Thompson Catharine Ward, Elizalde Aldo, Cummins Steven, Leyland Alastair H, Botha Willings, Briggs Andrew, Tilley Sara, de Oliveira Eva Silveirinha, Roe Jenny, Aspinall Peter, Mitchell Richard
OPENspace, University of Edinburgh, Edinburgh EH3 9DF, UK.
Adam Smith Business School, University of Glasgow, Glasgow G12 8QQ, UK.
Sustainability. 2019 Jun;11(12):3317. doi: 10.3390/su11123317. Epub 2019 Jun 15.
High prevalence of poor mental health is a major public health problem. Natural environments may contribute to mitigating stress and enhancing health. However, there is little evidence on whether community-level interventions intended to increase exposure to natural environments can improve mental health and related behaviours. In the first study of its kind, we evaluated whether the implementation of a programme designed to improve the quality of, and access to, local woodlands in deprived communities in Scotland, UK, was associated with lower perceived stress or other health-related outcomes, using a controlled, repeat cross-sectional design with a nested prospective cohort. Interventions included physical changes to the woodlands and community engagement activities within the woodlands, with data collected at baseline (2013) and post-intervention (2014 and 2015). The interventions were, unexpectedly, associated with increased perceived stress compared to control sites. However, we observed significantly greater increases in stress for those living >500 m from intervention sites. Visits to nearby nature (woods and other green space) increased overall, and moderate physical activity levels also increased. In the intervention communities, those who visited natural environments showed smaller increases in stress than those who did not; there was also some evidence of increased nature connectedness and social cohesion. The intervention costs were modest but there were no significant changes in quality of life on which to base cost-effectiveness. Findings suggest factors not captured in the study may have contributed to the perceived stress patterns found. Wider community engagement and longer post-intervention follow-up may be needed to achieve significant health benefits from woodland interventions such as those described here. The study points to the challenges in evidencing the effectiveness of green space and forestry interventions to enhance health in urban environments, but also to potential benefits from more integrated approaches across health and landscape planning and management practice.
心理健康状况不佳的高患病率是一个重大的公共卫生问题。自然环境可能有助于减轻压力和增进健康。然而，关于旨在增加自然环境接触机会的社区层面干预措施是否能改善心理健康及相关行为，几乎没有证据。在同类研究中，我们采用嵌套前瞻性队列的对照重复横断面设计，评估了一项旨在改善英国苏格兰贫困社区当地林地质量和增加其可及性的项目实施后，是否与较低的感知压力或其他健康相关结果相关。干预措施包括对林地的物理改造以及林地内的社区参与活动，数据收集于基线期（2013年）和干预后（2014年及2015年）。出乎意料的是，与对照地点相比，这些干预措施与感知压力增加相关。然而，我们观察到，居住在距离干预地点超过500米的人群压力增加幅度明显更大。前往附近自然区域（树林和其他绿地）的总体访问量增加，适度身体活动水平也有所提高。在干预社区中，访问自然环境的人群压力增加幅度小于未访问自然环境的人群；也有一些证据表明与自然的联系以及社会凝聚力有所增强。干预成本适度，但生活质量没有显著变化，因此无法据此判断成本效益。研究结果表明，研究中未涵盖的因素可能导致了所发现的感知压力模式。可能需要更广泛的社区参与以及干预后更长时间的随访，才能从此处所述的林地干预措施中获得显著的健康益处。该研究指出了证明绿地和林业干预措施在城市环境中促进健康有效性方面的挑战，但也指出了在健康与景观规划及管理实践中采用更综合方法可能带来的潜在益处。
