Benefits of Outdoor Walks in Reducing Depressive Symptoms

NCT06989801 | Completed

• 1 other identifier: STUDY00022242
• Study Type: interventional
• Target: 138
• Locations: 1 country
• Sites: 2

Brief Summary

The goal of this clinical trial is to determine whether outdoor walking in different environments-urban or natural-can reduce depressive symptoms among college students. The study also tests whether providing prompts for active engagement during nature walks enhances the benefits compared to unstructured nature walks. Participants will be randomly assigned to one of three groups: (1) urban walk, (2) nature walk, or (3) active nature walk with guided interaction. Each participant will walk for 30 minutes, twice a week, for 3 weeks, complete questionnaires, and participate in interviews. Our primary outcome (PHQ-9) will be used to test the following two primary hypotheses:

• Hypothesis 1: Participants in both nature walk conditions (combined) will show greater reductions in depressive symptoms (PHQ-9) than those in the urban walk group.
• Hypothesis 2: Participants in the active nature walk will show greater reductions than those in the regular nature walk.

Conditions

Depressive Symptoms

Outcome Measures

Primary Outcomes (1)

• Patient Health Questionnaire

  Patient Health Questionnaire measures the severity of depressive symptoms. It includes nine items that evaluate symptoms such as persistent sad, loss of interest or pleasure in activities, fatigue, and lack of energy. Each item is rated on a 4-point Likert scale, ranging from 0 (not at all) to 3 (nearly every day). Higher scores indicate more severe symptoms of depression.

  Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.

Secondary Outcomes (5)

• Generalized Anxiety Disorder 7-item scale

  Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.

• Positive and Negative Affect Scale

  Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.

• Cognitive Flexibility Inventory

  Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.

• Extended Inclusion of Nature in Self scale

  Right before the first walking session, immediately after the sixth walking session, and one month after the sixth walking session.

• Presence Scale

  Immediately after each walking session.

Study Arms (3)

Urban Walk

ACTIVE COMPARATOR

Regular walks in an urban area, 30 minutes twice a week for 3 weeks.

Behavioral: Urban Walk

Nature Walk

EXPERIMENTAL

Regular walks in a natural area, 30 minutes twice a week for 3 weeks.

Behavioral: Nature Walk

Active Nature Walk

EXPERIMENTAL

Regular walks in a natural area, 30 minutes twice a week for 3 weeks. Prior to the walk, participants will be instructed to actively interact with the natural environment.

Behavioral: Active Nature Walk

Interventions

Urban Walk BEHAVIORAL

For each session, participants will take a 30-minute walk in an urban environment along a designated looped route. They will walk at a comfortable pace and follow the assigned path. During the walk, participants will be instructed to experience their surroundings as naturally as possible. No specific activities beyond walking are required. To fully immerse in the experience, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the GPS app recording throughout the walk without interacting with it-just allow it to run in the background. Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience.

Urban Walk

Nature Walk BEHAVIORAL

For each session, participants will take a 30-minute walk in a natural environment along a designated looped route. They will walk at a comfortable pace and follow the assigned path. During the walk, participants will be instructed to experience their surroundings as naturally as possible. No specific activities beyond walking are required. To fully immerse in the experience, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the Gaia GPS app recording throughout the walk without interacting with it-just allow it to run in the background. Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience.

Nature Walk

Active Nature Walk BEHAVIORAL

For each session, participants will take a 30-minute walk in a natural area, following a designated looped route. Unlike a regular walk, participants will be encouraged to engage with nature (e.g., listening to natural sounds, looking for birds, and touching flowers). To make the most of the walk, participants will be asked to avoid using their phones unless necessary (e.g., in case of an emergency). They should keep the Gaia GPS app recording throughout the walk without interacting with it-just letting it run in the background. Once the loop is completed, participants will stop the GPS recording and return to the starting point, where a research team member will be waiting. They will then be guided indoors to complete a brief post-walk survey and participate in a short interview to share their experience.

Active Nature Walk

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• College students in Seattle
• Aged over 18.
• Having depressive symptoms with self-rated Patient Health Questionnaire-9 (PHQ-9) scored higher than 5.
• Normal or corrected-to-normal visual acuity.
• No identified hearing impairment.
• No history of neurological or mental disorders.

You may not qualify if:

• Receiving clinical psychiatric treatment or psychological counseling.
• Failing in providing consent form.

Sponsors & Collaborators

• University of Washington: lead

Study Sites (2)

Condon Hall

Seattle, Washington, 98105, United States

Location

Merrill Hall

Seattle, Washington, 98105, United States

Location

MeSH Terms

Conditions

Depression

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Study Officials

• Xuanyi Wang

  University of Washington

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: The participants were informed that the study was about outdoor walking interventions but were not told about the different groups.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD Student, Department of Psychology

Study Record Dates

• First Submitted: April 11, 2025
• First Posted: May 25, 2025
• Study Start: April 11, 2025
• Primary Completion: December 17, 2025
• Study Completion: December 27, 2025
• Last Updated: May 4, 2026

Record last verified: 2026-04

Locations

US (2)