Nature-Based Interventions Associated with Improved Health Outcomes in Urban Adults: A Scoping Review
TL;DR
Findings suggest that nature-based interventions are associated with improvements in psychological, physiological, and social health outcomes among urban adults, and the literature is limited by heterogeneity in study design, intervention definitions, and outcome measurement.
Abstract
Rapid urbanization has reduced routine exposure to natural environments, contributing to rising rates of health disorders among urban populations. Nature-based interventions, including forest bathing, green exercise, and other forms of nature exposure, have emerged as promising nonpharmacologic approaches to support health and well-being. However, evidence specific to urban adults remains heterogeneous and has not been comprehensively synthesized. A scoping review was conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Eight electronic databases were searched from inception through December 2024. Eligible studies included adults in urban settings and evaluated nature-based interventions associated with mental, physical, physiological, or social health outcomes. Seventy-seven peer-reviewed studies met inclusion criteria, representing diverse geographic regions and interventions. Most studies utilized cross-sectional or quasi-experimental designs, while fewer employed randomized or controlled methodologies. Mental health was the most frequently assessed outcome domain, with many studies reporting reductions in stress, anxiety, and depressive symptoms after nature exposure. Physiological benefits included reductions in blood pressure, heart rate, and cortisol levels, while social outcomes included enhanced social cohesion and reduced loneliness. Interventions involving deeper sensory immersion were generally associated with more consistent benefits. Current evidence suggests that nature-based interventions are associated with improvements in psychological, physiological, and social health outcomes among urban adults. Although the literature is limited by heterogeneity in study design, intervention definitions, and outcome measurement, findings support the potential benefits of these interventions. Future research should prioritize standardized intervention frameworks, longitudinal designs, and randomized controlled studies to better characterize sustained and generalizable effects.