Please use this identifier to cite or link to this item:
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Co-production of "nature walks for wellbeing" public health intervention for people with severe mental illness: use of theory and practical know-how
Author(s): Hubbard, Gill
Ward Thompson, Catharine
Locke, Robert
Jenkins, Dan
Munoz, Sarah-Anne
Van Woerden, Hugo
Maxwell, Margaret
Yang, Yaling
Gorely, Trish
Keywords: Intervention development
Mental health
Issue Date: 2020
Citation: Hubbard G, Ward Thompson C, Locke R, Jenkins D, Munoz S, Van Woerden H, Maxwell M, Yang Y & Gorely T (2020) Co-production of "nature walks for wellbeing" public health intervention for people with severe mental illness: use of theory and practical know-how. BMC Public Health, 20 (1), Art. No.: 428.
Abstract: 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.
DOI Link: 10.1186/s12889-020-08518-7
Rights: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Licence URL(s):

Files in This Item:
File Description SizeFormat 
s12889-020-08518-7.pdfFulltext - Published Version708.94 kBAdobe PDFView/Open

This item is protected by original copyright

A file in this item is licensed under a Creative Commons License Creative Commons

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact providing details and we will remove the Work from public display in STORRE and investigate your claim.