Nature-based interventions

As youth with autism often have difficulty focusing within academic settings, there is a need for research and intervention strategies to promote their engagement in classroom activities. In line with Attention Restoration Theory (Kaplan, 1995), exposure to nature may bolster attention among autistic individuals, however prior research has seldom addressed this topic within the autistic population, due to methodological challenges. We examine the effects of outdoor time on classroom focus among autistic youth with high support needs who reside at The Center for Discovery, a medical and educational provider, located in rural New York State, United States. 

A cluster-randomized crossover trial examined whether nature exposure increased focus among autistic youth (n = 44) during subsequent classroom lessons. Before school, students spent 30-minutes either outdoors on woodland trails and fields, or indoors around exercise stations (e.g., balance beams, etc.). Classroom engagement was operationalized via (a) behavioral coding of classroom videos and (b) teacher surveys.  Results suggest that time outdoors may enhance classroom engagement and focus among autistic youth within the classroom. 

Through a robust research design and rigorous methods, this study advances our understanding of nature’s effects on high-needs youth with autism.  Our findings have implications for both the design of spaces to support this population and for the daily routines for parents, educators and caregivers working with youth with autism. 

Background: The Nature-Based Biopsychosocial Resilience Theory and growing evidence suggest that Nature-based Therapies (NbTs) can build coping resources and complement conventional mental health interventions. Mental health problems are prevalent among young adults, and hamper the well-being and achievements of many university students.

Aim: We aimed to generate robust evidence for well-defined NbT programs tailored to university students and feasible for implementation in academic contexts.

Method: N = 253 students with diverse backgrounds and up to moderate psychological symptoms participated in a four-arm trial conducted across four waves (spring 2024–autumn 2025). Two five-week NbT programs, conducted in groups, were compared: (1) Restoration Skills Training (ReST), integrating nature-based and mindfulness-based treatment components, and (2) a program emphasizing accessible and meaningful nature activities without specific psychotherapeutic components. These were tested against an active control (indoor mindfulness training) and a waitlist condition. Depression, anxiety and stress symptoms were assessed through self-reports pre-intervention, post-intervention, and at 1- and 6-month follow-ups, alongside other resilience dimensions including psychosocial coping resources, environmental values, and behaviors.

Results: Analyses of symptoms up to the 1-month follow-up showed that all three active interventions improved mental health trajectories compared to the waitlist. Secondary analyses indicated that the nature-based and mindfulness-based treatment components had both shared and distinct effects on different resilience dimensions.

Implications: These findings support integration of NbTs as part of universities’ mental health strategies and commitment to resilient academic environments. They also advance theory and practice by disentangling the contributions of common nature-based and mindfulness-based treatment components in NbTs.

Nature-based interventions (NBIs) are increasingly promoted as strategies to improve population health and support sustainable lifestyles. Observational studies on green space have suggested that natural environments may buffer socioeconomic health disparities through equigenesis, potentially via increased opportunities for nature contact or indirect environmental pathways, e.g. decreased heat and pollution. However, these mechanisms remain largely speculative due to the predominance of observational designs. Interventional studies offer a unique opportunity to examine whether, and through which pathways, NBIs may contribute to reducing health inequities. This review assesses to what extent the current evidence base is equipped to do so.

This scoping review maps how current NBI research conceptualises and evaluates impacts on health inequities, including whether studies consider differential effects across social groups or intersectional vulnerabilities. NBIs were defined as interventions with an explicit focus on contact with nature. We systematically searched PubMed, Scopus, Web of Science, Embase, and CINAHL, screening 3,368 records and identifying seven studies meeting the inclusion criteria. 

Preliminary analysis indicates that although many interventions reference “vulnerable” groups, few adopt an explicit intersectional lens. Environmental and nature‑interaction outcomes are largely absent from current evaluations, hindering exploration of more‑than‑human dimensions of NBIs. Detailed results will be presented at the conference.

Our findings highlight a significant gap in the solid integration of equity, diversity, and inclusion principles within NBI research. This review provides a foundation for advancing evidence-based approaches to nature-based health promotion by strengthening attention to intersectionality and equity-focused evaluation.

Scotland’s Women’s Health Plan prioritises mental health and wellbeing. Non-pharmaceutical interventions such as nature-based interventions (NBIs) are highlighted as an important opportunity. Research on forest bathing, an NBI, shows positive impacts on health and wellbeing, yet reveals a gap in understanding the impacts for women 40 years and older who often encounter challenges associated with the menopausal transition.

Our aim is to understand how forest therapy (FT), a 2-3-hour sensory walk, similar to forest bathing, might improve women’s mental health and wellbeing through exploration of motivations, experiences, and outcomes associated with participation.  

Within a mixed methods study exploring the feasibility and acceptability of FT, we conducted semi-structured interviews with a purposively selected maximum variation sub-sample of twelve women 4-6 weeks following participation in an FT experience. 

We highlight key elements of their stories that underpin the value of FT as a wellbeing practice, and potential barriers to uptake. Participating alongside other women in their age group was important for emotional comfort and safety. Barriers include accessibility issues and concerns (location, terrain), life  commitments (work, family), and pre-existing perceptions/uncertainty (activity-related, self-consciousness). Taking time for self, to slow down, be present, and notice nature in a mindful way was important in participants’ experience and outcomes. All interviewees highly recommended the experience.

We present a perspective on FT that has been absent from the literature, including attention to a distinct segment of the population. Forest therapy holds potential to support women’s health and wellbeing and warrants further study for utilisation in Scotland.

Forest bathing (Shinrin-yoku) and the related forest therapy (FT) show promise as nature-based interventions (NBIs) for mental wellbeing. Internationally, there is increasing interest in green prescribing. In Scotland, research priorities include meeting needs of peri- and menopausal women, supporting use of local natural settings, and providing evidence for green prescribing. 

Within a mixed methods study, the viability of researching FT for wellbeing in women aged 40+ in Scotland was assessed by evaluating (1) the feasibility of combining research procedures with FT experiences and (2) participants’ acceptance of the intervention. 

With a sample of 24 participants, we implemented protocolized 2-hour slow, sensory FT walks for groups of 5-13 led by a certified guide. Quantitative (surveys) and qualitative (arts activity, interviews) data were collected. Validated self-report measures assessing biopsychosocial-spiritual health domains and a menopause rating scale (MRS) were administered at baseline, pre- and post-walk, and 1 and 2 weeks. A bespoke feasibility and acceptability survey was completed at 3 weeks. Researcher notes recorded programme delivery, environmental, and social factors. 

Results include the feasibility of recruitment and study procedures, completion and retention rates, the acceptability of FT conducted in an urban woodland, and measurement burden. We reflect on programme fidelity and collaboration with NBI practitioners. The MRS psychological sub-scale improved 1 week following FT and had not returned to baseline at 2 weeks. 

Findings reveal multiple challenges associated with implementing protocolized NBIs and highlight critical research design solutions for a future large-scale trial that could support green prescribing of forest therapy.