Professor Zoe Knowles - Health, wellbeing and the environment
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Presentation by Professor Zoe Knowles, Liverpool John Moores University: Evaluating outcomes for the Natural Health Service at the Health, wellbeing and the environment event on Monday 28 January 2019 at The Isla Gladstone Conservatory, Liverpool
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Professor Zoe Knowles - Health, wellbeing and the environment
- 1. The Natural Health Service The Mersey Forest Prof. Zoe Knowles Dr Lisa Newson, Dr Simon Cooper, Clare Austin Liverpool John Moores University Paul Nolan The Mersey Forest Team
- 2. Overview • The Mersey Forest • Why a focus on health and the natural environment ? • Natural Health Service basics • Results and impacts
- 5. Why a focus on health and the natural environment?
- 6. It’s in our genes!
- 7. We evolved in contact with nature With thanks to Tim Urban - Wait but Why?
- 8. Increasing costs of keeping us all well - Health care costs rise rapidly with age - we have an ageing population
- 9. Mersey Forest Four strands for wellbeing • Greener Places – healthier communities • More people, more active, more often • Promoting the passive benefits of trees and woodland • Natural Health Service
- 10. The Natural Health Service • Use the natural environment as a health asset • 8-12 week programmes – a “dose” of nature • Evidence-based products and interventions • Targeted at areas of need • Long term partnership with universities to develop evidence and improve practice.
- 11. What would GSK do? • Products • Evidence-based • Targeted at conditions • A huge marketing machine!
- 14. Natural Health Service Research Centre of Excellence Working with two universities in Liverpool via 2 PhDs • Evaluating the health and wellbeing benefits associated with outdoor interventions • Mindful contact with nature BSc and MSc placements, MSc research Research bids eg. NIHR Academic papers and conference presentations
- 15. Participants as at 30 June 2018
- 16. Changes to physical activity over time
- 18. Changes in wellbeing over time 0 10 20 30 40 50 60 Time 1 Time 2 TotalWEMWEBSscore(14-70) Time point Changes in mental well being over time
- 19. Feedback (qualitative analysis in progress) It was a beautiful day in the sunshine…. I thought I'd be out of my depth ...but gladly I was wrong. This exercise is keeping me out of the hospital I want to continue - 12 weeks is too short! I would go mad if we stopped as I enjoy my regular session The group is good and I can now take on the world - bring it on! “If it wasn’t for the course I would probably still be stuck sat in my house”
- 20. Forest School Children had significantly greater levels of light PA on a FS day and a PE school day compared to a regular school day and children reported feeling both happier and relaxed as a consequence of the intervention. From the qualitative data, boys and girls reported different likes of the FS interventions, whereas their dislikes of FS were comparable
- 21. Mindful contact with nature • 8 week course developed with clinical psychologists • Research programme with University of Liverpool through CLAHRC • Enabling self management and developing coping skills
- 22. 19.29 14.21 11.68 Baseline Post-Intervention Follow-up PerceivedStress Scores Data Collection Time Points MCN Perceived Stress Results In publication Emelia Trepasso University of Liverpool Significant decrease in perceived stress
- 23. Our Learning • We can prove the Natural Health Service works • Targeting hard to reach communities is…hard! • Research evidence needs to be gathered sensitively and consistently, over an extended period of time • Our research partnership provides benefits for all involved • Natural Health Service fits into the social prescribing model very well
- 24. What Next? • Continue our data analysis • We continue to gather data • Continuation of the Natural Health Service • Cheshire West and Chester Public Health • Lottery • Urban GreeenUP - EU H2020 funds
- 25. Thank You Prof. Zoe Knowles Dr Lisa Newson, Dr Simon Cooper, Clare Austin Liverpool John Moores University Emillia Trepasso – University of Liverpool Paul Nolan The Mersey Forest Team
Editor's Notes
- 1,370 km2 1.7 million people
- We are programmed to respond to nature - Biophyllia
- IPAQ A data – self report questionnaire There was a significant increase in the number of days participants engaged in vigorous physical activity increasing from 1.43 days (SD=1.87) to 1.70 days (SD=1.96), t(417) = -2.34, p<.01, η2 = .017 (a 18.9% increase). There was a significant increase in the number of days participants engaged in moderate physical activity increasing from 2.08 days (SD=2.28) to 2.76 days (SD=2.54), t(415) = -5.46, p<.001, η2 = .067 (a 32.7% increase). There was no significant increase in the number of days participants spent walking though it increased from 4.85 days (SD=5.06) to 5.22 days (SD=2.50), t(434) = -1.51, p=.13, η2 = .005 (a 7.6% increase). The change in activity did not depend on: product; activity type; gender; employment; disability or health issues.
- Simon, could you check this headline please The note from your e-mail states …………With regards to the IPAQ data, there appears to be no significant changes in activity over time. I haven’t checked to see whether the change or lack thereof varies according to the factors listed above. The finding is also based on parametric statistics, but since there is so much variation around the mean of activity levels at both time points for all measures, it may be a good idea to use non-parametric tests instead.
- Overall, there is a highly significant increase in WEBS scores from time 1 (M= 47.74, SD=10.87) to time 2 1 (M= 53.90, SD=9.85, N=488; F(1,487) = 191.39, p<.001, η2 = .282). Statistically, this constitutes a large effect. This indicates that mood significantly improved over time. However, for the most part, the improvement was the same for most groups. I examined this by including each of the different between participant factors into a mixed ANOVA. This shows whether there is an effect over time, a difference between different groups, and crucially, whether one group improves more than the other(s). This was not influenced by gender F(1,481) = 0.89, p=.35, η2 = .002), nor were there any gender differences in WEBS data F(1,481) = 0.67, p=.41, η2 = .001). Five people who did not indicate their gender were removed from the analysis. It was not influenced by activity type/product F(1,486) = 0.57, p=.45, η2 = .001), nor were there any product differences in WEBS data F(1,486) = 1.18, p=.28, η2 = .002). It was not influenced by employment status after removing 27 people who preferred not to say or was unknown F(4,456) = 1.46, p=.22, η2 = .013). Unemployed people had lower WEBS scores than all other groups F(4,456) = 15.10, p<.001, η2 = .117. It was not influenced by disability after removing 30 people who preferred not to say or was unknown F(1,455) = 1.87, p=.17, η2 = .004). Disabled people had lower WEBS scores than able bodied respondents F(4,456) = 33.25, p<.001, η2 = .068). It was not influenced by health issues after removing 39 people who preferred not to say or was unknown F(1,445) = 0.01, p=.92, η2 = .000). People with health issues had lower WEBS scores than people without F(1,445) = 32.56, p<.001, η2 = .068). Key point is that regardless of activity chosen there was a significant increase in WWEMWBS scores by equivalent to half a point on WEMWBS scale.