Public Health Research (Dec 2023)
Nature-based interventions to support mental health and well-being of young women in pregnancy: exploratory work for future feasibility RCT
Abstract
Background The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16–24 years) in a future study. Methods This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women’s panel (Research Influencers Group). Networking and stakeholder engagement to support future research. Results The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women’s focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial. Conclusion This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout. Limitations This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey. Future work Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167. Plain language summary What is the project about and why is it important? The mental health and well-being of young women has been getting worse since the 1990s. In particular, young women are more likely to experience depression or anxiety when pregnant or after giving birth. This can have long-term effects for them and their children. This also results in high costs for the National Health Service and social services. We know that social support can help to protect people against poor mental health and well-being. Research has also shown that access to nature may be linked to better mental health and well-being. This project aimed to find out what types of group nature activities were offered in the community and whether young women (aged 16–24) felt doing these activities might help their mental health during and after pregnancy. What have we done? Our first step was to map the nature-based activities that are available in the East Midlands region of the United Kingdom by sending a short survey to organisations to find out more. These may include activities such as walking, music or dance, or arts and crafts sessions held in natural settings such as forests or community gardens. We also held focus groups with young women to discuss the idea of nature activities to promote mental health and well-being. We invited some women to work with us as part of our ‘Research Influencer Group’. They were involved in co-designing the future research, including choosing the nature activity to be tested. We have also linked up with the right people to support this and future projects. What did we find out? In this small preparatory study, young women we spoke to were very enthusiastic about spending time in nature and they felt it could benefit young pregnant women and their babies in many ways. There are currently a wide range of nature activities available in the East Midlands. Providers of these activities have recommended ways to make sure a future study works well. An outline research plan has been co-developed with the Research Influencer Group to move forward with the next stages of this research.
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