The use of a written nature prescription (Park Rx) written by a child's primary care provider (PCP), physician, or nurse practitioner, is one hypothesized approach to encouraging children to participate in free, unstructured play in nature. PCPs recruited through the local chapter of the American Academy of Pediatrics were provided Park Rxs to write for children aged 6–10 attending a well-child visit. The written prescription was a tool for the PCP to use to start a conversation on the value of nature for physical and mental health. In addition, the Park Rx could be redeemed as a free day pass to any state park. The prescribing and redemption patterns for the Park Rxs were studied over the 15-week summer season in a rural state in the Northeast. The nature relatedness (NR) of PCPs and their likelihood to prescribe nature with a Park Rx prior to, during, and after the project were also examined. Eleven PCP offices in six counties participated in the pilot study and wrote a combined 1,935 park prescriptions with a patient redemption rate of 13% in the face of some of the wettest summer months on record for the state. The PCP NR did not significantly influence prescribing patterns. PCPs did however report that participation in the project influenced them to discuss the value of nature and write the Park Rx. Key Words: Nature deficit disorder—Park prescription.
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References
1.
AbramsonS., SteinJ., SchaufeleM., FratesE., & RoganS. (2000). Personal exercise habits and counseling practices of primary care physicians: A national survey. Clinical Journal of Sport Medicine, 10, 40–48.
2.
AittasaloM., MiilunpaloS., Kukkonen-HarjulaK., & PasanenM. (2006). A randomized intervention of physical activity promotion and patient self-monitoring in primary health care. Preventive Medicine, 42, 40–46.
3.
American Academy of Pediatrics. (2013). Policy statement: The crucial role of recess in school. Pediatrics, 131, 183–188.
4.
BellJ. F., WilsonJ. S., & LiuG. C. (2008). Neighborhood greenness and 2-year changes in body mass index of children and youth. American Journal of Preventive Medicine, 35, 547–553.
5.
BuroB., GoldA., ContrerasD., KeimA., MobleyA., OscarsonR., … SmathersC. (2015) An ecological approach to exploring rural food access and active living for families with preschoolers. Journal of Nutrition Education and Behavior, 47, 548–554.
6.
CervinkaR., RödererK., & HeflerE. (2012). Are nature lovers happy? On various indicators of well-being and connectedness with nature. Journal of Health Psychology, 17, 379–388.
7.
ClelandV., CrawfordD., BaurL. A., HumeC., TimperioA., & SalmonJ. (2008). A prospective examination of children's time spent outdoors, objectively measured physical activity and overweight. International Journal of Obesity, 32, 1685–1693.
8.
CoffeyJ. (2011). Children in nature prescription study. Unpublished manuscript.
9.
DillmanD. A. (2007). Mail and internet surveys: The Tailored Design Method (2nd ed., update with new Internet, visual, and mixed-mode guide). Hoboken, NJ: Wiley.
10.
DymentJ. E., & BellA. C. (2008). Grounds for movement: Green school grounds as sites for promoting physical activity. Health Education Research, 23, 952–962.
11.
ElleyC., KerseN., ArrillB., & RobinsonE. (2003) Effectiveness of counselling patients on physical activity in general practice: Cluster randomized trial. BMJ, 326, doi:10.1136/bmj.326.7393.793
12.
FieS., NormanI. J., & WhileA. E. (2013). The relationship between physicians' and nurses' personal physical activity habits and their health-promotion practice: A systematic review. Health Education Journal, 72, 102–119.
13.
FrankE., RothenbergR., LewisC., & BelodoffB. F. (2000). Correlates of physicians' prevention-related practices: Findings from the women physicians' health study. Archives of Family Medicine, 9, doi:10.1001/archfami.9.4.359
14.
FrumkinH. (2001). Beyond toxicity: Human health and the natural environment. American Journal of Preventive Medicine, 20, 234–240.
15.
FuemmelerB., AndersonC., & MasseL. (2011). Parent-child relationship of directly measured physical activity. International Journal of Behavioral Nutrition and Physical Activity, 8, doi:10.1186/1479-5868-8-17
16.
FuscaldoJ. M. (2002). Prescribing physical activity in primary care. West Virginia Medical Journal, 98, 250–253.
17.
GinsbergK. (2007). The importance of play in promoting health child development and maintaining strong parent child bonds. Pediatrics, 119, 182–191.
18.
GoldsteinA. O., HellierA., FitzgeraldS., StegallT. S., & FischerP. M. (1987). Hospital nurse counseling of patients who smoke. American Journal of Public Health, 77, 1333–1334.
19.
HaganJ. F., ShawJ. S., & DuncanP. M. (Eds.). (2008). Bright Futures guidelines for health supervision of infants, children and adolescents (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics.
20.
HarrisonR. A., RobertsC., & EltonP. J. (2005). Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. Journal of Public Health, 27, 25–32.
21.
KellertS. (2012). Birthright. New Haven, CT: Yale University Press.
22.
LouvR. (2005). Last child in the woods: Saving our children from nature-deficit disorder. Chapel Hill, NC: Algonquin Books.
23.
LudwigD. (2007). Childhood obesity—the shape of things to come. New England Journal of Medicine, 357, 2325–2327.
24.
MaasJ., VerheijR. A., de VriesS., SpreeuwenbergP., SchellevisF. G., GroenewegenP. P. (2009). Morbidity is related to a green living environment. Journal of Epidemiology and Community Health, 63, 967–973.
25.
McCurdyL. E., WinterbottomK. E., MehtaS. S., & RobertsJ. R. (2010). Using nature and outdoor activity to improve children's health. Current Problems in Pediatric and Adolescent Health Care, 40, 102–117.
26.
McKennaJ., NaylorP. J., & McDowellN. (1998). Barriers to physical activity promotion by general practitioners and practice nurses. British Journal of Sports Medicine, 32, 242–247.
NisbetE. K., ZelenskiJ. M., & MurphyS. A. (2009). The nature relatedness scale linking individuals' connection with nature to environmental concern and behavior. Environment and Behavior, 41, 715–740.
29.
NoonanR., BoddyL., FaircloughS., & KnowlesZ. (2016). Write draw, show and tell: A child centered dual methodology to explore perceptions of out-of-school physical activity. BMC Public Health, 16, doi:10.1186/s12889-016-3005-1
30.
OliveK. E., & BallardJ. A. (1992). Attitudes of patients toward smoking by health professionals. Public Health Reports, 107, 335–339.
31.
PolitD., & BeckC. (2016). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA: Wolters Kluwer.
32.
PotwarkaL. R., KaczynskiA. T., & FlackA. L. (2008). Places to play: Association of park space and facilities with healthy weight status among children. Journal of Community Health, 33, 344–350.
33.
RideoutV. J., FoehrU. G., & RobertsD. F. (2010). Generation M2: Media in the lives of 8- to 18-year-olds (Publication No. 8010). Menlo Park, CA: Kaiser Family Foundation.
34.
TaylorA., KuoF., & SullivanW. (2001). The surprising connection to green play settings. Environment and Behavior, 33, 54–77.
35.
WellsN. M., & EvansG. W. (2003). Nearby nature: A buffer of life stress among rural children. Environment and Behavior, 35, 311–330.
36.
WyndC. A., CihlarC., GraorC. H., ImaniJ., & McDougalM. (2007). Employee health fair data: Evidence for planning health promotion programs. Clinical Nurse Specialist, 21, 255–263.
37.
ZelenskiJ. M., & NisbetE. K. (2012). Happiness and feeling connected: The distinct role of nature relatedness. Environment and Behavior, 46, doi:10.1177/0013916512451901
