Self-help Forest Bathing (Shinrin-yoku) on Depression, Anxiety, and Stress

NCT05743920 | Unknown

• 1 other identifier: PSY030
• Study Type: interventional
• Target: 80
• Locations: 0 countries
• Sites: N/A

Brief Summary

The objective of this pilot randomized controlled trial is to evaluate the efficacy and acceptability of self-help forest bathing on depression, anxiety, and stress in the Hong Kong adult population. Prior to all study procedures, eligible participants will be required to complete an online informed consent form (with telephone support). Around 80 eligible participants aged between 18 to 65 years old with at least a mild level of depression, anxiety, or stress symptoms will be randomly assigned to either the self-help forest bathing intervention group (FB group) or the waitlist control group (WL group) in a ratio of 1:1. Participants in the FB group will receive forest bathing guidance via an in-house smartphone app. The WL group will be asked to maintain their typical activity in week 1-7. This group will receive the guide upon trial completion in week 8. The outcomes of the interest will include generalized anxiety symptoms, depressive symptoms, insomnia symptoms, wellbeing, health-related quality of life, functional impairment at baseline (week 0), immediate (week 7), and 1-month post-intervention assessments (week 10). Treatment credibility and acceptability will be collected at baseline and immediately after the intervention.

Conditions

Depression, Anxiety; Stress

Keywords

Lifestyle medicine; Randomised controlled trial; Depression; Stress; Anxiety

Outcome Measures

Primary Outcomes (1)

• Change in the Patient Health Questionnaire (PHQ-9)

  The PHQ-9, a 9-item questionnaire used for screening, diagnosing, monitoring, and measuring the severity of depression, which scores each of the nine DSM-IV criteria as "0" (not at all) to "3" (nearly every day).

  Baseline, immediate post-treatment, and 1-month follow-up

Secondary Outcomes (8)

• Change in the Generalized Anxiety Disorder 7-Item Scale (GAD-7)

  Baseline, immediate post-treatment, and 1-month follow-up

• Change in the Perceived Stress Scale (PSS)

  Baseline, immediate post-treatment, and 1-month follow-up

• Change in the Insomnia Severity Index (ISI)

  Baseline, immediate post-treatment, and 1-month follow-up

• Change in the The World Health Organisation- Five Well-Being Index (WHO-5)

  Baseline, immediate post-treatment, and 1-month follow-up

• Change in the Sheehan Disability Scale (SDS)

  Baseline, immediate post-treatment, and 1-month follow-up

Study Arms (2)

Self-help Forest Bathing Group

EXPERIMENTAL

Participants in the FB group will perform forest bathing activity at the Chinese University of Hong Kong for two session.

Behavioral: Self-help Forest Bathing

Wait List Group

OTHER

Behavioral: Self-help Forest Bathing

Interventions

Self-help Forest Bathing BEHAVIORAL

The self-help forest bathing includes two sessions (i.e., participants will perform the first intervention within week 1 to 3, and the second intervention within week 4 to 6) that are related to the following forest bathing activities : (a) forest meditation, (b) forest walking, (c) calling attention to sensory experiences of the forest, including seeing, hearing, touching, and smelling, and (d) building connection to the nature by partnership invitation. Each session will last for 45 minutes.

Self-help Forest Bathing Group; Wait List Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Hong Kong residents;
• Aged between 18 to 65 years;
• Meet the threshold for mild depression (score of \>5 on the Patient Health Questionnaire 9 \[PHQ-9\], anxiety (\>5 Generalized Anxiety Disorder 7 \[GAD-7\]), or stress (\>15 on the Depression, Anxiety, and Stress Scale \[DASS-21\] stress subscale, after multiplying score by 2);
• Able to read and understand Chinese and type in Chinese or English
• Have an Internet-enabled mobile device (iOS or Android operating system)
• Willing to provide informed consent and comply with the trial protocol

You may not qualify if:

• Received psychotherapy for depression, anxiety and stress in the past 6 months;
• A change in psychotropic drugs or over-the-counter medications that target depression, anxiety, and stress within 2 weeks before the baseline assessment.
• Patient Health Questionnaire-9 (PHQ-9) item 9 score \> 2, indicating a moderate level of suicidal risk that requires active crisis management (referral information to professional mental health services will be provided);
• Currently participating in another intervention study that may potentially affect mental health;
• Self-disclosure of having unsafe health conditions for which physical activity was contraindicated by physicians;
• Self-disclosure of any psychiatric, medical, or neurocognitive disorder(s) that makes participation unfeasible;
• Pregnancy;
• Hospitalization.

Sponsors & Collaborators

• Chinese University of Hong Kong: lead

MeSH Terms

Conditions

Depression; Anxiety Disorders

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Mental Disorders

Study Officials

• Fiona Yan-Yee Ho

  Chinese University of Hong Kong

  STUDY CHAIR

Central Study Contacts

Ka Man Ho, MA in Psychology

CONTACT

852-39436575; 1155016857@link.cuhk.edu.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: February 16, 2023
• First Posted: February 24, 2023
• Study Start: February 1, 2023
• Primary Completion: December 1, 2023
• Study Completion: December 1, 2023
• Last Updated: February 24, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share