Strengthening the Parent-Child Relationship Through Urban Nature

The study uses an experimental design (RCT) to estimate the causal impact of nature-based activities on the parent-child relationship and children's emotional regulation without random assignment. After consenting to participate, all students were asked to complete a questionnaire containing questions from six validated scales to measure baseline social health and well-being conditions. i.e. Nature Connection Index (NCI), Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), Child-parent relationship scale (CPRS), and Children's Emotion Management Scale (CEMS). For the intervention group, 50 low-income families will be invited to experience touching the lawn barefoot and lying down to relax. Participants will also engage in nature-based games to enhance their well-being, increase creativity, and improve mood. Additionally, collective nature-inspired music and jamming activities will facilitate social bonding and encourage community interaction, while supporting participants in forming habits of connecting with nature in daily life for sustainable overall well-being. The families in the control group were not asked any specific tasks during the period. After completing the nature-based activity, participants will be asked to complete the initial questionnaire again.

Considering the importance of a connection with nature in early childhood and throughout life, this study attempts to explore how nature-based activities enhance family relationships and children's emotional management.

Study Overview

• Status: Completed
• Conditions: Stress (Psychology)
• Intervention / Treatment: Behavioral: Outdoor activity

Detailed Description

Study site:

We selected communities in Yuen Long, Tin Shui Wai (part of Yuen Long), and Tuen Mun due to their low socio-economic status and high child poverty rates. These areas have constantly high number of reported child abuse cases in the past ten years where Tuen Mun was the top in 2016. Moreover, the three communities all have large public parks which are ideal locations to provide exposure to nature settings as well as accessible for the families to join the activities. In this study, the families can develop a habit of spending regular time in their neighbourhood parks in the future.

Target population:

The target groups include low-income families with young children, families of SEN children, single-parent families, families with poor parenting skills or other families in need. We will partner with local NGOs to recruit these families in need. Priority will be given to low-income families supported by the Kindergarten and Child Care Centre Fee Remission Scheme of The Student Finance Office, as well as families receiving CSSA. In the meantime, our public education resources will also benefit teachers and social workers from NGO service units or kindergartens as they utilize the tools to carry out Nature Healing activities with their users. Family members of stressed families will also directly benefit, as the improved well-being of one member leads to more harmonious family relationships. As families share their experiences, neighbours and friends can indirectly benefit and may potentially be recruited to become new participants in the programme. A total of 100 low-income families will be recruited and randomly assigned to either an intervention group or a control group (50 families per group). All participants will be required to provide informed consent before taking part in the study.

Procedure:

The experimental procedure was explained to potential participants in a recruitment email, which required them to provide informed consent before participating. After consenting, all parents will be asked to complete a baseline questionnaire comprising items from four validated scales to assess family relationships and emotional health.

• Intervention Group: The 50 families assigned to the intervention group will be invited to engage in nature-based activities, including: touching the lawn barefoot, lying down to relax, participating in nature-based games to enhance well-being, increase creativity, and improve mood. Further, collective nature-inspired music and jamming activities will be to facilitate social bonding and encourage community interaction.
• Control Group: The 50 families assigned to the control group will not be asked to perform any specific tasks during the study period.

After completing the nature-based activities, participants in the intervention group will be asked to complete the same questionnaire again for post-intervention assessment.

Data analysis:

A repeated measures analysis of covariance will assess the fidelity with which results in changes in family relationship and emotional health during the intervention. Paired samples t-tests will be used to further investigate differences within each group. An intention-to-treat (ITT) analysis will be performed on outcomes in which all participants are included with drop-outs assigned a follow-up value at baseline. All analyses will be performed using the IBM SPSS Statistics v. 27.0 software.

The questionnaire, participant information sheet and consent form are attached.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

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

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Low-income families

Exclusion Criteria:

• Severe physical and mental conditions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Outdoor activity group; Participants are asked to attend one day outdoor activity in urban park.	Behavioral: Outdoor activity; Experience touching the lawn barefoot and lying down to relax.
No Intervention: Control; Participants in the control group are not asked to attend specific activities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Child-parent relationship scale (CPRS)	The quality of the parent-child relationship was assessed using the Child-Parent Relationship Scale (CPRS). The CPRS is a 15-item self-report questionnaire designed to measure parents' perceptions of their relationship with their child aged 3-12 years. Items are rated on a 5-point Likert scale ranging from 1 (definitely does not apply) to 5 (definitely applies). A higher Closeness score (8 items) combined with a lower Conflict score (7 items) reflects a healthier parent-child relationship.	From enrollment to the end of treatment at 2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Children's Emotion Management Scale (CEMS)	The CEMS is a self-report questionnaire designed to assess how children manage their emotions in response to three specific emotions: sadness, anger, and worry. Items are rated on a 3-point Likert scale ranging from 1 (hardly ever) to 3 (often). Higher scores reflect more adaptive emotion regulation.	The same time with the primary measurement
Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS)	The SWEMWBS is a 7-item self-report measure developed as a shortened version of the original 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS). It was designed to enable the monitoring of mental well-being in the general population. The SWEMWBS is scored by first summing the scores for each of the seven items (each scored 1 to 5), resulting in a total raw score ranging from 7 to 35, where higher scores indicate better mental well-being.	The same time with primary measure

Collaborators and Investigators

• Sponsor: The Chinese University of Hong Kong, Shenzhen
• Investigators: Principal Investigator: Eun Yeong Choe, PhD, The Chinese University of Hong Kong, Shenzhen

Study record dates

Study Major Dates

• Study Start (Actual): September 30, 2025
• Primary Completion (Actual): October 31, 2025
• Study Completion (Actual): December 30, 2025

Study Registration Dates

• First Submitted: April 30, 2026
• First Submitted That Met QC Criteria: April 30, 2026
• First Posted (Actual): May 6, 2026

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 7, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Stress
• Other Study ID Numbers: CUHKShenzhen_1

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