Research Summary

Effect of park prescriptions with and without group visits to parks on stress reduction in low-income parents: SHINE randomized trial

Park prescriptions are a promising tool for addressing stress in low-income parents


High stress levels of people with low-income contribute to health outcome disparities in society. In addressing this concern, a growing field of related research focuses on increased exposure to nature as a stress-relief measure for people in low-income communities. This body of research includes studies on the effectiveness of park prescription programs planned and implemented through the cooperative efforts of healthcare professionals and city, state, and/or national park personnel. One such study -- the Stay Healthy In Nature Everyday (SHINE) study -- was conducted to determine if park prescriptions will improve stress and other behavioral and health outcomes for parents at a low-income clinic. This study also compared the outcomes of two different forms of the park prescription program: one with group outings; one without group outings.

The researchers recruited 78 parents from a low-income patient population at a pediatric clinic in Oakland, California and randomly assigned them to two different groups. A pediatrician at the clinic counseled all participating parents on the health benefits of time in nature; and all participants received a postcard with a map of local parks, a journal for tracking their park visits, and a pedometer. One group of parents (the “supported park prescription group”), however, were also advised to participate in three group nature outings along with their families. The outings included free transportation, food, and programming. The other group (the “independent park prescription group”) were not offered this option.

All participating parents completed assessments three times during the course of the study: prior to the program, one month after enrollment, and three months after enrollment. These assessments collected information about participants’ stress (using the Perceived Stress Scale), park visits per week (self-report and journaling), loneliness (using a modified UCLA-Loneliness Scale), physical activity (self-report, journaling, pedometry), physiologic stress (salivary cortisol), and nature affinity (using a validated scale).

Results showed a significant decrease in stress for both groups with no significant difference between the two groups. Results also showed increased visits to parks for both groups, but more so for the independent group than the supported group. Further analysis showed that each unit increase in park visits per week was associated with a significant and incremental decrease in stress. Other positive outcomes for participants included increases in physical activity and nature affinity and decreases in loneliness and physiologic stress.

This study indicates that park prescriptions are a promising tool for addressing stress in low-income parents.