Contact persons: Doctor Pauline Marsh, Doctor Joanna Sun, Doctor Cassandra Thomson, and Doctor Hoang Nguyen
Project: current
A nature-based intervention project set in parks, gardens and other green spaces to help delay and/or mitigate symptom severity and improve quality of life for people living with dementia and their care partners.
Project Summary:
Nature-based interventions (NBIs) across green spaces have been shown to improve health and wellbeing through a range of physical, social, psychological and cognitive mechanisms. There is a growing need for non-pharmacological interventions of this type for people in the aftermath of receiving a diagnosis of MCI or dementia. NBIs show promise of enabling improvements in the five key domains of dementia wellbeing: physical activity, social interaction, mental wellbeing, cognitive function and carer wellbeing. However, there is a need for participatory-designed, randomised control trials to establish whether NBIs can delay or slow disease progression and the type and intensity of nature engagement required to be effective. We propose that engagement in a supported nature-based intervention will mitigate symptoms of disease progression and improve quality of life for people living with dementia.
Objectives:
To test and explore mechanisms and impacts of a nature-based, non-pharmacological intervention on the onset and progression of symptoms and severity of dementia and improvements in quality of life for people living with dementia and care partners.
Research Questions:
- Does semi-structured, supported nature engagement protect against symptom severity and disease progression, and improve QOL for people living with dementia; and if so, how?
- Does semi-structured, supported NBIs enhance care-partner support; and if so, how?
Design:
A participatory-designed, randomised implementation research design, based on participatory action research principles. It will be a multi-site, multi-phase, mixed-methods project conducted over 5 years. Participants will initially be recruited through The ISLAND Clinic, a multidisciplinary diagnostic service based in Hobart. Individuals assessed at-risk of dementia (subjective cognitive decline, MCI) or diagnosed with a dementia (all type) will be invited to participate. Care partners can opt into the research.
Pre-intervention participatory-design and training: Engagement and collaboration with key stakeholders including people living with dementia, care partners, and project partners (naturebased, health care, aged care). Through an iterative series of workshops, interviews, training sessions, and outdoor trials, a suite of user-centred and sustainable nature-based interventions will be developed. A customised training program for dementia support workers, care-partners and outdoor health practitioners will be co-designed and rolled out. Venture Out Dementia Research Group, CIs Pauline Marsh, Cassandra Thomson and Jo Sun.
Intervention a) Measure and Test: (quant) Three arm, single-blind, randomised control trial. Participants are randomised to intervention (self-directed or supported nature engagement) or control (monitoring nature engagement). Baseline measures administered during ISLAND Clinic assessment and re-administered at varying intervals (3-, 6-, 12-months). Quantitative measures will assess cognitive function, physical and functional ability, mental health, quality of life, sleep, genetic and protein biomarkers (blood sample), and carer wellbeing. b) Explore and Understand: (qual) An inductive thematic analysis approach drawing from a range of qualitative methods (writen journals, photo diaries, interviews, direct observation).
Post intervention Outcomes: 1. Evidence to support the positive role of nature engagement in improving QOL and mitigating symptom progression through improvements to 5 domains of dementia wellbeing; 2. An evidence-based training program for health practitioners (understanding dementia) and dementia care-givers (outdoor therapies) to guide safe, ethical practice; and 3. Translational research outcomes to inform dementia and care-partner strategies, ageing-in-place, and carer support policy and practice; identification of nature’s enablement of dignity, relational care, and active citizenship
Research Team:
- Dr Pauline Marsh
- Dr Joanna Sun
- Dr Cassandra Thomson
- Dr Hoang Nguyen
Venture Out Community of Practice:
The Venture Out Community of Practice is an open group that brings together diverse organisations, health, social and outdoor health professionals who collaborate within parks, gardens, and green spaces. This united effort aims to mitigate the severity of symptoms and enhance the overall quality of life for individuals living with dementia and their dedicated care partners. Through shared expertise, innovative strategies, and a collective commitment, this community seeks to create meaningful experiences and positive impacts within these therapeutic environments to create dementia inclusivity.
