Evaluating the feasibility of “Friends in Nature,” a complex nature-based social intervention to address loneliness and quality of life in six cities worldwide

Abstract

Background Loneliness, a major public health concern, could be alleviated through social interventions with nature contact as a primary component. “Friends in Nature” is a complex naturebased social intervention designed to be implemented as part of“Reimagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces" (RECETAS). This project aims to alleviate loneliness and promote healthrelated quality of life in six diferent geographic areas worldwide. Feasibility studies are crucial to assess the viability of complex inter‑ ventions and study procedures before conducting defnitive studies. This paper aims to describe the design, imple‑ mentation, and evaluation of the sixrelated feasibility studies on the “Friends in Nature” intervention. These studies specifcally evaluate feasibility of recruitment and study procedures, intervention implementation, and data collection and distribution. Methods We defned a comprehensive set of indicators to assess the feasibility of“Friends in Nature.” For the frst domain, recruitment procedures were assessed to determine their adequacy, while attrition rates were exam‑ ined to assess participant retention. For the second domain, the implementation of interventions was evaluated, along with the study design’s ability to adapt to unexpected situations and participant adherence to the intervention. Finally, for the third domain, completion rates and the acceptability of the study activities were also analyzed. The feasibility of using specifc scales to assess loneliness and wellbeing was also explored. Results The feasibility indicators defned for this study were useful to assess the feasibility of“Friends in Nature.” Recruitment procedures were generally found to be adequate, and the number of dropouts was low. Interventions were implemented with minor adjustments, and facilitators played a vital role in the wellfunctioning of the interven‑ tions. Although some unexpected situations occurred during the study, adaptations were made, and participants were generally satisfed with the activities proposed. Scales used to assess loneliness and quality of life showed poten‑ tial for measuring the efects of naturebased social prescribing in the full trial.