Nature-based Outdoor Activities for Promoting Stress Resilience in Employees

May 15, 2026 updated by: EUN YEONG CHOE, The Chinese University of Hong Kong, Shenzhen

The goal of this randomized controlled trial (RCT) is to assess the impact of a nature-based workplace intervention on stress resilience in full-time employees in Hong Kong.

The main question it aims to answer is: Does a nature-based group activity intervention improve stress resilience in employees?

Researchers will compare the intervention group (participants who attend three nature-based group sessions) to the control group (participants who receive no intervention and continue their usual routines) to see if the nature-based activities lead to greater improvements in stress resilience compared to no intervention.

Participants will complete baseline measurements (questionnaires, blood pressure, and heart rate variability) one week before the first session.

If assigned to the intervention group: Attend three one-hour group sessions at a nearby park (once every two weeks, 8:00-9:00 AM) involving mindful walking, gentle movement, nature observation, breathing exercises, and group reflection

If assigned to the control group: Continue their usual daily routines with no specific activities

Complete follow-up assessments (same measurements as baseline): immediately after the second session and one week after the third session

Primary measurement: HRV Secondary measurements: Blood pressure, Perceived stress scale (PSS) and the Difficulties in emotion regulation scale (DERS).

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Participants:

The participants of this study will be recruited from full-time employees at diverse corporate settings in Hong Kong. The sample size was determined using G*Power software. With a medium effect size (f = 0.25), an alpha level of 0.05, a desired power of 0.80, and a correlation among repeated measures of 0.50, the required total sample size was calculated to be 34. Accounting for an anticipated 20% attrition rate, the investigator aims to recruit 43 participants.

Study procedure:

This study uses a randomized controlled trial (RCT) to assess the impact of the workplace intervention on stress resilience in employees. To ensure allocation concealment, randomization will be performed by a third party (a program instructor who was not involved in participant recruitment or outcome assessment). Participants and researchers will be blinded to group assignment. The experimental procedure will be explained to potential participants in a recruitment poster, which required them to send their informed consent before participating. All participants will be invited to complete baseline measurements one week before the start of the first intervention session. Baseline measurements will take approximately 15-20 mins. Once the participants complete the questionnaire, the investigator will ask them to measure BP and HRV. All measurements will be taken after a 5-minute rest period in a seated position with back support, feet flat on the floor, and no talking. Participants will complete follow-up assessments at three time points using the same measures as at baseline (T1): T2 (immediately after the second session) and T3 (one week after the third session).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
160

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Hong Kong
    • Kowloon
      • Hong Kong, Kowloon, Hong Kong
        • The Hong Kong Polytechnic University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Over 18 years
  • Full-time employees

Exclusion Criteria:

  • part-time employees
  • individuals employed for less than six months
  • those with symptoms of heart disease
  • participants over 65 years of age

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Outdoor activity group
Three days outdoor activity group
Behavioral: Nature outdoor activities
After randomization, participants in the intervention group will attend three group activity sessions, while those in the control group will receive no intervention and were instructed to continue their usual daily routines. The group activity sessions will be conducted at a nearby park for one hour each session (8:00-9:00 AM). Sessions will be held once every two weeks, for a total of three sessions. Each session will be contained various group activities, such as mindful walking, gentle movement, nature observation, breathing exercises and group reflection. These group activities led by facilitators aims to increase social interaction and nature exposure. Participants in the control group were not asked to attend specific activities.
No Intervention: No-treatment control group
No specific activities required

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Heart rate variability (HRV)
Time Frame: From enrollment to the end of treatment at 8 weeks
HRV will be measured using SA-3000P (MEDICORE, Korea). The sensor is positioned with a strap around the fingertip of the middle finger on one of the participants hands. This study will use RMSSD (ms), SDNN (ms) and LF/HF ratio as HRV indicators to evaluate the stress response. In HRV analysis, higher RMSSD values indicate greater parasympathetic activity, reflecting relaxation and recovery. Similarly, Higher SDNN values indicate greater overall HRV, reflecting better autonomic nervous system flexibility. In contrast, higher LF/HF ratio values indicate sympathetic dominance, reflecting stress and arousal. This will be measured three times: at baseline (T1), immediately after the second session (T2), and one week after the third session (T3).
From enrollment to the end of treatment at 8 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Blood pressure (BP)
Time Frame: From enrollment to the end of treatment at 8 weeks
BP will be measured using a digital automatic BP monitor (PASESA AVE-2000, Japan) with an arm cuff placed on the non-dominant arm at heart level. Normal systolic blood pressure (SBP) is defined as 120-139 mmHg, and normal diastolic blood pressure (DBP) as 80-89 mmHg. The incidence of elevated BP (SBP ≥140 mmHg or DBP ≥90 mmHg) in follow-up, rather than the diagnosis of hypertension, will be used as an outcome indicator of changes in stress levels. This will be measured three times: at baseline (T1), immediately after the second session (T2), and one week after the third session (T3).
From enrollment to the end of treatment at 8 weeks
Perceived stress scale (PSS)
Time Frame: From enrollment to the end of treatment at 8 weeks
PSS measures the degree to which individuals perceive their lives as stressful. A total of 14 items (e.g., 'In the last three months, how often have you been upset because of something that happened unexpectedly? '), each of which uses a Likert scale ranging from 1 (never) to 5 (very often), are rated by participants. Higher score indicates higher stress levels. This will be measured three times: at baseline (T1), immediately after the second session (T2), and one week after the third session (T3).
From enrollment to the end of treatment at 8 weeks
Difficulties in emotion regulation scale (DERS)
Time Frame: From enrollment to the end of treatment at 8 weeks
DERS assesses emotion regulation problems. A total of 18 items (e.g., 'I have difficulty making sense out of my feelings') are rated by participants using a Likert scale ranging from 1 (almost never) to 5 (almost always). Higher scores indicate greater emotion regulation difficulties. This will be measured three times: at baseline (T1), immediately after the second session (T2), and one week after the third session (T3).
From enrollment to the end of treatment at 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
The Chinese University of Hong Kong, Shenzhen

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Eun Yeong Choe, PhD, The Chinese University of Hong Kong, Shenzhen

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 30, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 30, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 15, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
May 22, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 22, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 15, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • CUHKShenzhen_2

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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