The SHINE study is a randomized controlled study of the effect of a park-based family support group on multiple outcomes (including stress and physical activity) in a low income population.
Despite mounting evidence that nature matters for human health, we are not aware of any prospective intervention trials looking at the use of nature as a health intervention. Like other protective factors, such as the presence of a caring adult, safe play places, greater stimulation, the presence of green-space in a child's life has been empirically linked to greater resilience. Nature has been proposed as a buffer to stress through several pathways: by providing a space for friends and families to gather (thereby increasing social support and improving family relationships), by increasing opportunities for physical activity, and by improving cognition. Research to date suggests that participation in outdoor activities facilitates a sense of connectedness to place. This sense of attachment may also provide a form of social support. Families served by Children's Hospital Oakland Primary Care Clinic experience high levels of stress. As a safety-net clinic, the primary care clinic serves a diverse set of patients, with a common thread of poverty. The Stay Healthy In Nature program was developed to encourage stress management skills through play and physical activity in parks. The program uses a combination of facilitated and independent outings into local parks to encourage sustained behavior change and measurable health benefits.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
156
Participants will be invited to three weekly outings to local parks, case management and support in getting to nature. Participants will be offered transportation to the outings and s meal at local nature destinations. Programming at the park will include a picnic and walk with nature exploration, and will be facilitated by park and clinic staff.
Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature.
Participants will record their daily pedometry.
UCSF Benioff Children's Hospital Oakland Primary Care Clinic
Oakland, California, United States
Change in Stress
measured through the Perceived Stress Score10 (PSS10) over 0, 1 and 3 months. The PSS10 is a ten item, validated instrument which ranges from 0-40. Each item on the instrument is summed to create a total score. Higher values correspond with higher stress.
Time frame: 3 months
Change in Stress
measured through the Perceived Stress Score10 (PSS10), a ten item, validated instrument which ranges from 0-40.
Time frame: 1 month
Change in Park Visits Per Week
Self-reported number of park visits in the last week, measured at 0, 1, and 3 months.
Time frame: 1 month
Change in Minutes of Moderate Physical Activity Per Day
Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1, and 3 months out. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results.
Time frame: 3 months
Change in Cortisol Level in Parents
Salivary cortisol from parents
Time frame: 3 months
Change in Minutes of Moderate Physical Activity Per Day
Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1months follow up. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results.
Time frame: 1 month
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Participants will receive a phone call to list potential barriers to participating in nature outings, and will talk through solutions with an investigator. Participants will be offered assistance with transportation if necessary.
Change in Cortisol Level in Parents
Salivary cortisol from parents
Time frame: 1 month
Change in Park Visits Per Week
Self-reported number of park visits in the last week, measured at 0, 1, and 3 months.
Time frame: 3 month