Roots and Shoots: A Pilot Parallel Randomised Controlled Trial Assessing the Feasibility and Acceptability of a Nature-Based Self-Help Intervention for Low Wellbeing

Abstract

The burden of depression is a public health concern, and traditional treatment approaches to mental health alone may be insufficient. The effects of contact with nature on wellbeing have been shown to reduce stress and improve mood, emotional wellbeing and mental health difficulties. Thus, self-guided nature-based interventions (NBIs) present a promising approach to improving mental health and wellbeing. However, there is limited evidence on the development of such interventions. This two-armed pilot randomised controlled trial aimed at determining the feasibility, acceptability and preliminary efficacy of a novel, 4-week, self-help NBI (Roots and Shoots©). Forty-seven participants were randomised (1:1) to either receive the Roots and Shoots intervention or a waitlist control. Participants in both conditions completed measures including wellbeing (primary outcome) and depressive symptoms, rumination, sleep and nature relatedness (secondary outcomes) at three timepoints: baseline (T0), 2 weeks (T1) and 4 weeks (T2). Those who completed the intervention period reported high acceptability and satisfaction with the intervention. The findings from this pilot study indicate potential for improvements in wellbeing following the intervention, which appears reasonably feasible and acceptable. Future research is warranted to further investigate the efficacy of this novel NBI in a larger, powered clinical trial.