Holistic Care in the Us Military I—-The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001—2012

Foote, Frederick O.; Bulger, Roger J.; Frampton, Susan B.; Pellegrino, Edmund D.

doi:10.7453/gahmj.2012.1.2.010

Cited by 3 publications

(5 citation statements)

References 19 publications

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“…NSA/B expanded significantly with the 2005 closure/merger the National Naval Medical Center and Walter Reed Army Medical Center. Concurrently, efforts have been underway to leverage evidence-based design principles (Casscells, Kurmel & Ponatoski, 2009) to make NSA/B a patient-centered environment that fosters holistic healing and welcomes patients and their families (Foote, 2012;Foote et al, 2012). One relevant approach for this is to create intentional green spaces with implicit and explicit invitations to relax, reflect, and enjoy.…”

Section: Introductionmentioning

confidence: 99%

A nature-based health intervention at a military healthcare center: a randomized, controlled, cross-over study

Ameli

Skeath²,

Abraham

et al. 2021

PeerJ

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We describe a mixed qualitative and quantitative research study in a military facility regarding the role of nature in well-being. Study intervention included two 20-minute walks. One walk was in an intentionally designed woodland environment (Green Road) and the other was on a busy campus road in a medical treatment facility (Urban Road). Twelve volunteers from a military facility participated in both walks in a cross-over experimental design. The two walking sessions were randomly ordered and preceded by pre-walk instructions appropriate to each road’s characteristics and incorporated focused attention and present moment orientation. A semi-structured post-walk interview, the primary outcome, was conducted after the conclusion of each walk. Qualitative data analyses consisted of sentiments and themes by using NVivo 12 software. The Green Road was unanimously rated as positive (100%). Responses to Urban Road were evenly distributed among positive (33.3%), negative (33.3%), and neutral/mixed (33.3%) sentiments. The Green Road yielded predominantly positive themes such as enjoyment of nature, relaxation, and feelings of privacy and safety. Urban Road produced significantly more negative themes such as concerns for safety, dislike of noise and other noxious experiences. Quantitative assessment of distress and mindfulness with Distress Thermometer (DT) and Mindful Attention Awareness Scale-state version (MAAS) demonstrated that a walk on the Green Road significantly decreased distress and increased mindfulness compared to a walk on the Urban Road. We also observed that pre-walk instructions could direct attention to both obvious and subtle elements of experience and enhance awareness. Results support the notion that an intentional nature-based environment may produce significantly more positive experiences and result in health-promoting benefits in a military health-care setting compared to an urban environment. Future studies with clinical populations could advance our understanding of the healing value of nature-based interventions. The impact of intentional green environments may be enhanced by well-designed instructions for both recreational and therapeutic use.

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Section: Introductionmentioning

confidence: 99%

A nature-based health intervention at a military healthcare center: a randomized, controlled, cross-over study

Ameli

Skeath²,

Abraham

et al. 2021

PeerJ

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“…A previous report has described the Epidaurus Project, an initiative to create holistic (or whole-body) therapies in the Military Health System (MHS) from 2001 to 2016. 1 , 2 Its method was to leverage the ideas of America’s leading clinicians, architects, and healthcare administrators (developed via a series of working groups) in the creation of the Walter Reed National Military Medical Center (WRNMMC), Bethesda, MD, the military’s new “flagship” academic medical center. The large number of wounded warriors with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) made holistic therapies an important agenda at that time.…”

Section: Introductionmentioning

confidence: 99%

“…3 – 6 Accordingly, the new WRNMMC became a center for innovation and application of new holistic therapies that might potentially benefit those with TBI/PTSD. 1 , 2 …”

Section: Introductionmentioning

confidence: 99%

“…Holistic therapies are defined as any modality that treats the entire body, rather than a single organ system. 2 Through the Epidaurus Project and other military initiatives, more than a dozen holistic medicine initiatives were successfully developed and launched at WRNMMC and the associated Fort Belvoir Community Hospital, Fort Belvoir, VA. Modalities ranged from healing buildings and family-centered care to healing via the arts and nature (see Table 1 ). Initial research from many of these programs has shown success in meliorating military TBI/PTSD by using standard organ-system metrics.…”

Section: Introductionmentioning

confidence: 99%

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Advanced Metrics for Assessing Holistic Care: The “Epidaurus 2” Project

Foote

Benson

Berger

et al. 2018

Glob Adv Health Med

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In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the “Epidaurus 2” Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and “Star Glyphs.” This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine.

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Section: Introductionmentioning

confidence: 99%

Supplemental Information 5: Raw Numeric Data (for Table 4)

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Holistic Care in the Us Military I—-The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001—2012

Cited by 3 publications

References 19 publications

A nature-based health intervention at a military healthcare center: a randomized, controlled, cross-over study

A nature-based health intervention at a military healthcare center: a randomized, controlled, cross-over study

Advanced Metrics for Assessing Holistic Care: The “Epidaurus 2” Project

Supplemental Information 5: Raw Numeric Data (for Table 4)

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