Outdoor activities to improve mental health in children

BLOOM: Boldly Living outdOOrs for Mental Health

This study is testing if outdoor activities can help children aged 9-12 who have faced tough experiences and feel anxious, by providing them with supportive group outings in nature.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 126 (estimated)
• Ages: 9 Years to 12 Years
• Sex: All
• Sponsor: University of California, San Francisco (other)
• Locations: 1 site (Oakland, California)
• Trial ID: NCT05973123 on ClinicalTrials.gov

What this trial studies

This study focuses on the impact of nature-based interventions on pediatric mental health, specifically targeting children aged 9-12 who have experienced adverse childhood experiences (ACEs) and exhibit symptoms of anxiety. Participants will engage in group nature outings designed to foster supportive relationships and promote physical activity, with the aim of alleviating anxiety and stress disorders. The study is part of a broader initiative to integrate community health resources with clinical care for children affected by ACEs. By evaluating the effectiveness of these outdoor experiences, the research seeks to fill a gap in evidence regarding nature's role in improving mental health outcomes for youth.

Who should consider this trial

Good fit: Ideal candidates are children aged 9-12 with an ACE score of 1 or higher and a SCARED-P score of 15 or higher.

Not a fit: Patients with serious health conditions that limit their ability to participate in outdoor activities may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a novel, effective approach to reducing anxiety and improving mental health in children who have experienced trauma.

How similar studies have performed: While there is limited evidence specifically evaluating nature-based programs for child mental health, similar approaches in adult populations have shown promising results.

Eligibility criteria

Pediatric Inclusion Criteria:

1. Age 9-12 years at enrollment
2. Has an ACE Score of 1 or higher
3. Has a SCARED-P score of 15 or higher
4. Is available to attend three group outings if assigned to group intervention arm.
5. Has a caregiver who is able to consent and attend outings with them.
6. Is able to read, write, and speak English, Spanish or Arabic.
7. Has no serious health conditions that affect their ability to be in nature.
8. Willing to wear a provided electronic sensor continuously for 6 weeks, including sleep, excluding bathing and device recharging time.
9. Have no major changes in their mental health treatment plan during the time of the study.

Caregiver eligibility criteria

1. Able to read, write and speak English, Spanish or Arabic
2. Be at least 18 years old.
3. Have no serious health conditions that affect their ability to be in nature.
4. Is available to attend 6 weekly outings if assigned to group intervention arm.
5. Have a smart phone and be willing to download NatureDose app from NatureQuant.

Exclusion Criteria Child:

1. Concomitant active treatment modification (eg medication changes) for the past month.
2. Unable to attend weekly nature outings if randomized to the group intervention.
3. Physical or health limitation to participating in outdoor activities.
4. Previous SHINE participant.
5. Caregiver unable to consent.
6. Unable to pass short quiz at the end of the assent.
7. Wards of the state who do not have a guardian other than the state who can consent on their behalf.
8. Non-English, Arabic or Spanish speaking participants.
9. Unwilling to use a FitBit.

Exclusion criteria - caregiver

1. Unable to attend weekly nature outings if randomized to the group intervention.
2. Physical or health limitation to participating in outdoor activities.
3. Previous SHINE participant.
4. Unable to provide informed consent.
5. Non-English, Arabic or Spanish speaking participants.
6. Unwilling to use NatureDose app.

Where this trial is running

Oakland, California

• UCSF Benioff Children's Hospitals — Oakland, California, United States (RECRUITING)

Study contacts

• Principal investigator: Nooshin Razani, MD MPH — UCSF and UCSF Benioff Children's Hospital Oakland
• Study coordinator: Nooshin Razani, MD MPH

Conditions: Anxiety, Stress Disorder, Posttraumatic, Loneliness, Adverse Childhood Experiences, Pediatric Mental Health