Depressive SymptomsNCT06989801
Benefits of Outdoor Walks in Reducing Depressive Symptoms
A study testing Urban Walk, Nature Walk and Active Nature Walk in people with Depressive Symptoms, run by University of Washington at 2 sites in United States.
Trial summary
The goal of this clinical trial is to determine whether outdoor walking in different environments-urban or natural-can reduce depressive symptoms among college students. The study also tests whether providing prompts for active engagement during nature walks enhances the benefits compared to unstructured nature walks. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Depressive Symptoms
- What is being tested?
- Urban Walk, Nature Walk and Active Nature Walk
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 138 participants
- Where
- 2 sitesUnited States
- Study dates
- 11 Apr 2025to 27 Dec 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 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- College students in Seattle
- Aged over 18.
- Having depressive symptoms with self-rated Patient Health Questionnaire-9 (PHQ-9) scored higher than 5.
- Normal or corrected-to-normal visual acuity.
- No identified hearing impairment.
- No history of neurological or mental disorders.
Who cannot join
- Receiving clinical psychiatric treatment or psychological counseling.
- Failing in providing consent form.
Trial locations and contacts
2 sites in 1 country.
United States2 sites
Condon Hall
Seattle, Washington, 98105
Merrill Hall
Seattle, Washington, 98105
About this study
Official title: Benefits of a Nature Walk vs. an Urban Walk in Reducing Depressive Symptoms: A Randomized Controlled Study Among College Students
The goal of this clinical trial is to determine whether outdoor walking in different environments-urban or natural-can reduce depressive symptoms among college students. The study also tests whether providing prompts for active engagement during nature walks enhances the benefits compared to unstructured nature walks.
Participants will be randomly assigned to one of three groups: (1) urban walk, (2) nature walk, or (3) active nature walk with guided interaction. Each participant will walk for 30 minutes, twice a week, for 3 weeks, complete questionnaires, and participate in interviews.
Read more
Our primary outcome (PHQ-9) will be used to test the following two primary hypotheses:
- Hypothesis 1: Participants in both nature walk conditions (combined) will show greater reductions in depressive symptoms (PHQ-9) than those in the urban walk group.
- Hypothesis 2: Participants in the active nature walk will show greater reductions than those in the regular nature walk.
Read the detailed description
The investigators aim to compare how walking in different outdoor environments influences depressive symptoms among college students. Specifically, the investigators will assess:
- walking in an urban environment (like a busy city street),
- walking in a natural environment regularly (e.g., walking without specific guidance), and
- walking in a natural environment with guided interaction prompts (e.g., noticing birds, listening to sounds, touching flowers).
Standardized questionnaires will measure changes in depressive symptoms, anxiety, affect, cognitive flexibility, nature connection, and Presence across all three groups.
The investigators will also explore potential mechanisms behind any observed effects, including interaction patterns, presence, cognitive changes, and emotional responses to the different environments.
- Conditions
- Depressive Symptoms
- Being tested
- Urban Walk, Nature Walk, Active Nature Walk
- Medical subject headings
- Depression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Urban WalkBehavioural
For each session, participants will take a 30-minute walk in an urban environment along a designated looped route. They will walk at a comfortable pace and follow the assigned path. During the walk, participants will be instructed to experience their surroundings as naturally as possible. No specific activities beyond walking are required.
To fully immerse in the experience, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the GPS app recording throughout the walk without interacting with it-just allow it to run in the background.
Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience.
Nature WalkBehavioural
For each session, participants will take a 30-minute walk in a natural environment along a designated looped route. They will walk at a comfortable pace and follow the assigned path. During the walk, participants will be instructed to experience their surroundings as naturally as possible. No specific activities beyond walking are required.
To fully immerse in the experience, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the Gaia GPS app recording throughout the walk without interacting with it-just allow it to run in the background.
Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience.
Active Nature WalkBehavioural
For each session, participants will take a 30-minute walk in a natural area, following a designated looped route. Unlike a regular walk, participants will be encouraged to engage with nature (e.g., listening to natural sounds, looking for birds, and touching flowers).
To make the most of the walk, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the Gaia GPS app recording throughout the walk without interacting with it-just letting it run in the background.
Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience.
| Study group | Role | What they receive |
|---|---|---|
| Urban Walk | Active comparator | Regular walks in an urban area, 30 minutes twice a week for 3 weeks. Receives: Behavioral: Urban Walk |
| Nature Walk | Experimental | Regular walks in a natural area, 30 minutes twice a week for 3 weeks. Receives: Behavioral: Nature Walk |
| Active Nature Walk | Experimental | Regular walks in a natural area, 30 minutes twice a week for 3 weeks. Prior to the walk, participants will be instructed to actively interact with the natural environment. Receives: Behavioral: Active Nature Walk |
What is being measured
The primary outcome is the main question the study is designed to answer.
Patient Health Questionnaire
Patient Health Questionnaire measures the severity of depressive symptoms. It includes nine items that evaluate symptoms such as persistent sad, loss of interest or pleasure in activities, fatigue, and lack of energy. Each item is rated on a 4-point Likert scale, ranging from 0 (not at all) to 3 (nearly every day). Higher scores indicate more severe symptoms of depression.
Measured: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Secondary outcomes (5)
Generalized Anxiety Disorder 7-item scale
Generalized Anxiety Disorder 7-item scale measures the severity of anxiety. It includes seven items, such as persistent nervousness, excessive worrying, difficulty relaxing, feeling restless, and becoming easily irritated. Each item is rated on a 4-point Likert scale, ranging from 0 (not at all) to 3 (nearly every day). Higher scores indicate more severe anxiety.
Measured: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Positive and Negative Affect Scale
Positive and Negative Affect Scale measures positive and negative affect. The scale consists of 20 items, with 10 assessing positive affect (e.g., "passionate," "excited") and 10 assessing negative affect (e.g., "distressed," "upset"). Participants rated how strongly they experienced each emotion on a 5-point Likert scale, from 1 (very slightly or not at all) to 5 (very strongly).
Measured: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Cognitive Flexibility Inventory
Cognitive Flexibility Inventory measures individuals' ability to adapt to changing situations and consider multiple perspectives. Participants rated each item on a 5-point Likert scale, ranging from 1 (never) to 5 (always). Higher scores indicate greater cognitive flexibility.
Measured: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Extended Inclusion of Nature in Self scale
Extended Inclusion of Nature in Self scale measures individuals' perceived connection with nature, which refers to the degree to which individuals incorporate nature into their self-concept. Each item consists of seven pictures, scored on a 7-point scale, with higher scores indicating a stronger connection to nature.
Measured: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Presence Scale
Presence Scale measures the state of being in which conditioned thinking ceases, and the mind is open, aware, non-reactive, and still; and often a witness of itself. Participants rated each item on a 7-point Likert scale, ranging from 1 (not at all) to 7 (completely). Higher scores indicate higher levels of Presence.
Measured: Immediately after each walking session.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 May 2025
- Study start11 Apr 2025
- Primary completion17 Dec 2025
- Study completion27 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Depressive SymptomsStudies of the same condition, open and under way.
- More trials run by University of WashingtonThe 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
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 138 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Washington
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Xuanyi Wang, University of Washington
- Investigators
- Xuanyi Wang, Principal investigator, University of Washington
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06989801
- Sponsor's protocol ID
- STUDY00022242
- Status last verified
- Apr 2026
- First submitted
- 11 Apr 2025
- Last updated
- 4 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 4 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Benefits of a Nature Walk vs. an Urban Walk in Reducing Depressive Symptoms: A Randomized Controlled Study Among College Students
- ClinicalTrials.gov ID
- NCT06989801
- Acronym / sponsor ID
- STUDY00022242
- Conditions
- Depressive Symptoms
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 138 participants (actual)
- Lead sponsor
- University of WashingtonUniversity, hospital or other
- Study start
- 11 Apr 2025 (actual)
- Primary completion
- 17 Dec 2025 (actual)
- Study completion
- 27 Dec 2025 (actual)
- First posted
- 25 May 2025 (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 goal of this clinical trial is to determine whether outdoor walking in different environments-urban or natural-can reduce depressive symptoms among college students. The study also tests whether providing prompts for active engagement during nature walks enhances the benefits compared to unstructured nature walks.
Participants will be randomly assigned to one of three groups: (1) urban walk, (2) nature walk, or (3) active nature walk with guided interaction. Each participant will walk for 30 minutes, twice a week, for 3 weeks, complete questionnaires, and participate in interviews.
Our primary outcome (PHQ-9) will be used to test the following two primary hypotheses:
- Hypothesis 1: Participants in both nature walk conditions (combined) will show greater reductions in depressive symptoms (PHQ-9) than those in the urban walk group.
- Hypothesis 2: Participants in the active nature walk will show greater reductions than those in the regular nature walk.
Detailed description
The investigators aim to compare how walking in different outdoor environments influences depressive symptoms among college students. Specifically, the investigators will assess:
- walking in an urban environment (like a busy city street),
- walking in a natural environment regularly (e.g., walking without specific guidance), and
- walking in a natural environment with guided interaction prompts (e.g., noticing birds, listening to sounds, touching flowers).
Standardized questionnaires will measure changes in depressive symptoms, anxiety, affect, cognitive flexibility, nature connection, and Presence across all three groups.
The investigators will also explore potential mechanisms behind any observed effects, including interaction patterns, presence, cognitive changes, and emotional responses to the different environments.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Urban Walk | Active comparator | Behavioral: Urban WalkRegular walks in an urban area, 30 minutes twice a week for 3 weeks. |
| Nature Walk | Experimental | Behavioral: Nature WalkRegular walks in a natural area, 30 minutes twice a week for 3 weeks. |
| Active Nature Walk | Experimental | Behavioral: Active Nature WalkRegular walks in a natural area, 30 minutes twice a week for 3 weeks. Prior to the walk, participants will be instructed to actively interact with the natural environment. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- College students in Seattle
- Aged over 18.
- Having depressive symptoms with self-rated Patient Health Questionnaire-9 (PHQ-9) scored higher than 5.
- Normal or corrected-to-normal visual acuity.
- No identified hearing impairment.
Key exclusion criteria (2 listed)
- Receiving clinical psychiatric treatment or psychological counseling.
- Failing in providing consent form.
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 |
|---|---|---|
| Urban WalkFor each session, participants will take a 30-minute walk in an urban environment along a designated looped route. They will walk at a comfortable pace and follow the assigned path. During the walk, participants will be instructed to experience their surroundings as naturally as possible. No specific activities beyond walking are required. To fully immerse in the experience, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the GPS app recording throughout the walk without interacting with it-just allow it to run in the background. Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience. | Behavioural | Urban Walk |
| Nature WalkFor each session, participants will take a 30-minute walk in a natural environment along a designated looped route. They will walk at a comfortable pace and follow the assigned path. During the walk, participants will be instructed to experience their surroundings as naturally as possible. No specific activities beyond walking are required. To fully immerse in the experience, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the Gaia GPS app recording throughout the walk without interacting with it-just allow it to run in the background. Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience. | Behavioural | Nature Walk |
| Active Nature WalkFor each session, participants will take a 30-minute walk in a natural area, following a designated looped route. Unlike a regular walk, participants will be encouraged to engage with nature (e.g., listening to natural sounds, looking for birds, and touching flowers). To make the most of the walk, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the Gaia GPS app recording throughout the walk without interacting with it-just letting it run in the background. Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience. | Behavioural | Active Nature Walk |
Primary outcome
Patient Health Questionnaire
Time frame: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Patient Health Questionnaire measures the severity of depressive symptoms. It includes nine items that evaluate symptoms such as persistent sad, loss of interest or pleasure in activities, fatigue, and lack of energy. Each item is rated on a 4-point Likert scale, ranging from 0 (not at all) to 3 (nearly every day). Higher scores indicate more severe symptoms of depression.
5 secondary outcomes
Generalized Anxiety Disorder 7-item scale
Time frame: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Positive and Negative Affect Scale
Time frame: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Cognitive Flexibility Inventory
Time frame: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Extended Inclusion of Nature in Self scale
Time frame: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.
Presence Scale
Time frame: Immediately after each walking session.
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 4 May 2026.
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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.
Xuanyi Wang principal investigator
University of Washington
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Urban Walk, Nature Walk and Active Nature Walk in people with Depressive Symptoms, run by University of Washington at 2 sites 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 6 inclusion and 2 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 4 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites 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?
Patient Health Questionnaire (time frame: Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.). 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 4 May 2026.