Adolescent mental health outcomes (depression, anxiety), adolescent well-being, and additional health-related measures Mental and Behavioural Disorders
Conditions
Interventions
Participants will be screened for moderate depression (based on the PHQ-9) at baseline survey. Following enrolment and the baseline survey, participants will receive a Nature Rx in an individual guide
(2) written (online, printed handout) resources summarizing the evidence on the health benefits of nature, which include a QR code link to three brief video summaries (i. The benefits of nature
ii. What is a nature Rx?
iii. Nature Rx ‘how to’)
(3) an Adolescent Nature Rx Sensory toolkit). Sensory toolkit items include a Nature journal (including somatic and embodied prompts, colouring activities and a Nature Rx logbook) with nature-based mi
Sponsors
London Health Sciences Centre Research Institute
Eligibility
Sex/Gender
All
Age
10 Years to 18 Years
Inclusion criteria
Inclusion criteria: Adolescent eligibility: Inclusion criteria for quantitative survey include: 1. At recruitment stage, a list of adolescents with a depression diagnosis based on PHQ-9A with HCP at CH-LHSC OR depression diagnosis based on clinic procedures will be provided to the study team 2. Screen for depression (using PHQ-9A, with a validated cutoff score of 10) on quantitative survey by study team 3. Aged 10-18 years 4. Ability to participate in English 5. Are able to provide informed consent (as determined by the recommending HCP) Inclusion criteria for adolescent qualitative patients include: 1. Adolescent patients who have participated in the quantitative survey and intervention (i.e., inclusion criteria as above apply) 2. Informed patient consent Healthcare providers: Inclusion criteria include: 1. Health provider at CH-LHSC 2. Prescribed nature to an adolescent participant 3. Ability to participate in English 4. Informed consent Caregivers: Inclusion criteria include: 1. A caregiver of a patient who participated in the intervention 2. Ability to participate in English 3. Provide informed consent to participate 4. Patient (their child) provided consent for their participation
Exclusion criteria
Exclusion criteria: Adolescent eligibility: Exclusion criteria for quantitative survey: 1. Did not screen for depression (using PHQ-9A, with a validated cutoff score of 10) by a HCP at CH-LHSC AND has not received depression diagnosis by a CH-LHSC HCP 2. Are not between the ages of 10-18 years 3. Are unable to participate in English 4. Informed patient consent is not obtained Exclusion criteria for qualitative patients: 1. Adolescent patients did not in the quantitative survey and intervention (i.e., inclusion criteria as above apply) 2. Informed patient consent not obtained Healthcare Providers: Exclusion criteria include: 1. Is not a health provider at CH-LHSC 2. Did not prescribe nature to an adolescent participant in this study 3. Are unable to participate in English 4. Informed consent is not obtained Caregivers: Exclusion criteria include: 1. Not a caregiver of a patient who participated in the intervention 2. Are unable to participate in English 3. Do not provide informed consent to participate 4. Patient (their child) did not provide consent for their participation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The acceptability and feasibility of Nature Rx as an adolescent (aged 10-18 years) mental health intervention, measured using: 1. Enrolment, recorded as the number of eligible participants who consent to participate at baseline 2. HCP completion: the number of patients who healthcare providers are able to prescribe nature to and follow-up with, measured at baseline and follow-up at 3 and 6 months 3. Recruitment rate recorded as the number of eligible participants who consent to participate who remain in the study until the end of follow up at 6 months 4. Adherence to Nature Rx (=75%) assessed using the number of participants who consent to participate who adhere to their nature prescription at 3- and 6-month follow-ups, and RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) measured at 3 and 6 months 5. The researchers will qualitatively explore acceptability, barriers and facilitators using in-depth semi-structured interviews (adolescents, caregivers, healthcare provider), photo elicitation and narrative interviewing methods (adolescents). Adolescents will be interviewed at three timepoints (T1 - baseline, T2, T3). Caregiver and healthcare provider interviews will happen at one timepoint (T3). | — |
Secondary
| Measure | Time frame |
|---|---|
| Preliminary evidence on the effectiveness of Nature Rx for improving adolescent mental health outcomes (depression, anxiety) and wellbeing outcomes: 1. Depression measured using the Patient Health Questionnaire for Adolescents (PHQ-9) at T1, T2 and T3 (baseline, 3 months, 6 months). 2. Anxiety measured using the Severity Measure for Generalized Anxiety Disorder for Children 11-17 at T1, T2 and T3 (baseline, 3 months, 6 months). 3. Wellbeing measured using the Adolescent Wellbeing Scale for Young People Aged 11 to 16 at T1, T2 and T3 (baseline, 3 months, 6 months). 4. Quality of life measured using the Youth Quality of Life Scale at T1, T2 and T3 (baseline, 3 months, 6 months). 5. Child and youth resilience measured using the Child & Youth Resilience Measure-Revised (CYRM-R)at T1, T2 and T3 (baseline, 3 months, 6 months). 6. Connectedness to nature measured using the connectedness to nature scale at T1, T2 and T3 (baseline, 3 months, 6 months). 7. Ecodistress measured using the Hogg Eco-Anxiety Scale (HEAS-13) at T1, T2 and T3 (baseline, 3 months, 6 months). 8. Substance use measured using a brief screener for tobacco, alcohol, and other drugs measure at T1, T2 and T3 (baseline, 3 months, 6 months). 9. Paediatric ACEs and related life events measured using PEARLS T1, T2 and T3 (baseline, 3 months, 6 months). 10. Hope measured using the HOPE Scale-Short Form T1, T2 and T3 (baseline, 3 months, 6 months). 11. Self-efficacy measured using the Generalised Self-efficacy Scale at T1, T2 and T3 (baseline, 3 months, 6 months). 12. Mindful self-care measured using the Mindful Self-Care Scale atT1, T2 and T3 (baseline, 3 months, 6 months). 13. Self-compassion measured using the Self-Compassion Scale Short Form 0 (SCS-SF) atT1, T2 and T3 (baseline, 3 months, 6 months). 14. Mindfulness measured using the Child and Adolescent Mindfulness Measure (CAMM) at T1, T2 and T3 (baseline, 3 months, 6 months). 15. Social connectedness measured using the Social Connectedness Scale at T1, T2 | — |
Countries
Canada
Contacts
Public ContactLesley;Anna Gittings;Gunz
;
Outcome results
None listed