Chronic DiseaseNCT06001697
Nature and Health: How Does Lifestyle and Environment Affect Health and Wellness
A study testing Park prescription and Regular health advice in people with Chronic Disease and Risk Reduction, run by Stanford University at 1 site in United States.
Trial summary
The purpose of this study is to examine if and how implementing nature prescriptions can increase time in nature and improve health to yield an actionable understanding of the nature-health connection. It aims to explore how public green spaces can be better used to improve individual and community health. Read more about this study
- Who is it for?
- Ages 13 to 65 years
- Conditions the study is for
- Chronic Disease, Risk Reduction, Mental Health Wellness 1
- What is being tested?
- Park prescription and Regular health advice
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 134 participants
- Where
- 1 siteUnited States
- Study dates
- 18 Dec 2023to 23 Apr 2025
- 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 13 to 65 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Participants must be a patient of the AHN Forbes Family Medicine clinic.
- Participants must have one or more chronic conditions, or significant lifestyle risks as identified by their healthcare provider.
- Participants must be between 13-65 years old.
- Participants must be willing and able to provide informed consent to participate
- Participants under 18 must be willing and able to assent for themselves and obtain parental consent.
- Participants must be willing to comply with all study procedures for the duration of the study.
Show all 13Show fewer
- Participants must reside in the greater Pittsburgh area for the duration of 6-month study.
- Participants must have a smartphone that is capable of running the Urban Mind App and connecting to the Garmin wearable device (iPhone 6 and newer as well as most Android phones).
- Minors who participate must have their own smartphone.
- Participants must have their own email address to register with the Urban Mind App and the Garmin App.
- Only one participant from a household may enroll in the study.
- Participants must be able to comprehend written English (questionnaires will be provided to participants in English).
- Participants may not be an employee of Forbes Family Medicine clinic
Who cannot join
- None, must meet all inclusion criteria.
Trial locations and contacts
1 site in 1 country.
United States1 site
Forbes Family Medicine/AHN Research Institute
Monroeville, Pennsylvania, 15146
About this study
The purpose of this study is to examine if and how implementing nature prescriptions can increase time in nature and improve health to yield an actionable understanding of the nature-health connection. It aims to explore how public green spaces can be better used to improve individual and community health. Finally, this study aims to advance science by conducting a randomized controlled trial to improve understanding of the linkages between time in nature and human health.
Read the detailed description
The investigators will conduct a randomized controlled trial in which physicians prescribe time in nature as an intervention to the study group. In total a goal of 240 patients will be recruited, including both children (13+) and adults. 120 of them will be assigned to the study group and 120 to the assigned to the control group. All study participants will be provided with a Global Positioning System (GPS)-enabled wearable device (Garmin Vivosmart 5) that is able to measure their activity levels, location, and additional health-related metrics, such as heart rate. All participants will be asked to provide information about their health and well-being through survey instruments and electronic health records. Both groups (intervention and control) will receive regular health advice targeting lifestyle factors associated with risk of chronic diseases. The treatment group will additionally receive a park prescription with information about the benefits of spending time in nature. They will also received a specified target amount of time to spend in nature, along with frequency of visits and recommended locations (e.g., specific parks), and information about parks and programming in the study area. Participants will also be asked to answer brief questions regarding their mental and physical health, as well as their physical excercise patterns every 72-hours through a research-grade smartphone app called Urban Mind over the course of this study. At baseline and end of study at 6-months the participants will also answer questionnaires that will assess their mental and physical health, as well as lifestyle factors such as physical activity, sleep, stress and exposure to nature. These questionnaires will be administered through the REDCap survey system.
- Conditions
- Chronic Disease, Risk Reduction, Mental Health Wellness 1, Physical Inactivity, Sleep, Depression
- Being tested
- Park prescription, Regular health advice
- Keywords
- Nature, Park prescription, Mental health, Physical health, Chronic disease, Lifestyle
- Medical subject headings
- Chronic Disease, Risk Reduction Behavior, Sedentary Behavior, Depression, Anxiety Disorders, Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Park prescriptionBehavioural
The park prescription given by the patients care-provider includes information about the health benefits of spending time in nature and detailed information about the parks in the neighboring area. As well as access to a web-based platform called ParkRx which includes information and details about events in the parks in the study area. Together with information about the frequency and duration of visits to the parks.
Regular health adviceBehavioural
Regular health advice relating to lifestyle factors that can decrease the risk of chronic disease and/or reducing the burden of an existing chronic disease. Areas included are diet, physical activity, sleep, stress and medications.
| Study group | Role | What they receive |
|---|---|---|
| Intervention | Experimental | The treatment group will receive information regarding wellness factors by the doctor (health advice) and they will be asked to follow those recommendations for the duration of the study. In addition they will also receive a park prescription specifying a target amount of time to spend in nature, along with frequency of visits and recommended locations (e.g., specific parks), and information about parks and programming in the study area. Receives: Behavioral: Park prescription; Behavioral: Regular health advice |
| Control | Other | The control group will receive regular health advice and information regarding wellness factors by the doctor and they will be asked to follow those recommendations for the duration of the study. Receives: Behavioral: Regular health advice |
What is being measured
The primary outcome is the main question the study is designed to answer.
Nature Exposure Scale II (NES-II)
Assess each participant's exposure to nature in everyday life. The Nature Exposure Scale II uses a 5-point likert scale for each item. Higher score means greater exposure to nature. The total score is an average of all the items included.
Measured: Baseline and 6-months
Secondary outcomes (12)
CDC Health related quality of life - 14 (CDC-HRQOL-14)
The Health related quality of life scale rates an individual's perceived physical and mental health over time. The main outcome score is the unhealthy days index, computed by adding a respondent's physically and mentally unhealthy days. Score goes from 0-30 where higher is worse.
Measured: Baseline and 6-months
Brief-Pittsburgh Sleep Quality Index (B-PSQI)
Brief-Pittsburgh Sleep Quality Index assesses an individuals perceived sleep quality. The questionnaires contains 6 items and the total score ranges from 0-15 where higher scores indicate worse sleep.
Measured: Baseline and 6-months
Perceived Stress Scale (PSS-10)
The Perceived Stress Scale is a measure of an individuals perceived stress levels. 10-items with scoring from 0-4 were higher is higher levels of perceived stress (worse). Total score is obtained by summing across all items.
Measured: Baseline and 6-months
International Physical Activity Questionnaire Short form (IPAQ-S)
The International Physical Activity Questionnaire - Short Form rates an individuals physical activity levels and types of exercise. The questionnaire consists of 7 items that measures days physically active as well as duration. Scores will calculated as categorical low/medium/high where higher is more active (1-3). And continuous by calculating metabolic equivalent of task (MET) minutes for a week MET-minutes/week where higher is better. 0-10000
Measured: Baseline and 6-months
Patient Health Questionnaire (PHQ-8/PHQ-A)
The Patient Health Questionnaire is a scale for measuring depression in adults. The scale has 8 items and the scores ranges from 0-3. The total score ranges from 0-24 where higher is more depression (worse). The Patient Health Questionnaire - Adolescence measures depression in teens (PHQ-A). The scale consists of 9 items and scores from 0-3 and a total score of 27. Where higher scores is worse (more depression).
Measured: Baseline and 6-months
General Anxiety Disorder (GAD-7)
The General Anxiety Disorder questionnaire is a scale for measuring levels of anxiety in individuals. The scale has 7 items and each items is scored 0-3 where the total score ranges from 0-21 where higher is worse (more anxiety).
Measured: Baseline and 6-months
Step count
Daily step count measured through the Garmin Vivosmart 5. Steps measured is day can range from 0 to unlimited where higher steps is considered better (more physical activity). Total steps will be averaged by days to calculate an average steps per days.
Measured: From study start until study end (6 months)
Green view index
Individuals nature exposure level measured through their GPS trajectories and Google Street View (GSV) images. Higher scores is better (more green space exposure).
Measured: From study start until study end (6 months)
Urban Mind mental health assessment
Scores of the mental health assessment taken every 72-hours. The Urban Mind mental health assessment consists of one question which rates mental health from 1-5 where higher is better (poor/fair/good/very good/excellent). The total score will be the average score per day.
Measured: From study start until study end (6 months)
Urban Mind physical health assessment
Scores of the physical health assessment taken every 72-hours. The Urban Mind physical health assessment consists of one question which rates physical health from 1-5 where higher is better (poor/fair/good/very good/excellent). The total score will be the average score per day.
Measured: From study start until study end (6 months)
Urban Mind physical activity assessment
Scores of the physical activity assessment taken every 72-hours. The Urban Mind physical activity assessment consists of one question which rates physical activity in minutes by increments where higher is better (None/<10/10-30/30-60/60-120/>120. The categories are converted into likert scale scores 1-6 and the total score is the average score.
Measured: From study start until study end (6 months)
Urban Mind nature exposure assessment
Scores of the nature exposure assessment taken every 72-hours. The Urban Mind nature exposure assessment consists of one question which rates nature exposure in minutes by increments where higher is better (None/<10/10-30/30-60/60-120/>120. The categories are converted into likest scale scores 1-6 and the total score is the average score.
Measured: From study start until study end (6 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Aug 2023
- Study start18 Dec 2023
- Primary completion23 Apr 2025
- Study completion23 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic DiseaseStudies of the same condition, open and under way.
- More trials run by Stanford UniversityThe sponsor's other registered studies.
- 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
- Model description
- In total a goal of 240 patients will be recruited and randomised in a 1:1 ration to either the intervention or control group. This means 120 of them will be assigned to the study group and 120 to the assigned to the control group. The intervention group will receive health advice and a park prescription by their health care provider while the control group will receive regular health advice regarding lifestyle.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 134 participants (actual)
Sponsor and investigators
- Lead sponsor
- Stanford University
- Sponsor type
- University, hospital or other
- Collaborators
- Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute), Richard King Mellon Foundation
- Responsible party
- Principal investigator, Gretchen Daily, Stanford University
- Investigators
- Gretchen Daily, PhD, Principal investigator, Stanford University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06001697
- Sponsor's protocol ID
- 72478
- Status last verified
- May 2025
- First submitted
- 14 Aug 2023
- Last updated
- 6 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Nature and Health: How Does Lifestyle and Environment Affect Health and Wellness
- ClinicalTrials.gov ID
- NCT06001697
- Acronym / sponsor ID
- 72478
- Conditions
- Chronic Disease, Risk Reduction, Mental Health Wellness 1, Physical Inactivity, Sleep, Depression
- Keywords
- Nature, Park prescription, Mental health, Physical health, Chronic disease, Lifestyle
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 134 participants (actual)
- Lead sponsor
- Stanford UniversityUniversity, hospital or other
- Collaborators
- Allegheny Singer Research Institute (also known as Allegheny Health Network Research Institute), Richard King Mellon Foundation
- Study start
- 18 Dec 2023 (actual)
- Primary completion
- 23 Apr 2025 (actual)
- Study completion
- 23 Apr 2025 (actual)
- First posted
- 21 Aug 2023 (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 purpose of this study is to examine if and how implementing nature prescriptions can increase time in nature and improve health to yield an actionable understanding of the nature-health connection. It aims to explore how public green spaces can be better used to improve individual and community health. Finally, this study aims to advance science by conducting a randomized controlled trial to improve understanding of the linkages between time in nature and human health.
Detailed description
The investigators will conduct a randomized controlled trial in which physicians prescribe time in nature as an intervention to the study group. In total a goal of 240 patients will be recruited, including both children (13+) and adults. 120 of them will be assigned to the study group and 120 to the assigned to the control group. All study participants will be provided with a Global Positioning System (GPS)-enabled wearable device (Garmin Vivosmart 5) that is able to measure their activity levels, location, and additional health-related metrics, such as heart rate. All participants will be asked to provide information about their health and well-being through survey instruments and electronic health records. Both groups (intervention and control) will receive regular health advice targeting lifestyle factors associated with risk of chronic diseases. The treatment group will additionally receive a park prescription with information about the benefits of spending time in nature. They will also received a specified target amount of time to spend in nature, along with frequency of visits and recommended locations (e.g., specific parks), and information about parks and programming in the study area. Participants will also be asked to answer brief questions regarding their mental and physical health, as well as their physical excercise patterns every 72-hours through a research-grade smartphone app called Urban Mind over the course of this study. At baseline and end of study at 6-months the participants will also answer questionnaires that will assess their mental and physical health, as well as lifestyle factors such as physical activity, sleep, stress and exposure to nature. These questionnaires will be administered through the REDCap survey system.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- In total a goal of 240 patients will be recruited and randomised in a 1:1 ration to either the intervention or control group. This means 120 of them will be assigned to the study group and 120 to the assigned to the control group. The intervention group will receive health advice and a park prescription by their health care provider while the control group will receive regular health advice regarding lifestyle.
| Arm | Type | Receives |
|---|---|---|
| Intervention | Experimental | Behavioral: Park prescription, Behavioral: Regular health adviceThe treatment group will receive information regarding wellness factors by the doctor (health advice) and they will be asked to follow those recommendations for the duration of the study. In addition they will also receive a park prescription specifying a target amount of time to spend in nature, along with frequency of visits and recommended locations (e.g., specific parks), and information about parks and programming in the study area. |
| Control | Other | Behavioral: Regular health adviceThe control group will receive regular health advice and information regarding wellness factors by the doctor and they will be asked to follow those recommendations for the duration of the study. |
Who may qualify
- Ages
- 13 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (13 listed)
- Participants must be a patient of the AHN Forbes Family Medicine clinic.
- Participants must have one or more chronic conditions, or significant lifestyle risks as identified by their healthcare provider.
- Participants must be between 13-65 years old.
- Participants must be willing and able to provide informed consent to participate
- Participants under 18 must be willing and able to assent for themselves and obtain parental consent.
Key exclusion criteria (1 listed)
- None, must meet all inclusion criteria.
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 |
|---|---|---|
| Park prescriptionThe park prescription given by the patients care-provider includes information about the health benefits of spending time in nature and detailed information about the parks in the neighboring area. As well as access to a web-based platform called ParkRx which includes information and details about events in the parks in the study area. Together with information about the frequency and duration of visits to the parks. | Behavioural | Intervention |
| Regular health adviceRegular health advice relating to lifestyle factors that can decrease the risk of chronic disease and/or reducing the burden of an existing chronic disease. Areas included are diet, physical activity, sleep, stress and medications. | Behavioural | Control, Intervention |
Primary outcome
Nature Exposure Scale II (NES-II)
Time frame: Baseline and 6-months
Assess each participant's exposure to nature in everyday life. The Nature Exposure Scale II uses a 5-point likert scale for each item. Higher score means greater exposure to nature. The total score is an average of all the items included.
12 secondary outcomes
CDC Health related quality of life - 14 (CDC-HRQOL-14)
Time frame: Baseline and 6-months
Brief-Pittsburgh Sleep Quality Index (B-PSQI)
Time frame: Baseline and 6-months
Perceived Stress Scale (PSS-10)
Time frame: Baseline and 6-months
International Physical Activity Questionnaire Short form (IPAQ-S)
Time frame: Baseline and 6-months
Patient Health Questionnaire (PHQ-8/PHQ-A)
Time frame: Baseline and 6-months
General Anxiety Disorder (GAD-7)
Time frame: Baseline and 6-months
Step count
Time frame: From study start until study end (6 months)
Green view index
Time frame: From study start until study end (6 months)
Urban Mind mental health assessment
Time frame: From study start until study end (6 months)
Urban Mind physical health assessment
Time frame: From study start until study end (6 months)
Urban Mind physical activity assessment
Time frame: From study start until study end (6 months)
Urban Mind nature exposure assessment
Time frame: From study start until study end (6 months)
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 6 May 2025.
- Individual participant dataSharing planned: No
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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.
Gretchen Daily, PhD principal investigator
Stanford University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Park prescription and Regular health advice in people with Chronic Disease and Risk Reduction, run by Stanford University at 1 site in United States.
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 13 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 6 May 2025. 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 United States. 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?
Nature Exposure Scale II (NES-II) (time frame: Baseline and 6-months). 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 6 May 2025.