Greengage is a pilot randomised controlled trial aiming to understand how nature-based activities might impact people’s mental health.

Working with the Eden Project, Sensory Trust, and the Wildfowl and Wetlands Trust, it will deliver group nature-based activities to participants throughout 2025.

The project is funded by NIHR and its full title is Nature on prescription to support mental ill health (GREENGAGE): a pilot randomised controlled trial and process evaluation

Aim

This pilot trial will test a research plan for a future full randomised controlled trial (RCT) of nature-based activities to support people with mild to moderate depression and/or anxiety.

Background

There is increasing evidence that taking part in activities in nature, such as gardening or conservation, can have positive impacts on people’s health and well-being. Although there are a large number of nature-based activities, few have been formally evaluated using the most robust methods. Healthcare commissioners are increasingly seeking high quality evidence of the effectiveness of nature-based activities.

Methods

Before undertaking a large RCT, it is important to ensure the plans for that research are feasible, appropriate and acceptable. This pilot RCT will use the proposed methods and assess the research processes (for example, that we can recruit enough people and that methods used to measure impact are appropriate).

We will collect statistical data as well as speaking to participants and activity providers to understand what works well and what could be improved. We will randomise participants to either receive a 6-week nature-based activity (delivered by our partners at the Eden Project, Sensory Trust or the Wildfowl and Wetlands Trust) or to be in a comparison group that does not receive the intervention. Both groups will continue to receive usual care.

Changes in mental health, wellbeing and loneliness will be compared between these two groups. People in the comparison group will then be offered the chance to take part in nature-based activities.