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The aim of this randomized controlled trial is to test if digital engagement instructions (a nature guide APP) can enhance the nature connection and provide positive health outcomes for individuals with mobility disabilities.
The study has an active control group, that will have the same nature exposure without the guidance of the APP. 124 participants will be randomized to either the intervention group or the control group.
The intervention consists of two parts:
Intervention day 1: The intervention starts for both the 'intervention group' and the 'control group' in the Hoersholm arboretum, which contain Denmark's largest collection of different trees and shrubs. The intervention group will listen to the 'intervention APP' during a tour with three stops along a trail in the arboretum. The active control group will take the same tour but does not have access to the 'intervention APP'.
4 week intervention: During the following 4 weeks the participants will be encouraged to visit nature for 120 minutes in total per week on their own. The intervention group will still be encouraged to use the APP during the nature visits.
See protocol
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Audio guided nature tour | Experimental | Listening to audio instructions by an app while visiting nature. |
|
| Non audio guided nature tour | Active Comparator | Visiting nature without audio guided instructions (app). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Audioguided Nature tour | Behavioral | Listening to audio instructions by an app while visiting nature. The instructions emphasize the connection between self and nature and direct attention to the present moment experience by guiding focus towards sensory experiences and specific natural elements. |
| Measure | Description | Time Frame |
|---|---|---|
| The Nature Connection Index | Questionnaire Nature Connection Index (NCI) is a 6-item self-report measure of connection to nature. The level of agreement with each of the 6 statements is rated on a scale from 1 (completely agree) to 7 (completely disagree), where a higher score indicates higher level of nature connection. | Baseline 0 (1 week before intervention), After intervention day 1, End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| the State Mindfulness Scale | The State Mindfulness Scale (SMS) is a 21-item self-report measure of state mindfulness. The level of agreement with each of the 21 statements is rated on a scale from 1 (not at all) to 5 (very much), where a higher score indicates higher level of state mindfulness. | Baseline 1 (just before intervention), After tour on intervention day 1, End of intervention (after 4 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Eye-tracking | Portable eye-tracking recording | During tour on intervention day 1 |
| System Usability Scale | The System Usability Scale (SUS) consists of 10 question, scored on a 5 point likert scale ranging from strongly disagree (0) to strongly agree (4), where item 2,4,6,8 and 10 have reverse scoring. A higher score indicate higher level of perceived usability. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ulrika K Stigsdotter, PHD | Contact | 40110801 | +45 | uks@ign.ku.dk |
| Sus S Corazon, PDH | Contact | 61680921 | +45 | suoe@ign.ku.dk |
| Name | Affiliation | Role |
|---|---|---|
| Ulrika K Stigsdotter, PHD | University of Copenhagen - IGN | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42032758 | Derived | White MP, Egger JAM, Amato G, Astell-Burt T, Bekke-Hansen S, Borja A, Burov A, Busse S, Costongs C, Dimitrova D, Doimo I, Dzhambov AM, Elliott LR, Godfrey A, Grellier J, Hartig T, Hartl A, Nyed PK, Konijnendijk C, Lem M, Litt JS, Lovell R, Lymeus F, Mammadova A, Martin L, Moe A, Trimmer SM, O'Driscoll C, Ostberg J, Pahl S, Pazzaglia F, Pichler C, Poole A, Pouso S, Razani N, Rogelja T, Secco L, Stigsdotter UK, Corazon SS, Sowman G, Uyarra MC, van den Berg AE, van Rompay T, Voracek M, Wells NM, Wheeler BW, van den Bosch M. Testing nature-based biopsychosocial resilience theory: a research programme protocol. Arch Public Health. 2026 Apr 24;84(1):90. doi: 10.1186/s13690-026-01903-5. |
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Data is shared exclusively in pseudonymized form with all partners in the RESONATE project. The countries included in RESONATE are: Denmark, Spain, Italy, Belgium, Sweden, Bulgaria, Austria, and the Netherlands. The UK is an associated partner.
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2025 to 2028
The RESONATE project is currently developing a Joint Control Agreement which is an arrangement on shared responsibility for data processing, which determines in a transparent manner the partner's respective responsibilities for GDPR compliance. Signing this agreement allows results to be shared freely within the consortium. Thus, the RESONATE partners would not need separate Data Sharing or Data Transfer agreements with each partner.
The General Data Protection Regulation (GDPR) is enforced in all EU countries and also in the UK. All partners in the consortium need to follow the GDPR.
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randomized controlled trial
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| Non audio guided nature tour | Behavioral | Visiting nature without listening to audio instructions by an app |
|
| The Restorative Outcome Scale | The Restorative Outcome Scale (ROS) is a 6-item self-report measure of the restorative effect of natural environments. The level of agreement with each of the six statement is rated on a 7 point scale from 0 (completely disagree) to 6 (completely agree), where a higher score indicates higher level of self perceived restorative outcome. | After tour on intervention day 1, End of intervention (after 4 months) |
| The Subjective Vitality Scale | The Subjective Vitality Scale (SVS) is a 6-item self-report measure of subjective vitality. The level of agreement with each of the six statement is rated on a 7 point scale from 1(completely disagree) to 7 (completely agree), where a higher score indicates higher level of subjective vitality. | Baseline 0 (1 week before intervention), After intervention day 1, End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up |
| The State-Trait Assessment of Resilience Scale | The State-Trait Assessment of Resilience Scale (STARS) is a 7-item self-report measure of resilience. The level of agreement with each of the 7 statements is rated on a 4 point scale from 1(disagree) to 4 (completely agree). Item 3,4,5 have reverse scoring. A higher score indicates higher level of subjective vitality. | Baseline 0 (1 week before intervention), After intervention day 1, End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up |
| Heart Rate Variability | HRV analysis will be performed on electrocardiograms, ECG signals | During tour on intervention day 1 |
| The Health-related Quality of Life Short Form Survey | The Health-related Quality of Life Short Form Survey (SF-12) is a 12-item Short Form Survey measuring health related quality of life. Each question is answered on a 6 point scale ranging from not at all (1) to all the time (6). A higher total score indicates higher level of health-related quality of life. | Baseline 0 (1 week before intervention), End of intervention (after 4 months), 1 month follow-up, 3 month-follow up, 6-months follow-up |
| After tour on intervention day 1 |