Publications by year
2020
White MP, Bratman GN, Pahl S, Young G, Cracknell D, Elliott LR (2020). Affective reactions to losses and gains in biodiversity: Testing a prospect theory approach. Journal of Environmental Psychology, 72, 101502-101502.
White MP, Elliott LR, Gascon M, Roberts B, Fleming LE (2020). Blue space, health and well-being: a narrative overview and synthesis of potential benefits.
Environmental Research,
191Abstract:
Blue space, health and well-being: a narrative overview and synthesis of potential benefits
© 2020 Elsevier Inc. Research into the potential health and well-being benefits from exposure to green spaces such as parks and woodlands has led to the development of several frameworks linking the different strands of evidence. The current paper builds on these to provide a model of how exposure to aquatic environments, or blue spaces such as rivers, lakes and the coast, in particular, may benefit health and well-being. Although green and blue spaces share many commonalities, there are also important differences. Given the breadth of the research, spanning multiple disciplines and research methodologies, a narrative review approach was adopted which aimed to highlight key issues and processes rather than provide a definitive balance of evidence summary. Novel aspects of our framework included the inclusion of outcomes that are only indirectly good for health through being good for the environment, the addition of nature connectedness as both a trait and state, and feedback loops where actions/interventions to increase exposure are implemented. Limitations of the review and areas for future work, including the need to integrate potential benefits with potential risks, are discussed.
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Hooyberg A, Roose H, Grellier J, Elliott LR, Lonneville B, White MP, Michels N, De Henauw S, Vandegehuchte M, Everaert G, et al (2020). General health and residential proximity to the coast in Belgium: Results from a cross-sectional health survey.
Environ Res,
184Abstract:
General health and residential proximity to the coast in Belgium: Results from a cross-sectional health survey.
The health risks of coastal areas have long been researched, but the potential benefits for health are only recently being explored. The present study compared the general health of Belgian citizens a) according to the EU's definition of coastal (50 km), and b) between eight more refined categories of residential proximity to the coast (250 km). Data was drawn from the Belgian Health Interview Survey (n = 60,939) and investigated using linear regression models and mediation analyses on several hypothesized mechanisms. Results indicated that populations living 50-100 km. Four commonly hypothesized mechanisms were considered but no indirect associations were found: scores for mental health, physical activity levels and social contacts were not higher at 0-5 km from the coast, and air pollution (PM10 concentrations) was lower at 0-5 km from the coast but not statistically associated with better health. Results are controlled for typical variables such as age, sex, income, neighbourhood levels of green and freshwater blue space, etc. The spatial urban-rural-nature mosaic at the Belgian coast and alternative explanations are discussed. The positive associations between the ocean and human health observed in this study encourage policy makers to manage coastal areas sustainably to maintain associated public health benefits into the future.
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Yeo NL, Elliott LR, Bethel A, White MP, Dean SG, Garside R (2020). Indoor Nature Interventions for Health and Wellbeing of Older Adults in Residential Settings: a Systematic Review.
Gerontologist,
60(3), e184-e199.
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Indoor Nature Interventions for Health and Wellbeing of Older Adults in Residential Settings: a Systematic Review.
BACKGROUND AND OBJECTIVES: Having contact with nature can be beneficial for health and wellbeing, but many older adults face barriers with getting outdoors. We conducted a systematic review of quantitative studies on health and wellbeing impacts of indoor forms of nature (both real and simulated/artificial), for older adults in residential settings. RESEARCH DESIGN AND METHODS: Search terms relating to older adults and indoor nature were run in 13 scientific databases (MEDLINE, CINAHL, AgeLine, Environment Complete, AMED, PsychINFO, EMBASE, HMIC, PsychARTICLES, Global Health, Web of Knowledge, Dissertations and Theses Global, and ASSIA). We also pursued grey literature, global clinical trials registries, and a range of supplementary methods. RESULTS: of 6,131 articles screened against eligibility criteria, 26 studies were accepted into the review, and were quality-appraised using the Effective Public Health Practice Project (EPHPP) tool. The participants were 930 adults aged over 60. Nature interventions and health/wellbeing outcomes were heterogeneous, which necessitated a narrative synthesis. The evidence base was generally weak, with 18 of 26 studies having a high risk of bias. However, several higher-quality studies found indoor gardening and horticulture programs were effective for cognition, psychological wellbeing, social outcomes, and life satisfaction. DISCUSSION AND IMPLICATIONS: There is inconsistent evidence that indoor nature exposures are beneficial for older care residents. We expect that successful interventions were, at least partly, facilitating social interaction, supporting feelings of autonomy/control, and promoting skill development, that is, factors not necessarily associated with nature per se. Higher-quality studies with improved reporting standards are needed to further elucidate these mechanisms.
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Vert C, Gascon M, Ranzani O, Márquez S, Triguero-Mas M, Carrasco-Turigas G, Arjona L, Koch S, Llopis M, Donaire-Gonzalez D, et al (2020). Physical and mental health effects of repeated short walks in a blue space environment: a randomised crossover study.
Environmental Research,
188, 109812-109812.
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Elliott LR, White MP, Fleming LE, Abraham C, Taylor AH (2020). Redesigning walking brochures using behaviour change theory: implications for walking intentions in natural environments.
Health Promot IntAbstract:
Redesigning walking brochures using behaviour change theory: implications for walking intentions in natural environments.
Natural environments can be used to promote health through facilitating recreational walking. However, efforts to encourage this often neglect messages identified in psychological research that are effective at influencing intentions to walk. This is despite the National Institute for Health and Care Excellence stating that promotional efforts should utilize theoretical frameworks of behaviour change and be targeted towards less active adults. As an illustrative example, this experiment compared a prototypical recreational walking brochure with an "enhanced" version including such persuasive messages on people's intentions to walk for recreation in natural environments. The enhanced brochure heightened intentions for inexperienced recreational walkers through our hypothesized mechanisms, but appeared to dissuade already-experienced walkers. Optimal messaging strategies in recreational walking brochures require tailoring to more and less active readerships. Guidelines are provided for authors of recreational walking brochures, though the principles and techniques could easily be extended to other means of outdoor walking promotion.
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Elliott LR, White MP, Grellier J, Garrett JK, Cirach M, Wheeler BW, Bratman GN, van den Bosch MA, Ojala A, Roiko A, et al (2020). Research Note: Residential distance and recreational visits to coastal and inland blue spaces in eighteen countries.
Landscape and Urban Planning,
198, 103800-103800.
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Tester-Jones M, White MP, Elliott LR, Weinstein N, Grellier J, Economou T, Bratman GN, Cleary A, Gascon M, Korpela KM, et al (2020). Results from an 18 country cross-sectional study examining experiences of nature for people with common mental health disorders.
Scientific Reports,
10(1).
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Results from an 18 country cross-sectional study examining experiences of nature for people with common mental health disorders
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. Exposure to natural environments is associated with a lower risk of common mental health disorders (CMDs), such as depression and anxiety, but we know little about nature-related motivations, practices and experiences of those already experiencing CMDs. We used data from an 18-country survey to explore these issues (n = 18,838), taking self-reported doctor-prescribed medication for depression and/or anxiety as an indicator of a CMD (n = 2698, 14%). Intrinsic motivation for visiting nature was high for all, though slightly lower for those with CMDs. Most individuals with a CMD reported visiting nature ≥ once a week. Although perceived social pressure to visit nature was associated with higher visit likelihood, it was also associated with lower intrinsic motivation, lower visit happiness and higher visit anxiety. Individuals with CMDs seem to be using nature for self-management, but ‘green prescription’ programmes need to be sensitive, and avoid undermining intrinsic motivation and nature-based experiences.
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Bell S, Mishra HS, Elliott LR, Shellock R, Vassiljev P, Porter M, Sydenham Z, White MP (2020). Urban Blue Acupuncture: a Protocol for Evaluating a Complex Landscape Design Intervention to Improve Health and Wellbeing in a Coastal Community.
Sustainability,
12(10), 4084-4084.
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Urban Blue Acupuncture: a Protocol for Evaluating a Complex Landscape Design Intervention to Improve Health and Wellbeing in a Coastal Community
Within the BlueHealth project, funded under the Horizon 2020 European Union research framework, a number of targeted experimental design interventions were used to test the effect and impact of planning and design on encouraging people to use various blue spaces. Complex interventions were implemented and evaluations before and after each were made using a set of tools which triangulate with each other—a site assessment tool, a behaviour observation tool, a questionnaire survey (including an economic evaluation) and qualitative interviews. The theoretical basis for the research is that of affordances, and the projects each involved modest changes to the landscape using the approach of “urban acupuncture” where a small intervention can potentially have an effect out of all proportion to the investment. This paper is a protocol paper and describes the research strategy and methodology in detail for one of the intervention sites, located in Plymouth in the UK. The aim is to present the methodology as a whole so as to act as (a) a reference framework for the results of all the projects which will be reported separately in a series of research articles once all the results are in and analysed and (b) a useful reference for other researchers wishing to carry out such complex projects and where a comprehensive presentation of the strategy and methodology is unavailable. We offer this protocol for reference, for critique and for inspiration to those following us.
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Garrett JK, White MP, Elliott LR, Wheeler BW, Fleming LE (2020). Urban nature and physical activity: Investigating associations using self-reported and accelerometer data and the role of household income.
Environmental Research,
190, 109899-109899.
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2019
Vert C, Carrasco-Turigas G, Zijlema W, Espinosa A, Cano-Riu L, Elliott LR, Litt J, Nieuwenhuijsen MJ, Gascon M (2019). Impact of a riverside accessibility intervention on use, physical activity, and wellbeing: a mixed methods pre-post evaluation.
LANDSCAPE AND URBAN PLANNING,
190 Author URL.
Pasanen TP, White MP, Wheeler BW, Garrett JK, Elliott LR (2019). Neighbourhood blue space, health and wellbeing: the mediating role of different types of physical activity.
Environ Int,
131Abstract:
Neighbourhood blue space, health and wellbeing: the mediating role of different types of physical activity.
BACKGROUND: Evidence suggests that living near blue spaces such as the coast, lakes and rivers may be good for health and wellbeing. Although greater levels of physical activity (PA) may be a potential mechanism, we know little about the types of PA that might account for this. OBJECTIVES: to explore the mediating role of: a) 'watersports' (e.g. sailing/canoeing); b) 'on-land outdoor PA' in natural/mixed settings (e.g. walking/running/cycling); and, c) 'indoor/other PA' (e.g. gym/squash) in the relationships between residential blue space availability and health outcomes. METHODS: Using data from the Health Survey for England (n = 21,097), we constructed a path model to explore whether weekly volumes of each PA type mediate any of the relationships between residential blue space availability (coastal proximity and presence of freshwater) and self-reported general and mental health, controlling for green space density and a range of socio-economic factors at the individual- and area-level. RESULTS: Supporting predictions, living nearer the coast was associated with better self-reported general and mental health and this was partially mediated by on-land outdoor PA (primarily walking). Watersports were more common among those living within 5kms of the coast, but did not mediate associations between coastal proximity and health. Presence of freshwater in the neighbourhood was associated with better mental health, but this effect was not mediated by PA. CONCLUSIONS: Although nearby blue spaces offer potentially easier access to watersports, relatively few individuals in England engage in them and thus they do not account for positive population health associations. Rather, the benefits to health from coastal living seem, at least in part, due to participation in land-based outdoor activities (especially walking). Further research is needed to explore the mechanisms behind the relationship between freshwater presence and mental health.
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Elliott LR, White MP, Sarran C, Grellier J, Garrett JK, Scoccimarro E, Smalley AJ, Fleming LE (2019). The effects of meteorological conditions and daylight on nature-based recreational physical activity in England.
Urban Forestry and Urban Greening,
42, 39-39.
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Garrett JK, White MP, Huang J, Ng S, Hui Z, Leung C, Tse LA, Fung F, Elliott LR, Depledge MH, et al (2019). Urban blue space and health and wellbeing in Hong Kong: Results from a survey of older adults.
Health Place,
55, 100-110.
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Urban blue space and health and wellbeing in Hong Kong: Results from a survey of older adults.
The potential benefits of aquatic environments for public health have been understudied in Asia. We investigated the relationships between blue space exposures and health outcomes among a sample of predominantly older adults in Hong Kong. Those with a view of blue space from the home were more likely to report good general health, while intentional exposure was linked to greater odds of high wellbeing. Visiting blue space regularly was more likely for those within a 10-15 min walk, and who believed visit locations had good facilities and wildlife present. Longer blue space visits, and those involving higher intensity activities, were associated with higher recalled wellbeing. Our evidence suggests that, at least for older citizens, Hong Kong's blue spaces could be an important public health resource.
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2018
Elliott LR, White MP, Taylor AH, Abraham C (2018). How do brochures encourage walking in natural environments in the UK? a content analysis.
Health Promot Int,
33(2), 299-310.
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How do brochures encourage walking in natural environments in the UK? a content analysis.
Although walking for leisure can support health, there has been little systematic attempt to consider how recreational walking is best promoted. In the UK, local authorities create promotional materials for walking networks, but little is known about whether they effectively encourage walking through persuasive messaging. Many of these materials pertain to walks in natural environments which evidence suggests are generally visited less frequently by physically inactive individuals. Consequently the present study explores whether and how recreational walking brochures use persuasive messages in their promotion of walks in natural environments. A coding taxonomy was developed to classify text in recreational walking brochures according to five behavioural content areas and 87 categories of potentially persuasive messages. Reliability of the taxonomy was ascertained and a quantitative content analysis was applied to 26 brochures collected from Devon, UK. Brochures often provided information about an advertised route, highlighted cultural and aesthetic points of interest, and provided directions. Brochures did not use many potentially effective messages. Text seldom prompted behaviour change or built confidence for walking. Social norm related information was rarely provided and there was a general lack of information on physical activity and its benefits for health and well-being. The limited range of message strategies used in recreational walking brochures may not optimally facilitate walking in natural environments for inactive people. Future research should examine the effects of theory-informed brochures on walking intentions and behaviour. The taxonomy could be adapted to suit different media and practices surrounding physical activity in natural environments.
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White MP, Elliott LR, Wheeler BW, Fleming LE (2018). Neighbourhood greenspace is related to physical activity in England, but only for dog owners.
Landscape and Urban Planning,
174, 18-23.
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Neighbourhood greenspace is related to physical activity in England, but only for dog owners
© 2018 Evidence supporting a positive association between neighbourhood greenspace and physical activity is equivocal. Using data from a large, nationally representative survey in England (n = 280,790), we found that while a positive relationship between the amount of neighbourhood greenspace and the odds of achieving recommended weekly physical activity existed for dog owners, no relationship was found for non-dog owners. The findings highlight the importance of neighbourhood greenspaces for supporting physical activity through dog walking in the UK context, but also raise the issue of how to encourage non-dog owners to use greenspaces in health-promoting ways. The results may also help to explain previously mixed findings in the international evidence base, and emphasise the need to adequately account for dog-ownership in future research exploring the relationship between greenspaces and physical activity.
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Elliott LR, White M, Grellier J, Rees S, Waters R, Fleming L (2018). Recreational visits to marine and coastal environments in England: Where, what, who, why, and when?.
Marine Policy Full text.
2017
Grellier J, White MP, Albin M, Bell S, Elliott LR, Gascón M, Gualdi S, Mancini L, Nieuwenhuijsen MJ, Sarigiannis DA, et al (2017). BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces.
BMJ Open,
7(6).
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BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces.
INTRODUCTION: Proximity and access to water have long been central to human culture and accordingly deliver countless societal benefits. Over 200 million people live on Europe's coastline, and aquatic environments are the top recreational destination in the region. In terms of public health, interactions with 'blue space' (eg, coasts, rivers, lakes) are often considered solely in terms of risk (eg, drowning, microbial pollution). Exposure to blue space can, however, promote health and well-being and prevent disease, although underlying mechanisms are poorly understood. AIMS AND METHODS: the BlueHealth project aims to understand the relationships between exposure to blue space and health and well-being, to map and quantify the public health impacts of changes to both natural blue spaces and associated urban infrastructure in Europe, and to provide evidence-based information to policymakers on how to maximise health benefits associated with interventions in and around aquatic environments. To achieve these aims, an evidence base will be created through systematic reviews, analyses of secondary data sets and analyses of new data collected through a bespoke international survey and a wide range of community-level interventions. We will also explore how to deliver the benefits associated with blue spaces to those without direct access through the use of virtual reality. Scenarios will be developed that allow the evaluation of health impacts in plausible future societal contexts and changing environments. BlueHealth will develop key inputs into policymaking and land/water-use planning towards more salutogenic and sustainable uses of blue space, particularly in urban areas. ETHICS AND DISSEMINATION: Throughout the BlueHealth project, ethics review and approval are obtained for all relevant aspects of the study by the local ethics committees prior to any work being initiated and an ethics expert has been appointed to the project advisory board. So far, ethical approval has been obtained for the BlueHealth International Survey and for community-level interventions taking place in Spain, Italy and the UK. Engagement of stakeholders, including the public, involves citizens in many aspects of the project. Results of all individual studies within the BlueHealth project will be published with open access. After full anonymisation and application of any measures necessary to prevent disclosure, data generated in the project will be deposited into open data repositories of the partner institutions, in line with a formal data management plan. Other knowledge and tools developed in the project will be made available via the project website (www.bluehealth2020.eu). Project results will ultimately provide key inputs to planning and policy relating to blue space, further stimulating the integration of environmental and health considerations into decision-making, such that blue infrastructure is developed across Europe with both public health and the environment in mind.
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Calogiuri G, Elliott LR (2017). Why Do People Exercise in Natural Environments? Norwegian Adults' Motives for Nature-, Gym-, and Sports-Based Exercise.
Int J Environ Res Public Health,
14(4).
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Why Do People Exercise in Natural Environments? Norwegian Adults' Motives for Nature-, Gym-, and Sports-Based Exercise.
Exercise in natural environments ("green exercise") confers numerous health benefits, but little is known about why people engage in green exercise. This study examined the importance of nature experiences as a motive for physical activity and the motivational profile of people who engage in green exercise compared to gym- and sports-based exercise. Physical activity motives and typical times spent in different domains of physical activity were reported by 2168 Norwegian adults in a survey. Experiencing nature was generally rated as the second-most important physical activity motive, exceeded only by convenience motives, and it was especially important for older adults and those who engage in greater amounts of instrumental physical activity. Green exercisers reported stronger motives concerning convenience and experiencing nature, whereas gym- or sports-based exercisers reported stronger motives for physical health and sociability. The motives associated with different leisure-time exercise domains may assist in understanding optimal promotion of green exercise.
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2016
Frühauf A, Niedermeier M, Elliott LR, Ledochowski L, Marksteiner J, Kopp M (2016). Acute effects of outdoor physical activity on affect and psychological well-being in depressed patients – a preliminary study. Mental Health and Physical Activity, 10, 4-9.
White MP, Elliott LR, Taylor TJ, Wheeler BW, Spencer AE, Bone A, Depledge MH, Fleming LE (2016). Recreational physical activity in natural environments and implications for health: a population based cross-sectional study in England.
Preventative Medicine Full text.
2015
Elliott LR, White MP, Taylor AH, Herbert S (2015). Energy expenditure on recreational visits to different natural environments.
Soc Sci Med,
139, 53-60.
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Energy expenditure on recreational visits to different natural environments.
Physical inactivity poses a significant challenge to physical and mental health. Environmental approaches to tackle physical inactivity have identified natural environments as potentially important public health resources. Despite this, little is known about characteristics of the activity involved when individuals visit different types of natural environment. Using Natural England's Monitor of Engagement with the Natural Environment Survey, we examined 71,603 English respondents' recreational visits to natural environments in the past week. Specifically, we examined the intensity of the activities they undertook on the visits (METs), the duration of their visit, and the associated total energy expenditure (MET minutes). Visits to countryside and urban greenspace environments were associated with more intense activities than visits to coastal environments. However, visits to coastal environments were associated with the most energy expenditure overall due to their relatively long duration. Results differed by the urbanity or rurality of the respondent's residence and also how far respondents travelled to their destination. Knowledge of what types of natural environment afford the highest volumes and intensities of physical activity could inform landscape architecture and exercise prescriptions. Isolating activity-supporting characteristics of natural environments that can be translated into urban design is important in providing physical activity opportunities for those less able to access expansive environments.
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