indicated the frequency of these experiences at work in the past two weeks on a 7-point scale (0 = never, 6 = always).
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Mar 2022.
- Individual participant dataSharing planned: No. Individual participant data (IPD) will be available on request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Wai Kai Hou, PhD principal investigator
The Education University of Hong Kong
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Structured Protocol of Nature Contact in people with Mental Health Wellness 1 and Health Behavior, run by Education University of Hong Kong at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from baseline (T1) anxiety symptoms to post intervention (T2) and follow up (T3) (time frame: Before the intervention (T1), the day after the 10-day intervention (T2), and three months after the intervention (T3).). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Mar 2022.