Nature-based social interventions to address loneliness among vulnerable populations: a common study protocol for three related randomized controlled trials in Barcelona, Helsinki, and Prague within the RECETAS European project.

BACKGROUND: The negative effects of loneliness on population health and wellbeing requires interventions that transcend the medical system and leverage social, cultural, and public health system resources. Group-based social interventions are a potential method to alleviate loneliness. Moreover, nature, as part of our social and health infrastructure, may be an important part of the solutions that are needed to address loneliness. The RECETAS European project H2020 (Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is an international research project aiming to develop and test the effectiveness of nature-based social interventions to reduce loneliness and increase health-related quality of life. METHODS: This article describes the three related randomized controlled trials (RCTs) that will be implemented: the RECETAS-BCN Trial in Barcelona (Spain) is targeting people 18+ from low socio-economic urban areas; the RECETAS-PRG Trial in Prague (Czech Republic) is addressing community-dwelling older adults over 60 years of age, and the RECETAS-HLSNK trial is reaching older people in assisted living facilities. Each trial will recruit 316 adults suffering from loneliness at least sometimes and randomize them to nature-based social interventions called "Friends in Nature" or to the control group. "Friends in Nature" uses modifications of the "Circle of Friends" methodology based on group processes of peer support and empowerment but including activities in nature. Participants will be assessed at baseline, at post-intervention (3 months), and at 6- and 12-month follow-up after baseline. Primary outcomes are the health-related quality-of-life according to 15D measure and The De Jong Gierveld 11-item loneliness scale. Secondary outcomes are health and psychosocial variables tailored to the specific target population. Nature exposure will be collected throughout the intervention period. Process evaluation will explore context, implementation, and mechanism of impact. Additionally, health economic evaluations will be performed. DISCUSSION: The three RECETAS trials will explore the effectiveness of nature-based social interventions among lonely people from various ages, social, economic, and cultural backgrounds. RECETAS meets the growing need of solid evidence for programs addressing loneliness by harnessing the beneficial impact of nature on enhancing wellbeing and social connections. TRIAL REGISTRATION: Barcelona (Spain) trial: ClinicalTrials.gov, ID: NCT05488496. Registered 29 July 2022. Prague (Czech Republic) trial: ClinicalTrials.gov, ID: NCT05522140. Registered August 25, 2022. Helsinki (Finland) trial: ClinicalTrials.gov, ID: NCT05507684. Registered August 12, 2022.

Online psychosocial group intervention for parents: Positive effects on anxiety and depression.

OBJECTIVE: To evaluate the efficacy of an online psychosocial group intervention for parents of children with a chronic illness, in terms of anxiety and depression, and disease-related coping skills. METHODS: Parents (N = 73) participated in a parallel multicenter randomized controlled trial comparing an intervention group to a waitlist control group. In the group intervention Op Koers Online (English: On Track Online) parents learned how to use adaptive coping strategies taught with cognitive behavioral therapy and acceptance and commitment therapy techniques. Assessments (online questionnaires) took place at baseline (T0), 6-months (T1), and 12-months (T2) follow-up. Mixed-model analyses were performed to test the difference in change in outcomes between intervention (N = 34) and waitlist control group (N = 33). RESULTS: When compared with the waitlist control group, the intervention had a significant positive effect (p < .05) on changes in anxiety, depression, and total score T1 versus T0 (ß = -.47 to -.51) and T2 versus T0 (ß = -.39 to -.46), the coping skills open communication, relaxation, social support, acceptance, predictive control (ß = .42-.88) and helplessness (ß = -.47) T1 versus T0 and relaxation and positive thinking T2 versus T0 (ß = .42-.53). CONCLUSIONS: Parental anxiety and depression decreased, and use of adaptive coping skills improved after the intervention. The online character, the focus on parents themselves instead of on their child and the possibility for parents of children with rare illnesses to participate, are innovative and unique aspects of Op Koers Online for parents. The next step is to implement the intervention in clinical practice.

Psychological Factors and Characteristics of Recurrent Breast Cancer Patients with or without Psychosocial Group Therapy Intervention.

To clarify psychological factors of patients with recurrent breast cancer, we examined their interest in group intervention and studied the characteristics of participants and non-participants in an intervention program. Using several self-administered assessment scales to evaluate the quality of life (QOL) of cancer patients and the symptoms specific to breast cancer patients, we compared sociomedical variables and QOL scores between participants and non-participants. Inter-group differences were significant in the scores for constipation, body image and future perspectives, suggesting the QOL to be higher among participants than non-participants. Interest in group intervention was identified as a major reason for participation in this type of program. Not only physical but also psychologicalfactors were shown to be the reasons for deciding not to participate in group intervention. It is now desirable that efforts be made to stimulate greater understanding of group intervention as a means of psychosocial support for patients with recurrent breast cancer and that social environments be arranged so that these patients are supported by an approach tailored to individual cases, involving both group and individual intervention.

A Pychosocial Support Program for Women with Primary Breast Carcinoma

PURPOSE: To our knowledge, there had been no evidence for the efficacy of psychosocial intervention among Korean breast cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population. METHODS: The patient selection criteria were age younger than 70 years, undergoing any postoperative adjuvant therapy, and surgery undergone within the previous 3~6 months as of the start of the study. There were 30 patients that met this criteria. There was no wait-list control group because none of the eligible patients desired to stay in the wait-list control group. Therefore a one group pretest-posttest design was used. We conducted an 8-week, structured, psychosocial group intervention that used psychoeducational strategies combining education and psychological support. Subjects were assessed for psychological distress and coping by administering the Beck Depression Inventory (BDI) and the Ways of Coping Checklist-Revised (WCCL-R) at the baseline and at 8 weeks. RESULTS: Thirty patients participated and the results of 20 of these patients were used for the analysis as appropriate. The posttest results showed significantly lower scores than the pretest results for depression on the BDI (p<0.001), and for avoidance (p<0.001) and wishful thinking (p<0.001) on the WCCL-R. Additionally, the total score for coping on the WCCL-R showed a significant difference after the intervention (p=0.051). CONCLUSION: Despite some limitations, the results of this study suggest that short-term pshchosocial group intervention produces a significant improvement in the quality of life of patients with primary breast carcinoma in terms of managing depression and coping.

A Pychosocial Support Program for Women with Primary Breast Carcinoma / 한국유방암학회지

PURPOSE: To our knowledge, there had been no evidence for the efficacy of psychosocial intervention among Korean breast cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population. METHODS: The patient selection criteria were age younger than 70 years, undergoing any postoperative adjuvant therapy, and surgery undergone within the previous 3~6 months as of the start of the study. There were 30 patients that met this criteria. There was no wait-list control group because none of the eligible patients desired to stay in the wait-list control group. Therefore a one group pretest-posttest design was used. We conducted an 8-week, structured, psychosocial group intervention that used psychoeducational strategies combining education and psychological support. Subjects were assessed for psychological distress and coping by administering the Beck Depression Inventory (BDI) and the Ways of Coping Checklist-Revised (WCCL-R) at the baseline and at 8 weeks. RESULTS: Thirty patients participated and the results of 20 of these patients were used for the analysis as appropriate. The posttest results showed significantly lower scores than the pretest results for depression on the BDI (p<0.001), and for avoidance (p<0.001) and wishful thinking (p<0.001) on the WCCL-R. Additionally, the total score for coping on the WCCL-R showed a significant difference after the intervention (p=0.051). CONCLUSION: Despite some limitations, the results of this study suggest that short-term pshchosocial group intervention produces a significant improvement in the quality of life of patients with primary breast carcinoma in terms of managing depression and coping.

A Pychosocial Support Program for Women with Primary Breast Carcinoma / 한국유방암학회지

PURPOSE: To our knowledge, there had been no evidence for the efficacy of psychosocial intervention among Korean breast cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population. METHODS: The patient selection criteria were age younger than 70 years, undergoing any postoperative adjuvant therapy, and surgery undergone within the previous 3~6 months as of the start of the study. There were 30 patients that met this criteria. There was no wait-list control group because none of the eligible patients desired to stay in the wait-list control group. Therefore a one group pretest-posttest design was used. We conducted an 8-week, structured, psychosocial group intervention that used psychoeducational strategies combining education and psychological support. Subjects were assessed for psychological distress and coping by administering the Beck Depression Inventory (BDI) and the Ways of Coping Checklist-Revised (WCCL-R) at the baseline and at 8 weeks. RESULTS: Thirty patients participated and the results of 20 of these patients were used for the analysis as appropriate. The posttest results showed significantly lower scores than the pretest results for depression on the BDI (p<0.001), and for avoidance (p<0.001) and wishful thinking (p<0.001) on the WCCL-R. Additionally, the total score for coping on the WCCL-R showed a significant difference after the intervention (p=0.051). CONCLUSION: Despite some limitations, the results of this study suggest that short-term pshchosocial group intervention produces a significant improvement in the quality of life of patients with primary breast carcinoma in terms of managing depression and coping.