Finding With Nature: A Study Testing Nature-Based Support for Family Caregivers Aged 65 and Over (FWN)

Finding With Nature: A Nature-Based Intervention for the Well-Being of Family Caregivers Aged 65 and Over: Protocol for a Randomised Controlled Trial

This research project investigates the effects of a nature-based programme (Finding with Nature, FWN), on psychological well-being, functioning, and nature connectedness among older adults (65 and older) who provide care for their close one in Finland. The FWN programme combines nature exposure, physical activity, and Acceptance and Commitment Therapy (ACT) methods. The effects of the FWN programme are studied in a randomised controlled trial. The psychological well-being, functioning, and nature connectedness are investigated with self-report measures and analysed with quantitative methods. The results provide knowledge about the ability of nature-based, low-threshold methods to support older adults (65+) who provide care for their close one.

Study Overview

• Status: Not yet recruiting
• Conditions: Psychological Flexibility; Burden, Caregiver; Physical Functioning; Psychological Well Being; Natured-informed Therapy
• Intervention / Treatment: Behavioral: Finding with Nature Programme

Detailed Description

An intervention study in randomised control trial design will be conducted with a target sample of 350 participants living in Central Finland. After receiving information about the research and providing a written consent, participants answer a question of caregiver burden and indicate whether they would prefer to participate in the Finding with Nature (FWN) programme in face-to-face group meetings or individually via an interactive online platform. After that, the participants are randomly allocated to intervention and control groups which are balanced according to the caregiver burden. The participants in the intervention group will be offered a 6-week FWN programme either in a face-to-face group or individually online, according to their own preference. In the face-to-face group implementation, the FWN programme will be carried out by a trained facilitator with meetings once a week. In the online implementation, the FWN programme will be completed individually at their own pace via an interactive online platform. In both implementation formats, participants will complete independent tasks and have the opportunity to share their experiences with peers.

At the core of the FWN programme are facilitated nature-based, low-threshold exercises in six theme areas of the FWN programme (one theme for each week): 1) Introduction, personal situation, and starting points for change; 2) personally meaningful matters and values; 3) acceptance of emotions and confronting barriers; 4) listening to the body, meaningful movement, and natural settings; 5) mindfulness skills and everyday choices; and (6) self-concept, self-compassion, and self-awareness.

Participants respond to surveys at three measurement points: a pre-measurement at the start of the programme, a post-measurement at the end of the programme, and a follow-up measurement three months after the end of the programme. The participants in the intervention group are compared to the participants in the control group who continue life as usual and only respond to online surveys at three measurement points (pre-, post- and follow-up measurements). The control group participants are offered a opportunity to participate in face-to-face group meetings or the online implementation of the FWN programme after the follow-up measurement.

This research is funded by the Health Promotion Grant (Ministry of Social Affairs and Health, STM, va-thl-2025-1-80).

• Study Type: Interventional
• Enrollment (Estimated): 350
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Julija Chichaeva, MHS; Phone Number: +358504628081; Email: julija.chichaeva@jamk.fi
• Study Contact Backup: Name: Emmi Matikainen, PhD; Phone Number: +358504755530; Email: emmi.matikainen-tervola@jamk.fi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age 65 years and older
• Providing care for a close one, formally or informally
• Able to communicate adequately in Finnish
• Willingness to commit to a 6-week intervention programme

Exclusion Criteria:

-

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: Finding with Nature intervention; Participants aged ≥65 years who are informal/family caregivers and living in Central Finland. Participants randomized to this arm will take part in a 6-week structured intervention program.	Behavioral: Finding with Nature Programme; A 6-week nature-based program integrating physical activity in nature and Acceptance and Commitment Therapy (ACT) methods to promote well-being, functioning, and nature connectedness. Delivered either in face-to-face groups or via an online platform, including guided sessions, independent exercises, informational content, and opportunities for peer support.
No Intervention: No intervention; Participants aged ≥65 years who are informal/family caregivers and living in Central Finland. Participants randomized to this arm will continue their usual daily life without the study intervention during the 6-week follow-up period. After the follow-up, they will be offered the opportunity to participate in the intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological well-being: the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS)	7-item scale, range 7-35; higher scores indicate better mental well-being.	Pre-intervention, immediately post-intervention, and 3-month follow-up.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregivers' perceived coping as caregivers: COPE Index	COPE Index evaluates the caregiver's subjective experience of strain, support, and quality of the caregiving relationship. 15-item scale, range 15-75; higher scores indicate greater caregiving burden.	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Functioning: the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0)	A standardized assessment of functioning across multiple life domains. 12-item scale, range 0-48; higher scores indicate greater disability (worse functioning).	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Adult Social Care Outcomes Toolkit (ASCOT) SCT4	Measure designed specifically for informal caregivers, focusing on social care-related quality of life. 8-item scale; higher scores indicate better social care-related quality of life.	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Self-rated health: a single validated item		Pre-intervention, immediately post-intervention, and 3-month follow-up.
Connectedness to nature: short version of Connectedness to Nature Scale (CNS)	Short version of the Connectedness to Nature Scale (CNS), 7-item scale, range 7-35; higher scores indicate greater connectedness to nature.	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Connectedness to nature and nature-related experiences: the Holistic Nature Experience measure	16-item scale, range 16-96; higher scores indicate more positive nature-related experiences.	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Psychological flexibility: Comprehensive Assessment of ACT Processes (CompACT-10)	10-item scale, range 0-60; higher scores indicate greater psychological flexibility	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Anxiety: Generalized Anxiety Disorder 7-item Scale (GAD-7)	7-item scale, range 0-21; higher scores indicate greater anxiety symptoms	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Physical activity: International physical activity questionnaire -short form (IPAQ-SF)	International Physical Activity Questionnaire - Short Form (IPAQ-SF), 7-item questionnaire. Total physical activity is expressed as MET-minutes per week. The minimum value is 0 MET-minutes/week, with no fixed maximum value. Higher scores indicate higher levels of physical activity.	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Restorative experiences: the Restoration Outcome Scale (ROS)	6-item scale, range 6-42; higher scores indicate greater restorative experiences	Immediately before and after each of the six weekly intervention sessions during the 6-week intervention period.
Life-space mobility: the Life-Space Assessment (LSA)	Capture the spatial extent and frequency of participants' mobility in daily life, assessing mobility over the previous 4 weeks, range 0-120; higher scores indicate greater life-space mobility	Pre-intervention, immediately post-intervention, and 3-month follow-up.
Engagement with natural and green environments	Assessed through questions on frequency, purpose, and patterns of nature visits.	Pre-intervention, immediately post-intervention, and 3-month follow-up.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregiver characteristics	Information is collected on the care recipient, duration of caregiving, formal caregiver status, and use of support services.	Pre-intervention, immediately post-intervention, and 3-month follow-up.

Collaborators and Investigators

• Sponsor: JAMK University Of Applied Sciences
• Collaborators: University of Jyvaskyla
• Investigators: Principal Investigator: Julija Chichaeva, MHS, JAMK University Of Applied Sciences

Study record dates

Study Major Dates

• Study Start (Estimated): September 7, 2026
• Primary Completion (Estimated): March 1, 2028
• Study Completion (Estimated): March 1, 2028

Study Registration Dates

• First Submitted: September 3, 2026
• First Submitted That Met QC Criteria: September 15, 2026
• First Posted (Actual): September 16, 2026

Study Record Updates

• Last Update Posted (Actual): September 16, 2026
• Last Update Submitted That Met QC Criteria: September 15, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Acceptance and Commitment Therapy (ACT); Psychological well-being; Physical functioning; Nature connectedness; Nature-based intervention; Older caregivers
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Behavior; Personal Satisfaction; Caregiver Burden; Psychological Well-Being
• Other Study ID Numbers: VA-THL-2025-1-80

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anonymised quantitative data will be archived, where applicable, in the Finnish Social Science Data Archive (FSD).
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No