Walking on sunshine: scoping review of the evidence for walking and mental health

Kelly, Paul; Williamson, Chloë; Niven, Ailsa; Hunter, Ruth F.; Mutrie, Nanette; Richards, Justin

doi:10.1136/bjsports-2017-098827

Cited by 167 publications

(118 citation statements)

References 87 publications

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“…There has been some evidence to support that, compared to physical inactivity, engaging in physical activity levels less than those recommended and increased light intensity physical activity, may convey mental health benefits [28,37]. One accelerometry-based study demonstrated using isotemporal substitution models that substituting 30 min of light intensity physical activity for 30 min of sedentary time (while holding total wear time Table 3 Odds ratios (OR) and 95% confidence intervals (CI) derived from binominal logistic regression analyses as indicators of cross-sectional associations between physical activity (PA) and anxiety within sex categories and the total population…”

Section: Discussionmentioning

confidence: 99%

“…Given the worldwide promotion of the benefits of meeting these guidelines, it is important to clarify their association with anxiety symptoms and status. Furthermore, walking is an accessible behaviour for all ages and sexes that is known to confer many physical health benefits; however, just one longitudinal [36] and few cross-sectional [37] studies have examined associations of walking with anxiety.…”

Section: Introductionmentioning

confidence: 99%

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Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study

et al. 2020

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Background: Anxiety is an adaptive response to an objective or perceived threat; however, when symptoms become severe and chronic it that can become a maladaptive anxiety disorder. Limited evidence suggests that physical activity may be associated with prevention against anxiety. This study uses data from The Irish Longitudinal Study on Ageing (TILDA) and The Mitchelstown Cohort Study to investigate cross-sectional associations between physical activity and anxiety symptoms and status among Irish adults.Methods: Both datasets were harmonized (n = 7874). The short form International Physical Activity Questionnaire measured physical activity. Participants were classified as meeting World Health Organization physical activity guidelines (≥150 min weekly of moderate intensity physical activity, ≥75 min weekly of vigorous intensity physical activity, or ≥ 600 MET-minutes) or not. They were also divided into three groups based on weekly MET-minutes of moderate-to-vigorous physical activity (Low: 0-599; Moderate: 600-1199; High: ≥1200), and three groups based on weekly minutes of walking (Low: 0-209; Moderate: 210-419; High: 420+). Anxiety symptoms were measured by the Hospital Anxiety and Depression Scale with a score of ≥8 indicating anxiety. Binomial logistic regression, adjusted for relevant confounders examined physical activity-anxiety associations. Results: Females had higher rates of anxiety than males (28.0% vs 20.0%; p < 0.001). Following adjustment for relevant covariates, meeting physical activity guidelines was associated with 13.5% (95% CI: 2.0-23.7; p = 0.023) lower odds of anxiety. Moderate and High physical activity were associated with 13.5% (− 11.0-32.6; p = 0.254) and 13.6% (1.4-4.2; p = 0.030) lower odds of anxiety compared to Low physical activity, respectively. Moderate and High walking were associated with 2.1% (− 14.5-16.3; p = 0.789) and 5.1% (− 9.3-17.6; p = 0.467) lower odds of anxiety compared to Low walking, respectively. (Continued on next page)Conclusion: Meeting physical activity guidelines is associated with lower odds of anxiety, but the strength of associations did not increase considerably with increased physical activity levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study

et al. 2020

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“…Walking is a widely endorsed way to increase physical activity [5,8]. Walking is an accessible, low risk and inexpensive form of physical activity [8] that can prevent and treat non-communicable diseases [5], such as cardiovascular disease [9] and obesity [10,11], and improve mental health [12]. Whilst walking is the most common form of physical activity in the US and the UK [8,13,14], only half of adults in the US [15] and two-thirds of adults in the UK [16] meet the recommended levels of physical activity.…”

Section: Introductionmentioning

confidence: 99%

Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study

Irvine

Marselle

Melrose³

et al. 2020

IJERPH

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Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) incorporating activity trackers and use of a holistic health and wellbeing measure, the Self-sasessment of Change (SAC) scale. A mixed methods design explored participant recruitment and retention, programme delivery, and measures of physical activity and health and wellbeing. Walker data included: pre-post questionnaires, daily step counts, and interviews. Programme delivery information included: weekly checklists, staff reflections, stakeholder meeting minutes, and a report. Thirteen adults (age 63-81, 76% female) joined and completed the activity tracker GOHW. Activity trackers motivated walkers to join and be more active but complicated programme delivery. Activity trackers allowed the quantification of physical activity and the SAC health and wellbeing measure was easy to use. By week 12, all participants met national physical activity guidelines. Clinically relevant changes on the SAC scale included: sleeping well, experiencing vibrant senses, and feeling energised, focused, joyful, calm and whole. Results illustrate the feasibility of using activity trackers to motivate engagement in and provide a measure of physical activity from GOHWs. The SAC scale offers a promising measure for nature-health research. A conceptual model is provided for the development of future large-scale studies of NBIs, such as group outdoor health walks.

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“…The literature highlights that there are several theoretical hypotheses that have been proposed to explain how exposure to the natural environment may impact mental wellbeing [43,44], including the "Biophilia hypothesis" [45,46], Attention Restoration Theory (ART) [47] and "Psycho-evolutionary stress reduction theory" [48]. A recent systematic review of 5 systematic reviews and 50 individual papers suggests that walking benefits mental health [49]. There is also empirical evidence, summarised in systematic reviews, that being physically active outdoors has value-added mental health benefits to being active indoors [50,51].…”

Section: Resultsmentioning

confidence: 99%

Co-production of “nature walks for wellbeing” public health intervention for people with severe mental illness: use of theory and practical know-how

et al. 2020

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Background: Interventions need to be developed in a timely and relatively low-cost manner in order to respond to, and quickly address, major public health concerns. We aimed to quickly develop an intervention to support people with severe mental ill-health, that is systematic, well founded both in theory and evidence, without the support of significant funding or resource. In this article we aim to open and elucidate the contents of the 'black box' of intervention development. Methods: A multidisciplinary team of seven academics and health practitioners, together with service user input, developed an intervention in 2018 by scoping the literature, face-to-face meetings, email and telephone. Researcher fieldnotes were analysed to describe how the intervention was developed in four iterative steps. Results: In step 1 and 2, scoping the literature showed that, a) people with severe mental illness have high mortality risk in part due to high levels of sedentary behaviour and low levels of exercise; b) barriers to being active include mood, stress, body weight, money, lack of programmes and facilities and stigma c) 'nature walks' has potential as an intervention to address the problem. In Step 3, the team agreed what needed to be included in the intervention so it addressed the "five ways to mental wellbeing" i.e., help people to connect, be active, take notice, keep learning and give. The intervention was mapped to key behavioural change concepts such as, personal relevance, relapse prevention, self-efficacy. In Step 4, the team worked out how best to implement the intervention. The intervention would be delivered over 12 weeks by members of the hospital team and community walk volunteers. Participants would receive a nature walks booklet and text messages. Conclusions: We developed a theoretically-informed, evidence-based nature walks programme in a timely and relatively low-cost manner relevant in an era of growing mental illness and funding austerity. Further research is required to test if the intervention is effective and if this approach to intervention development works.

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Walking on sunshine: scoping review of the evidence for walking and mental health

Cited by 167 publications

References 87 publications

Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study

Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study

Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study

Co-production of “nature walks for wellbeing” public health intervention for people with severe mental illness: use of theory and practical know-how

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