Nature exposure and mental health during the COVID-19 pandemic: A Navigation Guide systematic review with meta-analysis.

Prior reviews have highlighted that nature exposure was a valuable coping strategy enhancing mental health during the COVID-19 pandemic. However, no existing reviews have determined the quality of evidence and risk of bias of the empirical studies supporting this claim. To address this gap, we employed a Navigation Guide systematic review and meta-analysis approach to investigate associations between nature exposure and mental health during the pandemic. Searches in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo retrieved relevant articles published between January 1, 2020, and March 4, 2024. We used the Navigation Guide methodology to assess the risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessments to evaluate the overall quality of evidence. Our search retrieved 113 studies that met the inclusion criteria and reported diverse types of exposure, including nature availability, nature visit frequency, green space accessibility, and green space type, alongside associations with 12 mental health outcomes. Meta-analyses found access to gardens was associated with lower odds of depression [(Pooled odds ratio [OR] = 0.71, 95%CI = 0.61, 0.82), I2 = 0%, n = 3] and anxiety [(Pooled OR = 0.73, 95%CI = 0.63, 0.84), I2 = 0%, n = 3]. Increased time in green spaces was associated with lower level of stress [(Pooled Corr = -0.11, 95%CI = -0.17, -0.05), I2 = 0%, n = 2]. Higher frequency of visits to nature was associated with improved mental well-being [(Pooled standardized beta = 0.10, 95%CI = 0.07, 0.14), I2 = 0%, n = 2] and general mental health [(Pooled standardized beta = 0.11, 95%CI = 0.03-0.38), I2 = 82%, n = 2]. However, the number of pooled studies was small and the overall quality of evidence was "very low" for all outcomes, and high levels of bias were observed (26% of studies had high, 71% probably high). Nonetheless, given the trends in the results, nature-based solutions emphasizing exposure to gardens and green spaces near the home may have promoted psychological resilience during this public health crisis.

Leisure Engagement during COVID-19 and Its Association with Mental Health and Wellbeing in U.S. Adults.

Leisure engagement has risen as a salient societal issue during the COVID-19 pandemic, not only because it provides a pathway for people to continue meeting their physical, cognitive, and social-emotional needs, but also due to the phenomenal juxtaposition of general increases in leisure time and unparalleled constraints. This study reports the results of the first investigation of U.S. adults' overall leisure engagement and its association with mental health amidst the major disruptions and sustained stress of the COVID-19 pandemic. Qualitative and quantitative data were collected through an online survey in February 2021 through Prolific from a sample representative of the U.S. adult population in age, gender, and race (n = 503) and analyzed using a mixed-method approach. A total of 104 unique leisure activities in 19 categories and 3 domains were identified through iterative thematic coding. Participants reported general increases in home-based traditional leisure and digital/online activities and decreases in physical and nature-based activities. Multiple regression analyses controlling for socio-demographic and context-specific covariates revealed distinct associations between changes in leisure engagement and different aspects of mental health (perceived stress, depressive symptoms, and mental wellbeing), supporting leisure's dual role in facilitating stress alleviation and wellbeing enhancement during taxing events, such as COVID-19.