A Forest Bathing Intervention in Adults with Intellectual Disabilities: A Feasibility Study Protocol

Abstract

Forest bathing practices benefit individuals’ physical and mental health. A growing number of published studies provide evidence of such effects in diverse populations and contexts. However, no literature has been found that evaluates the effects of forest bathing on people with intellectual disabilities. In this paper, we present a quasi-experimental pre–post protocol for assessing the preliminary efficacy and feasibility of a forest bathing intervention in a group of adults with intellectual disability. An 11-weekly session program will be applied in the forests of the Ollo Valley, Navarre (Spain). The preliminary efficacy outcomes will be blood pressure, psycho-physiological coherence parameters and quality of life. The feasibility of the intervention will be assessed through data on barriers and facilitators of the implementation process and indicators of environmental comfort (physiological equivalent temperature and thermic perception). This study offers an opportunity for people with intellectual disabilities to benefit from a forest bathing intervention and explore its effects not only on their quality of life, but also on the improvement in their physiological and psychological state. This feasibility study is an essential step to explore crucial aspects for a future full-scale trial.

A Multi-Country Study Assessing the Mechanisms of Natural Elements and Sociodemographics behind the Impact of Forest Bathing on Well-Being

“…All participants experienced the same NCA following a sequence of three parts: the "initial phase," which focuses on senses; the "intermediate phase," which is centred on connecting with the environment; and the "final phase," which aims to integrate all the experiences [19,39]. The time spent in the FB with NCA session was about two hours.…”

“…Feelings were measured through the self-assessment manikin five-item scale (SAM) [60], which uses a 1-9 Likert scale and provides Emojis as examples to clarify scoring (a detailed explanation of the questions can be seen in Table 2). Emotions were measured through a self-assessment using a 1-10 Likert scale designed for the purpose of this study and based on the characteristics of a standard FB session within the LIM framework [19,39] (Table 2). Nature connection was measured through the single item "inclusion of nature in self" scale (INS) [61], where the participant selects an image of two overlapping circles representing self and nature rated 0-6 (6 means the highest nature connection) (Table 2).…”

“…(c) The well-being-related sensations caused by nature and perceived during the FB with NCA sessions were explored through 16 self-assessments using a 0-10 Likert scale with indicators of natural elements, which had been previously highlighted and described by the LIM methodology [19,39] (Table 2) and is based on the three good things in nature, the five pathways to nature connection [32][33][34], and the practical experience gained through direct observation of sensations caused by nature in previous interventions. To facilitate the interpretation of the results, we associated some of the natural elements with four of the five human senses: vision, sound, smell, and touch (a detailed explanation for each natural element can be seen in Table 2).…”

“…The FTHub method is a practical tool for designing mindful activities in natural environments and planning them in various sequences to promote nature connectedness [18][19][20]. The LIM refers to an integrative and interactional theoretical model that understands health and wellbeing as dynamic, relative, and variable phenomena that go beyond inherited biological conditions: health is the result of an adaptive process of human beings to their physical and social environments [18][19][20]39]. This wide theoretical basis gives the LIM flexibility to put into practise and adjust the different activities of the FTHub method to the characteristics and specific needs of different groups.…”

A Three-Day Forest-Bathing Retreat Enhances Positive Affect, Vitality, Optimism, and Gratitude: An Option for Green-Care Tourism in Italy?

“…Evening activities also took place on the first and, especially, the second day of the retreats. The forest-bathing sessions followed the mindfulness-based protocol adopted by the Forest Therapy Hub (FTH) [46,55], which is very similar in its general structure and types of activity to those proposed by other organizations (e.g., the Association of Nature and Forest Therapy (ANFT), as described in its application in Slovenia [8]). All the sessions were led by trained forest-bathing guides (one guide was qualified with both the ANFT and FTH, the others with the FTH), who had an ongoing collaboration with the tour operator and applied the same protocol, even if adapted to the specific forest locations.…”