Shifting Gears: Engaging Nurse Practitioners in Prescribing Time Outdoors

Wessel, Lois

doi:10.1016/j.nurpra.2016.06.013

Cited by 11 publications

(10 citation statements)

References 12 publications

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“…The design of our built environment and the areas where people live, work, and play are directly related to the amount of time people spend outdoors [97]. The layout of our communities, transportation infrastructure, and access to parks and [98]. Our model ( Fig.…”

Section: Perceived Environmentmentioning

confidence: 99%

Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review

Leavell

Leiferman

Gascón

et al. 2019

Curr Envir Health Rpt

173

115

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Purpose of Review Recent reports of a "loneliness epidemic" in the USA are growing along with a robust evidence base that suggests that loneliness and social isolation can compromise physical and psychological health. Screening for social isolation among at-risk populations and referring them to nature-based community services, resources, and activities through a social prescribing (SP) program may provide a way to connect vulnerable populations with the broader community and increase their sense of connectedness and belonging. In this review, we explore opportunities for social prescribing to be used as a tool to address connectedness through nature-based interventions. Recent Findings Social prescribing can include a variety of activities linked with voluntary and community sector organizations (e.g., walking and park prescriptions, community gardening, farmers' market vouchers). These activities can promote nature contact, strengthen social structures, and improve longer term mental and physical health by activating intrapersonal, interpersonal, and environmental processes. The prescriptions are appropriate for reaching a range of high-risk populations including moms who are minors who are minors, recent immigrants, older adults, economically and linguistically isolated populations, and unlikely users of nature and outdoor spaces. Summary More research is needed to understand the impact of SPs on high-risk populations and the supports needed to allow them to feel at ease in the outdoors. Additionally, opportunities exist to develop technologically and socially innovative strategies to track patient participation in social prescriptions, monitor impact over time, and integrate prescribing into standard health care practice.

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Section: Perceived Environmentmentioning

confidence: 99%

Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review

Leavell

Leiferman

Gascón

et al. 2019

Curr Envir Health Rpt

173

115

View full text Add to dashboard Cite

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“…While many studies show a positive influence of nature exposure on health and well-being, there is little understanding about how much or in what form a nature experience (NE) should be for best effect. Healthcare providers in North America and Europe have begun to write nature prescriptions, often called “nature pills,” using common sense and interpretation of published research to motivate patients to take a nature break (James et al, 2017; Wessel, 2017). Likewise civic organizations and non-profits are emerging in support of the nature-well-being treatment such as the Mood Walks program in Canada 1 , the Nature Sacred program of the TKF Foundation 2 in the United States, the Dose of Nature project in the United Kingdom (Bloomfield, 2017), and the Coastrek program in Australia (Buckley et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers

2019

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Stress reduction through contact with nature is well established, but far less is known about the contribution of contact parameters – duration, frequency, and nature quality. This study describes the relationship between duration of a nature experience (NE), and changes in two physiological biomarkers of stress – salivary cortisol and alpha-amylase. It is the first study to employ long-term, repeated-measure assessment and the first evaluation wherein study participants are free to choose the time of day, duration, and the place of a NE in response to personal preference and changing daily schedules. During an 8-week study period, 36 urban dwellers were asked to have a NE, defined as spending time in an outdoor place that brings a sense of contact with nature, at least three times a week for a duration of 10 min or more. Their goal was compliance within the context of unpredictable opportunity for taking a nature pill. Participants provided saliva samples before and after a NE at four points over the study period. Before-NE samples established the diurnal trajectory of each stress indicator and these were in line with published outcomes of more closely controlled experiments. For salivary cortisol, an NE produced a 21.3%/hour drop beyond that of the hormone’s 11.7% diurnal drop. The efficiency of a nature pill per time expended was greatest between 20 and 30 min, after which benefits continued to accrue, but at a reduced rate. For salivary alpha-amylase, there was a 28.1%/h drop after adjusting for its diurnal rise of 3.5%/h, but only for participants that were least active sitting or sitting with some walking. Activity type did not influence cortisol response. The methods for this adaptive management study of nature-based restoration break new ground in addressing some complexities of measuring an effective nature dose in the context of normal daily life, while bypassing the limitations of a clinical pharmacology dose–response study. The results provide a validated starting point for healthcare practitioners prescribing a nature pill to those in their care. This line of inquiry is timely in light of expanding urbanization and rising healthcare costs.

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“…On the other hand, they are encouraged by the growing enthusiasm for prescribing nature‐based activities—e.g. care farming, horticultural therapy, and prescription trails—as a non‐medical referral option for general practitioners (Bragg & Leck, ; Wessel, ). Although sympathetic to the motivations underpinning such thinking, and based on the arguments presented in this paper, we suggest the need for caution in uncritically or universally prescribing these doses across the population without engaging with people's unique and relational embodied priorities.…”

Section: Discussionmentioning

confidence: 99%

“…Although sympathetic to the motivations underpinning such thinking, and based on the arguments presented in this paper, we suggest the need for caution in uncritically or universally prescribing these doses across the population without engaging with people's unique and relational embodied priorities. As noted by Wessel (), a key lesson from the US National Park Prescription Initiative (Park Rx) was the importance of developing and refining individualised plans over time, tailored to specific patient needs and interests.…”

Section: Discussionmentioning

confidence: 99%

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The “healthy dose” of nature: A cautionary tale

et al. 2018

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Growing cross‐disciplinary interest in understanding if, how, and why time spent with nature can contribute to human health and well‐being has recently prompted efforts to identify an ideal healthy dose of nature; exposure to a specific type of nature at a specified frequency and duration. These efforts build on longstanding attempts to prescribe nature in some way, most recently in the form of so‐called “green prescriptions.” In this critical discussion paper, we draw on key examples from within the fields of health and cultural geography to encourage deeper and more critical reflection on the value of such reductionist dose‐response frameworks. By foregrounding the relationally emergent qualities of people's dynamic nature encounters, we suggest such efforts may be both illusory and potentially exclusionary for the many individuals and groups whose healthy nature interactions diverge from the statistical average or “normal” way of being. We suggest value in working towards alternative more‐than‐human approaches to health and well‐being, drawing on posthumanist theories of social practice. We present two practice examples—beach‐going and citizen science—to demonstrate how a focus on social practices can better cater for the diverse and dynamic ways in which people come to conceptualise, embody, and interpret nature in their everyday lives. We close by reflecting on the wider societal transformations required to foster greater respect for embodied difference and diversity.

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Shifting Gears: Engaging Nurse Practitioners in Prescribing Time Outdoors

Cited by 11 publications

References 12 publications

Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review

Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review

Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers

The “healthy dose” of nature: A cautionary tale

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