Imagine going to the doctor for treatment of diabetes or heart disease and, along with your usual script for medication, being handed a prescription to stand among the trees at the botanic gardens or get your hands dirty at a bushcare group.
It might sound odd, but could become more common if a new $1.5 million trial, which will be co-led by University of Wollongong researcher Professor Thomas Astell-Burt, is a success.
The study will look at whether contact with nature can help sustain regular physical activity in people with these cardio metabolic diseases, testing the effectiveness, cost-effectiveness and sustainability of a "nature prescription".
Prof Astell-Burt said it would build on the already well-established notion that nature can have a positive effect on health, and will work with patients, doctors and providers of nature-based activities to come up with a prescription tailored to Australians.
He said written directions to spend more time in nature and therapies like the Japanese practice of shinrin yoku - or forest-bathing - were already well-known and practiced around the world.
"For instance, passes to access National Parks in Canada for free are being prescribed to individuals as a way of trying to remove any cost issues and affordability barriers that might be there," Prof Astell-Burt said.
"I believe that's been exceptionally well taken up, but here we're still working out what those nature prescriptions might actually look like so they're credible, not only from the perspective of the individuals who would benefit from them, but also from the health professionals who would be recommending them."
The study will be a randomised trial, with patients aged over 45 from the Illawarra Shoalhaven, Western Sydney and the Central Coast.
"The idea is to run a randomised trial to say, ok, over the course of 12-18 months, can we define the scale of benefit of participating in the nature prescription, and how long are those benefits sustained for once we turn off the intervention after 12 months," he said.
Prof Astell-Burt said it was hoped a nature prescription would provide an accessible and pleasant way for people to meet existing physical activity guidelines for controlling heart disease or diabetes.
He said there were already many physical interventions for these conditions, but that their success was inhibited "because a lot of people don't take them up or if they do take them up, they often go 'well, this is, this is tricky to keep up with'."
For instance, one of the researchers in the trial has found that less than 30% of people in NSW who have had a heart attack take up the cardiac rehab which is currently recommended, he said.
"We're trying to provide a different option which may cater to more people's tastes and help to increase levels of physical activity and overall health in the community," he said
While the study will focus on improvements for cardio metabolic conditions, Prof Astell-Burt said its findings could inform treatment for other issues and take the pressure off the broader health system.
"If we find there is a positive effect of being out in nature, for getting active and improving one's physical, mental and social health, there will be returns on investment of that," he said
"Not only in terms people with cardio metabolic diseases - so helping to control diabetes, helping to control blood pressure, helping to control biomarkers of heart disease - but also returns on investment [in the] longer term by helping to ensure people with these conditions do not end up at higher risk of having a heart attack later in life and that they have good mental health and good social health."
"You've got to start from somewhere, but principle, there's no reason why this type of thing couldn't be beneficial for people across the age spectrum in all different walks of life."
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