Research Library

Research Digest

In July 2016, a visit to the Trellis office from Maxel Ng of the National Parks Board, Singapore brought us news of a randomised control trial (RCT) being carried out there, exploring the potential of therapeutic horticulture to reduce inflammation levels and increase social connectedness in older residents, The Effects of Horticultural Therapy on Asian Elderly’s Mental Health.  The results were positive and we are delighted to share the link to the published paper here. Singapore has adopted a strategic approach to therapeutic and community gardening, with direct government investment in gardening projects across the country, see the wealth of gardening and greenspace in Singapore at https://www.nparks.gov.sg/gardening

Therapeutic Gardening: theory and evidence
A summary of the main studies relevant to gardening therapy Word | pdf

Dr Rachel Bragg, OBE, Fellow at University of Essex, has published extensively on therapeutic effects of being in gardens, green spaces and nature, including ‘green care’, ‘nature-based interventions (NBIs)’ and care farming. She was headline speaker at the Trellis Annual Conference 11th March 2016:  then as Development Coordinator, Care Farming UK, offering an animated and enlightening overview of therapeutic gardening, its place within green care and evidence of how it supports health and wellbeing. To open the presentation please right click on the link and select 'open in new window' . This is the accompanying research paper

AIPH International Green City Conference: Growing Green & Healthy Places
Sir Richard Thompson KCVO, DM, President of the Royal College of Physicians in his conference paper  Why and How Green Environments are Better for Your Health   (please right click on the link and select  'open in new window') at the AIPH International Green City Conference,  1st April 2014

Gardens and health: Implications for policy and practice
A useful publication making the case for increased use of gardening in health services, and gathering up some good research references about the health benefits of gardens and gardening. https://assets.kingsfund.org.uk/f/256914/x/3f83d457a4/gardens_and_health_2016.pdf
 

Forward to Nature: Why a Walk in the Woods Could Calm ADHD, Make Your Family Happier and Deliver Your Kid to Harvard. Research shows getting kids in nature can increase intelligence, creativity, and well-being, as well as solving a host of other psychological and physical illnessess.
http://www.parentmap.com/article/a-walk-in-the-woods-calm-adhd-make-your-family-happier-and-deliver-your-kid-to-harvard

Longitudinal study of older people in Sweden highlighting the importance of non sport based physical activity in cardio vascular health.
The importance of non-exercise physical activity for cardiovascular health and longevity, Ekblom-Bak, E. et al.,Br J Sports Med: 28th October 2013
Abstract: http://bjsm.bmj.com/content/early/2013/10/08/bjsports-2012-092038

Green spaces deliver lasting mental health benefits. Analysing data that followed people over a five year period, the research has found that moving to a greener area not only improves people’s mental health, but that the effect continues long after they have moved. Article: https://www.sciencedaily.com/releases/2014/01/140107093323.htm

PubMed: Healing gardens and cognitive behavioural units in the management of Alzheimer's disease patients: the Nancy experience.http://www.ncbi.nlm.nih.gov/pubmed/23207487
Healing gardens: recommendations and criteria for design French team rooted in psychiatric practice .https://pubmed.ncbi.nlm.nih.gov/23015232/
What Is the Evidence to Support the Use of Therapeutic Gardens for the Elderly? https://pmc.ncbi.nlm.nih.gov/articles/PMC3372556/

Physical Activity and the Prevention of Depression: A Systematic Review of Prospective Studies
George Mammen and  Guy Faulkner, PhD shows evidence that any level of physical activity including low levels (e.g., walking or  gardening  <150 minutes/weeks), can prevent future depression. From a population health perspective, promoting physical activity  may serve as a valuable mental health promotion strategy in reducing the risk of developing depression. Published in the
American Journal of Preventive Medicine Volume 45, Issue 5 , Pages 649-657, November 2013
Abstract: http://www.ajpmonline.org/article/PIIS0749379713004510/abstract

The Growing Healthy Older People in Wales (GHOP) research programme reveals that allotment and community gardening reduces stress, boosts self-esteem and enhances feelings of happiness and well-being, particularly for women see the report at
https://www.cardiffmet.ac.uk/health/research/cha/Documents/GHOP%20Report%20Online%20compressed.pdf
 

ecotherapy benefits for mental health and wellbeing
Mind (the mental health support charity in England and Wales) recently released Feel Better Outside, Feel Better Inside - a report showing the many benefits of ecotherapy for mental wellbeing. Ecotherapy involves activities such as gardening, food growing and conservation work in natural environments. The report demonstrates that ecotherapy improves mental health, boosts self-esteem, helps people with mental health problems return to work, improves physical health and reduces social isolation. It also calculates the savings to the public purse from engaging people in ecotherapy activities.see report at www.mind.org.uk  
also see Mind's report Ecominds effects on mental wellbeing: an evaluation for mind at
https://www.mind.org.uk/media/4418/ecominds-effects-on-mental-wellbeing-evaluation-report.pdf

Allotment gardening and health: a comparative survey among allotment gardeners and their
neighbors without an allotment,  van den Berg et al. Environmental Health 2010, http://www.ehjournal.net/content/9/1/74
 

Di Blackmore PhD postgraduate student at the University of Stirling gives an update on her research into the health effects of therapeutic gardening.

The main application of the research will be to raise awareness and convince service managers, funders and policy makers in organisations such as national government, local authorities, health and environmental agencies, of the value delivered by such projects.

Ground-breaking research into the impacts of greenspace, Prof Richard Mitchell of Glasgow University, and Prof Catharine Ward-Thompson of the OPENspace Research Centre at Edinburgh University have published many useful papers on the links between green spaces and health, for example this study from 2013: More green space is linked to less stress in deprived communities: evidence from salivary cortisol patterns - Enlighten Publications

More from Prof Mitchell here: University of Glasgow - Schools - School of Health & Wellbeing - Our staff - Prof Rich Mitchell and from Prof Ward-Thompson here: Prof Catharine Ward Thompson | Edinburgh College of Art

https://drive.google.com/file/d/1kA24rAZzoF-OBuGWIRVnR8I6swc0R4yk/view

https://drive.google.com/file/d/1PeBIs0UuAT8rzjbSHUd-ftDVRs_zK-zw/view

We aim to collate new research relevant to therapeutic gardening so that it's accessible to practitioners in one central place. We also work in partnership with researchers to encourage more studies that will help build the evidence base that demonstrates the benefits of therapeutic horticulture initiatives.

• Social and Therapeutic Horticulture as a Palliative Care Intervention

  Elisabeth Pilgrem

  2023

  BMJ Supportive & Palliative Care Journal: Online First

  https://spcare.bmj.com/content/early/2023/02/27/spcare-2021-003503

  Abstract:

  Abstract Objectives Social and therapeutic horticulture (STH) is little known in palliative care. This evaluation sets out to explore the effectiveness of STH in relieving distress, managing symptoms and supporting people with advanced and terminal illness to live well throughout each stage of the disease trajectory. Methods STH was provided for 218 patients in an indoor hospice setting during a 2-year period (April 2018 to March 2020). Nature-based interventions, such as potting up plants, floristry and creating miniature gardens, were adapted for all participants to create a nature connection experience while indoors. The Distress Thermometer (DT) was used to measure perceived distress before and after each session, and patients’ reports of their subjective experience were recorded verbatim. Results Results showed a statistically significant reduction in DT scores of between 54% and 60%. Patients also self-reported an improvement in quality of life and well-being and in management of symptoms including a reduction in pain. Conclusions This evaluation shows that STH is effective in relieving distress in palliative care and may be considered a valued therapeutic intervention. The findings can inform planning within hospices and palliative care settings to enhance the care of patients and their family members. http://dx.doi.org/10.1136/spcare-2021-003503

• Elizabeth R. Messer Diehl

2017

https://www.researchgate.net/publication/330401717_Do_All_Gardens_Heal_the_Sam

• Vitamin D Deficiency and Leisure Time Activities in the Elderly: Are All Pastimes the Same?

  Marina De Rui, Elena Debora Toffanello, Nicola Veronese, Sabina Zambon, Francesco Bolzetta, Leonardo Sartori, Estella Musacchio, Maria Chiara Corti, Giovannella Baggio, Gaetano Crepaldi, Egle Perissinotto, Enzo Manzato, Giuseppe Sergi

  2014

   

  PLOS ONE | www.plosone.org

  April 2014 | Volume 9 | Issue 4 | e94805

   

  Abstract:

  Abstract Background: Optimal vitamin D status is important for overall health and well-being, particularly in the elderly. Although vitamin D synthesis in the skin declines with age, exposure to sunlight still seems to help older-aged adults to achieve adequate serum 25-hydroxyvitamin D (25OHD) levels. Elderly people would therefore benefit from outdoor leisure activities, but the effects of different types of pastime on serum 25OHD levels have yet to be thoroughly investigated. Aims: To assess the association of different pastimes with 25OHD deficiency in elderly subjects. Methods: A sample of 2,349 community-dwelling elderly individuals (1,389 females and 960 males) enrolled in the Progetto Veneto Anziani was analyzed. Brisk walking, cycling, gardening and fishing were classed as outdoor activities, and dancing and gym workouts as indoor pastimes. Any activities undertaken for at least 1 hour/week during the previous month were considered as being practiced regularly. Logistic regression models were used to estimate the association between different pastimes and 25OHD deficiency. Results: Serum 25OHD levels were significantly higher in individuals who engaged in outdoor pastimes (+25% in women, + 27.7% in men) compared to those who did not. In particular, subjects regularly practicing gardening or cycling had higher serum 25OHD levels than those who did not, whereas 25OHD levels differed little between subjects who did or did not undertake indoor activities. Among the outdoor pastimes considered, logistic regression analysis confirmed a lower likelihood of vitamin D deficiency (25OHD,50 nmol/L) for cyclists (OR 0.51, 95% CI 0.37–0.69 in women; OR 0.50, 95% CI 0.29–0.87 in men) and gardeners (OR 0.62, 95% CI 0.47–0.83 in women; OR 0.46, 95% CI 0.26–0.80), but not for brisk walkers. Conclusions: Regular cycling and gardening reduce the likelihood of inadequate vitamin D status in Caucasian elderly people, irrespective of their age, BMI and comorbidities, and of the season of the year.

• Is gardening associated with greater happiness of urban residents? A multiactivity, dynamic assessment in the Twin-Cities region, USA

  Graham Ambrosea,, Kirti Dasb,, Yingling Fanb,, Yingling Fanb,

  2020

   

  Elsevier

  Volume 198, June 2020, 103776

   

   

   

  https://www.sciencedirect.com/science/article/pii/S0169204619307297?via%3Dihub

  Abstract:

  As cities seek to become more livable and environment-friendly, activities like bicycling, walking, and urban gardening (household and community-gardening) are receiving much attention. However, few field studies have measured well-being of urban gardening, particularly during household gardening. Our study develops protocols to measure emotional well-being (EWB) reported during household gardening, comparing it with other leisure and day-to-day activities. We also explore how gardening EWB varies across gardener type (vegetable vs ornamental), demographics, neighborhood type, and companionship during gardening. Using a recently developed app-based Day Reconstruction Method, EWB was measured across 370 participants in the Minneapolis-St. Paul Area, USA, wherein 118 (32%) reported engaging in household gardening. Innovatively, five measures of EWB were computed for each participant for each activity type: average net affect, average happiness, average meaningfulness, the frequency of experiencing peak positive emotions (happiness and meaningfulness). Among all three average EWB measures, gardening is among the top 5 out of 15 activities assessed, and, is not statistically different from biking, walking and eating out. All four of these activities fall behind other leisure/recreation activities, which ranks first. For frequency of experiencing peak happiness, only other leisure/recreation activities were statistically higher than all the remaining (14) activities. Average net affect of gardening was significantly higher for vegetable gardeners (vs ornamental), for low-income gardeners (vs higher income) and for women. Companionship while gardening at home, race/ethnicity and urban versus suburban location showed no significant difference. Livability and equity considerations based on these EWB findings, and their impacts on urban food plans, are discussed.

• What is the evidence for the impact of gardens and gardening on health and well-being: a scoping review and evidence-based logic model to guide healthcare strategy decision making on the use of gardening approaches as a social prescription

  Michelle Howarth, Alison Brettle, Michael Hardman , Michelle Maden

  2020

   

  BMJ Open

   

   

   

   

  https://bmjopen.bmj.com/content/10/7/e036923

  Abstract:

  Abstract Objective To systematically identify and describe studies that have evaluated the impact of gardens and gardening on health and well-being. A secondary objective was to use this evidence to build evidence-based logic models to guide health strategy decision making about gardens and gardening as a non-medical, social prescription. Design Scoping review of the impact of gardens and gardening on health and well-being. Gardens include private spaces and those open to the public or part of hospitals, care homes, hospices or third sector organisations. Data sources A range of biomedical and health management journals was searched including Medline, CINAHL, Psychinfo, Web of Knowledge, ASSIA, Cochrane, Joanna Briggs, Greenfile, Environment Complete and a number of indicative websites were searched to locate context-specific data and grey literature. We searched from 1990 to November 2019. Eligibility criteria We included research studies (including systematic reviews) that assessed the effect, value or impact of any garden that met the gardening definition. Data extraction and synthesis Three reviewers jointly screened 50 records by titles and abstracts to ensure calibration. Each record title was screened independently by 2 out of 3 members of the project team and each abstract was screened by 1 member of a team of 3. Random checks on abstract and full-text screening were conducted by a fourth member of the team and any discrepancies were resolved through double-checking and discussion. Results From the 8896 papers located, a total of 77* studies was included. Over 35 validated health, well-being and functional biometric outcome measures were reported. Interventions ranged from viewing gardens, taking part in gardening or undertaking therapeutic activities. The findings demonstrated links between gardens and improved mental well-being, increased physical activity and a reduction in social isolation enabling the development of 2 logic models. Conclusions Gardens and gardening can improve the health and well-being for people with a range of health and social needs. The benefits of gardens and gardening could be used as a ‘social prescription’ globally, for people with long-term conditions (LTCs). Our logic models provide an evidence-based illustration that can guide health strategy decision making about the referral of people with LTCs to socially prescribed, non-medical interventions involving gardens and gardening.