Abstract
This study investigated the efficacy of medium-term Green Exercise (GE; being physically active within a natural environment) interventions for improving wellbeing, by pooling data collected at the start and end of participants’ engagement with a range of GE interventions. Hypotheses were that (i) interventions would show good efficacy for improving wellbeing in the overall sample; (ii) compared to participants reporting ‘average to high’ wellbeing at the start of their project, participants with ‘low’ starting wellbeing would report greater improvements post-intervention; and (iii) improvements would significantly differ between age groups. The pooled dataset was categorized in line with UK norms (n = 318) and analyzed using a standardized meta-analysis approach. Effect size was large: g = 0.812 (95% CI [0.599, 1.025]), and differences in wellbeing changes associated with project duration, age or sex were not statistically significant. Compared to those reporting ‘average-high’ starting wellbeing, participants reporting ‘low’ starting wellbeing exhibited greater improvements (BCa 95% CI [−31.8, −26.5]), with 60.8% moving into the ‘average-high’ wellbeing category. GE can play an important role in facilitating wellbeing and can provide alternative pathways for health and social care practice. Public health commissioners should consider integrating such interventions for patients experiencing low wellbeing or associated comorbidities.
Highlights
The last decade has seen a growing number of studies evidencing the health and wellbeing benefits of ‘green exercise’ (GE; being physically active within a natural environment or greenspace), which provides greater physical and mental health benefits than physical activity (PA) or nature contact alone [1,2,3,4,5,6,7,8]
Tests of heterogeneity found that variation in effect size between projects was not statistically significant (p = 0.138); the calculated I2 value indicated that 40% of the observed variance in ∆ wellbeing scores between projects was due to real differences, with the remaining 60% due to sampling error, which represents low to moderate heterogeneity [36]
The difference in effect size reported in the current study and by Soga et al may be a function of Soga et al.: (a) including multiple health and wellbeing outcome measures, whereas the current study focused on one; (b) including studies from seven countries whereas the current study was entirely UK-based; (c) including projects attended by individuals who were experiencing more extreme health, wellbeing-related and learning issues, such as dementia and learning disabilities; and (d) including only horticulture activities whereas the current study included a range of Green Exercise (GE) activities
Summary
The last decade has seen a growing number of studies evidencing the health and wellbeing benefits of ‘green exercise’ (GE; being physically active within a natural environment or greenspace), which provides greater physical and mental health benefits than physical activity (PA) or nature contact alone [1,2,3,4,5,6,7,8]. GE reduces stress, depression and blood pressure, increases self-esteem, mood and wellbeing, and enhances heart rate variability. These benefits seem to be universally obtainable, with evidence of health and wellbeing improvements in children and adolescents [9], adults [1,2,3,4,5,6,7,8]. Vulnerable cohorts including disaffected youth [10], adults living with dementia [11] and those experiencing physical and/or mental ill-health such as post-traumatic stress disorders [12]. Wellbeing is important to health because it increases life expectancy, improves recovery from illness [13,14] and is associated with positive health behaviours. Public Health 2020, 17, 1526; doi:10.3390/ijerph17051526 www.mdpi.com/journal/ijerph
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