Design and evaluation of a park prescription program for stress reduction and health promotion in low-income families: The Stay Healthy in Nature Everyday (SHINE) study protocol
Study protocol developed for the design and evaluation of a park prescription program
This paper presents a study protocol (blueprint) for the design and evaluation of a park prescription program developed by a pediatric primary care clinic (PCC) in partnership with a local park agency. The PCC serves a linguistically, racially and culturally diverse group of pediatric patients living near the federal poverty level and with higher rates of chronic illness than the national pediatric population. The treatment program – referred to as Stay Healthy in Nature Everyday (SHINE) – was developed around the understanding that a physician recommendation to spend more time in nature would be more effective if supported by culturally appropriate reinforcements for creating behavior change.
This study protocol calls for a randomized controlled trial for the purpose of examining two levels of intensity in behavioral counseling about the health benefits of nature: one group receiving a park prescription in the form of a physician recommendation along with written resources; the other group receiving the same park prescription, plus assistance in planning park outings and invitations to three successive Saturday afternoon nature outings with free transportation and meals provided. Dyads, consisting of a caregiver and a child (aged 4 to 18), will be randomly assigned to one of the two study groups.
Outcomes, carefully selected after a review of multidisciplinary literature, will be measured through multiple forms of assessments. In addition to health outcomes, affinity for nature will also be assessed. The rationale for including this assessment is based on the understanding that affinity for nature is associated with increased interest in visiting nature and future environmental stewardship.
The overall goal of the design and evaluation protocol presented in this paper is to, not only establish evidence-based behavioral counseling techniques aimed at increasing family time in nature, but to also provide guidance to public health departments and clinicians seeking partnership with parks departments in designing and evaluating similar programs.
Razani, N., Kohn, M.A., Wells, N.M., Thompson, D., Flores, H.H., Rutherford, G.W., (2016). Design and evaluation of a park prescription program for stress reduction and health promotion in low-income families: The Stay Healthy in Nature Everyday (SHINE) study protocol. Contemporary Clinical Trials, 51,