Shinrin-Yoku (Forest Bathing) on Psychological Well-being

Effects of Shinrin-Yoku (Forest Bathing) on Psychological Well-being in Urban or Rural Green Space: A Pilot Randomized Controlled Trial

This study will examine the effects of Shinrin-Yoku (forest bathing) as an intervention for enhancing psychological well-being in Chinese population. The main component of Shinrin-Yoku is the use of 5 senses in various activities, which typically includes forest walking, meditation, yoga etc. While Shinrin-Yoku has been widely recognized in Japan as a means of preventative health and stress management, it is still a new concept in some countries. In the existing literature, there is increasing evidence demonstrating the efficacy of Shinrin-Yoku for improving for health promotion. However, there is very limited research examining the effectiveness of Shinrin-Yoku in different types of natural environment and the sustainability of its effects.

Study Overview

• Status: Unknown
• Conditions: Mental Health Wellness
• Intervention / Treatment: Behavioral: Shinrin-Yoku

Detailed Description

This study will be a pilot randomized controlled trial on the effects of Shinrin-Yoku (forest bathing) as an intervention for enhancing psychological well-being in Chinese population. Prior to all study procedures, an online informed consent (with phone support) will be obtained from potential participants. Around 30 eligible participants will be randomly assigned to either the natural forest group or the urban green area group in a ratio of 1:1.

• Study Type: Interventional
• Enrollment (Anticipated): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • The Chinese University of Hong Kong
  • Sha Tin, Hong Kong
    • The Chinese University of Hong Kong

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Hong Kong residents
• Aged from 18 to 65
• Cantonese language fluency
• a willingness to provide informed consent and comply with the trial protocol.

Exclusion Criteria:

• Pregnant
• Have suicidal ideation
• Using medication or psychotherapy for depression
• Experiencing Depression, Anxiety and Stress
• Having unsafe conditions and are not recommended for physical activity by physicians
• Have major psychiatric, medical or neurocognitive disorders that make participation infeasible based on the research team's judgment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Urban Green Space group; This group of participants would experience a 3-hour Shinrin-Yoku session in urban green space.	Behavioral: Shinrin-Yoku; Shinrin-Yoku is a traditional Japanese practice of getting in touch with nature through walking in the forest in a relaxed way using all five senses.; Other Names: Forest Bathing
Experimental: Rural Green Space group; This group of participants would experience a 3-hour Shinrin-Yoku session in rural green space.	Behavioral: Shinrin-Yoku; Shinrin-Yoku is a traditional Japanese practice of getting in touch with nature through walking in the forest in a relaxed way using all five senses.; Other Names: Forest Bathing

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in the Profile of Mood States-Short Form	The POMS-SF is a 30-item scale that measures six different dimensions of mood swings over a period of time. These include: Tension or Anxiety, Anger or Hostility, Vigor or Activity, Fatigue or Inertia, Depression or Dejection, Confusion or Bewilderment. A five-point scale ranging from "not at all" to "extremely" is administered by experimenters to patients to assess their mood states.	Pre-, post-intervention and 1-month post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Depression Anxiety Stress Scales-21	DASS-21 is a 21-item scale, comprises of three sub-scales which measures the negative emotional states of depression, anxiety, and stress, over the past week. The DASS is based on a dimensional rather than a categorical conception of psychological disorder, thus it has no direct implications for the allocation of patients to discrete diagnostic categories. However, recommended cutoff scores for conventional severity labels (normal, moderate, severe) are given in the DASS Manual.	Up to 1 month after the intervention
Change in Nature-relatedness Scale-6	NR-6 is a 6-item scale assesses the self and experience dimensions of individuals' connection to nature. The NR uses 5-point scale ranging from disagree strongly (1) to agree strongly (5). It is important to respond with the actual feelings rather than how "most people" feel.	Up to 1 month after the intervention
Change in Brief Resilience Scale	BRS consists of six items, three positively worded items, and three negatively worded items. All six relate to the individual's ability to bounce back from adversity. It was predictably related to personal characteristics, social relations, coping, and health in all samples. The BRS uses 5-point scale ranging from strongly disagree (1) to strongly agree (5).	Up to 1 month after the intervention
Change in Insomnia Severity Index	ISI is a 7-item scale designed to evaluate perceived insomnia severity. Ratings on the 5-point Likert scale are obtained on the perceived severity of sleep-onset, sleep-maintenance, early morning awakening problems, satisfaction with current sleep pattern, interference with daily functioning, noticeably of impairment attributed to the sleep problem, and level of distress caused by the sleep problem.	Up to 1 month after the intervention
Change in Subjective Vitality Scales - State Version	SVS is a 7-item scale, comprises of two versions which measures subjective vitality in two level, including individual differences level and state level. The SVS uses 7-point scale ranging from not at all true (1) to very true (7). The state level version assesses the state of subjective vitality rather than its enduring aspect.	Up to 1 month after the intervention
Change in Self-Compassion Scale-Short Form	SCS-SF is a 12-item scale to evaluates the degree of self-compassion. Ratings on the 5-point Likert scale are obtained on 6 factors, including self-kindness, common humanity, mindfulness, self-judgment, isolation and over-identification. The self-report 13-item SCS-SF explicitly represents the thoughts, emotions, and behaviors associated with self-compassion and includes items that measure how often people respond to feelings of inadequacy or suffering with each of six components.	Up to 1 month after the intervention

Collaborators and Investigators

• Sponsor: Chinese University of Hong Kong

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2019
• Primary Completion (Actual): January 30, 2020
• Study Completion (Anticipated): March 30, 2020

Study Registration Dates

• First Submitted: October 20, 2019
• First Submitted That Met QC Criteria: October 23, 2019
• First Posted (Actual): October 25, 2019

Study Record Updates

• Last Update Posted (Actual): March 11, 2020
• Last Update Submitted That Met QC Criteria: March 9, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: Psychological Well-being; Forest Bathing; Shinrin-Yoku; Natural Environment
• Other Study ID Numbers: PSY008

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