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| Name | Class |
|---|---|
| East Bay Regional Park District | OTHER |
| National Recreation and Park Association | OTHER |
| University of California, San Francisco | OTHER |
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The SHINE study is a randomized controlled study of the effect of a park-based family support group on multiple outcomes (including stress and physical activity) in a low income population.
Despite mounting evidence that nature matters for human health, we are not aware of any prospective intervention trials looking at the use of nature as a health intervention. Like other protective factors, such as the presence of a caring adult, safe play places, greater stimulation, the presence of green-space in a child's life has been empirically linked to greater resilience. Nature has been proposed as a buffer to stress through several pathways: by providing a space for friends and families to gather (thereby increasing social support and improving family relationships), by increasing opportunities for physical activity, and by improving cognition. Research to date suggests that participation in outdoor activities facilitates a sense of connectedness to place. This sense of attachment may also provide a form of social support. Families served by Children's Hospital Oakland Primary Care Clinic experience high levels of stress. As a safety-net clinic, the primary care clinic serves a diverse set of patients, with a common thread of poverty. The Stay Healthy In Nature program was developed to encourage stress management skills through play and physical activity in parks. The program uses a combination of facilitated and independent outings into local parks to encourage sustained behavior change and measurable health benefits.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Park prescription | Active Comparator | Park prescription, pedometry. |
|
| Park prescription and family outings | Experimental | Park prescription, pedometry, case management and 3 weekly family outings. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Family outings | Behavioral | Participants will be invited to three weekly outings to local parks, case management and support in getting to nature. Participants will be offered transportation to the outings and s meal at local nature destinations. Programming at the park will include a picnic and walk with nature exploration, and will be facilitated by park and clinic staff. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Stress | measured through the Perceived Stress Score10 (PSS10) over 0, 1 and 3 months. The PSS10 is a ten item, validated instrument which ranges from 0-40. Each item on the instrument is summed to create a total score. Higher values correspond with higher stress. | 3 months |
| Change in Stress | measured through the Perceived Stress Score10 (PSS10), a ten item, validated instrument which ranges from 0-40. | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Park Visits Per Week | Self-reported number of park visits in the last week, measured at 0, 1, and 3 months. | 1 month |
| Change in Minutes of Moderate Physical Activity Per Day | Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1, and 3 months out. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nooshin Razani, MD, MPH | UCSF Benioff Children's Hospital Oakland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCSF Benioff Children's Hospital Oakland Primary Care Clinic | Oakland | California | 94609 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29447248 | Derived | Razani N, Morshed S, Kohn MA, Wells NM, Thompson D, Alqassari M, Agodi A, Rutherford GW. Effect of park prescriptions with and without group visits to parks on stress reduction in low-income parents: SHINE randomized trial. PLoS One. 2018 Feb 15;13(2):e0192921. doi: 10.1371/journal.pone.0192921. eCollection 2018. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Park Prescription | Park prescription, pedometry. Park prescription: Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. Pedometry: Participants will record their daily pedometry. |
| FG001 | Park Prescription and Family Outings | Park prescription, pedometry, case management and 3 weekly family outings. Family outings: Participants will be invited to three weekly outings to local parks, case management and support in getting to nature. Participants will be offered transportation to the outings and s meal at local nature destinations. Programming at the park will include a picnic and walk with nature exploration, and will be facilitated by park and clinic staff. Park prescription: Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. Pedometry: Participants will record their daily pedometry. Case Management: Participants will receive a phone call to list potential barriers to participating in nature outings, and will talk through solutions with an investigator. Participants will be offered assistance with transportation if necessary. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Park Prescription | Park prescription, pedometry. Park prescription: Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. Pedometry: Participants will record their daily pedometry. |
| BG001 | Park Prescription and Family Outings |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Stress | measured through the Perceived Stress Score10 (PSS10) over 0, 1 and 3 months. The PSS10 is a ten item, validated instrument which ranges from 0-40. Each item on the instrument is summed to create a total score. Higher values correspond with higher stress. | Posted | Mean | 95% Confidence Interval | units on a scale | 3 months |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Park Prescription | Park prescription, pedometry. Park prescription: Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. Pedometry: Participants will record their daily pedometry. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Nooshin Razani, Principal Investigator | UCSF Benioff Children's Hospital Oaland | 415-428-3129 | nrazani@mail.cho.org |
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| D012934 | Social Isolation |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D012919 | Social Behavior |
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| ID | Term |
|---|---|
| D019090 | Case Management |
| ID | Term |
|---|---|
| D010347 | Patient Care Planning |
| D003191 | Comprehensive Health Care |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |
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|
| Park prescription | Behavioral | Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. |
|
| Pedometry | Device | Participants will record their daily pedometry. |
|
| Case Management | Behavioral | Participants will receive a phone call to list potential barriers to participating in nature outings, and will talk through solutions with an investigator. Participants will be offered assistance with transportation if necessary. |
|
| 3 months |
| Change in Cortisol Level in Parents | Salivary cortisol from parents | 3 months |
| Change in Minutes of Moderate Physical Activity Per Day | Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1months follow up. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results. | 1 month |
| Change in Cortisol Level in Parents | Salivary cortisol from parents | 1 month |
| Change in Park Visits Per Week | Self-reported number of park visits in the last week, measured at 0, 1, and 3 months. | 3 month |
Park prescription, pedometry, case management and 3 weekly family outings. Family outings: Participants will be invited to three weekly outings to local parks, case management and support in getting to nature. Participants will be offered transportation to the outings and s meal at local nature destinations. Programming at the park will include a picnic and walk with nature exploration, and will be facilitated by park and clinic staff. Park prescription: Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. Pedometry: Participants will record their daily pedometry. Case Management: Participants will receive a phone call to list potential barriers to participating in nature outings, and will talk through solutions with an investigator. Participants will be offered assistance with transportation if necessary. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
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|
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| Primary | Change in Stress | measured through the Perceived Stress Score10 (PSS10), a ten item, validated instrument which ranges from 0-40. | Posted | Mean | 95% Confidence Interval | units on a scale | 1 month |
|
|
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| Secondary | Change in Park Visits Per Week | Self-reported number of park visits in the last week, measured at 0, 1, and 3 months. | Posted | Mean | 95% Confidence Interval | park visits/week | 1 month |
|
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|
|
| Secondary | Change in Minutes of Moderate Physical Activity Per Day | Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1, and 3 months out. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results. | Minutes of moderate physical activity per average day in the week prior to follow up at 0, 1 and 3 months was measured. Below we list the mean within group change of minutes of moderate physical activity per day. | Posted | Mean | 95% Confidence Interval | minutes/day | 3 months |
|
|
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| Secondary | Change in Cortisol Level in Parents | Salivary cortisol from parents | Posted | Mean | 95% Confidence Interval | ug/dL | 3 months |
|
|
|
|
| Secondary | Change in Minutes of Moderate Physical Activity Per Day | Parents will report their physical activity in terms of minutes of moderate physical activity in the week before follow up at 0, 1months follow up. Pedometers were also given to participants. Of note, because of poor follow through with returning pedometer data, this variable was not analyzed in the study results. | Minutes of moderate physical activity per average day in the week prior to follow up at 0, 1 and 3 months was measured. Below we list the mean within group change of minutes of moderate physical activity per day. | Posted | Mean | 95% Confidence Interval | minutes/day | 1 month |
|
|
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| Secondary | Change in Cortisol Level in Parents | Salivary cortisol from parents | Posted | Mean | 95% Confidence Interval | ug/dL | 1 month |
|
|
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| Secondary | Change in Park Visits Per Week | Self-reported number of park visits in the last week, measured at 0, 1, and 3 months. | Posted | Mean | 95% Confidence Interval | park visits/week | 3 month |
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|
| 0 |
| 28 |
| 0 |
| 28 |
| 0 |
| 28 |
| EG001 | Park Prescription and Family Outings | Park prescription, pedometry, case management and 3 weekly family outings. Family outings: Participants will be invited to three weekly outings to local parks, case management and support in getting to nature. Participants will be offered transportation to the outings and s meal at local nature destinations. Programming at the park will include a picnic and walk with nature exploration, and will be facilitated by park and clinic staff. Park prescription: Participants will receive a map of local parks, and the recommendation to be physically active outdoors three days a week in nature. Pedometry: Participants will record their daily pedometry. Case Management: Participants will receive a phone call to list potential barriers to participating in nature outings, and will talk through solutions with an investigator. Participants will be offered assistance with transportation if necessary. | 0 | 50 | 0 | 50 | 0 | 50 |
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