The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.

<h4>Significance</h4>Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with eithe...

Full description

Bibliographic Details
Main Authors: Jean C Bikomeye, Joanna S Balza, Jamila L Kwarteng, Andreas M Beyer, Kirsten M M Beyer
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0276517
_version_ 1797788230764986368
author Jean C Bikomeye
Joanna S Balza
Jamila L Kwarteng
Andreas M Beyer
Kirsten M M Beyer
author_facet Jean C Bikomeye
Joanna S Balza
Jamila L Kwarteng
Andreas M Beyer
Kirsten M M Beyer
author_sort Jean C Bikomeye
collection DOAJ
description <h4>Significance</h4>Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. For both pathologies, factors such as poverty, lack of physical activity (PA), poor dietary intake, and climate change increase risk of adverse outcomes. Prior research has shown that greenspaces and other nature-based interventions (NBIs) contribute to improved health outcomes and climate change resilience.<h4>Objective</h4>To summarize evidence on the impact of greenspaces or NBIs on cardiovascular health and/or cancer-related outcomes and identify knowledge gaps to inform future research.<h4>Methods</h4>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Peer Review of Electronic Search Strategies (PRESS) guidelines, we searched five databases: Web of Science, Scopus, Medline, PsycINFO and GreenFile. Two blinded reviewers used Rayyan AI and a predefined criteria for article inclusion and exclusion. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS). This review is registered with PROSPERO, ID # CRD42021231619.<h4>Results & discussion</h4>Of 2565 articles retrieved, 31 articles met the inclusion criteria, and overall had a low risk of bias. 26 articles studied cardiovascular related outcomes and 5 studied cancer-related outcomes. Interventions were coded into 4 categories: forest bathing, green exercise, gardening, and nature viewing. Outcomes included blood pressure (BP), cancer-related quality of life (QoL) and (more infrequently) biomarkers of CVD risk. Descriptions of findings are presented as well as visual presentations of trends across the findings using RAW graphs. Overall studies included have a low risk of bias; and alluvial chart trends indicated that NBIs may have beneficial effects on CVD and cancer-related outcomes.<h4>Conclusions & implications</h4>(1) Clinical implication: Healthcare providers should consider the promotion of nature-based programs to improve health outcomes. (2) Policy implication: There is a need for investment in equitable greenspaces to improve health outcomes and build climate resilient neighborhoods. (3) Research or academic implication: Research partnerships with community-based organizations for a comprehensive study of benefits associated with NBIs should be encouraged to reduce health disparities and ensure intergenerational health equity. There is a need for investigation of the mechanisms by which NBIs impact CVD and exploration of the role of CVD biological markers of inflammation among cancer survivors.
first_indexed 2024-03-13T01:32:40Z
format Article
id doaj.art-0ed4f7ce85fb46d59501657fc244b402
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-03-13T01:32:40Z
publishDate 2022-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-0ed4f7ce85fb46d59501657fc244b4022023-07-04T05:32:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011711e027651710.1371/journal.pone.0276517The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.Jean C BikomeyeJoanna S BalzaJamila L KwartengAndreas M BeyerKirsten M M Beyer<h4>Significance</h4>Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. For both pathologies, factors such as poverty, lack of physical activity (PA), poor dietary intake, and climate change increase risk of adverse outcomes. Prior research has shown that greenspaces and other nature-based interventions (NBIs) contribute to improved health outcomes and climate change resilience.<h4>Objective</h4>To summarize evidence on the impact of greenspaces or NBIs on cardiovascular health and/or cancer-related outcomes and identify knowledge gaps to inform future research.<h4>Methods</h4>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Peer Review of Electronic Search Strategies (PRESS) guidelines, we searched five databases: Web of Science, Scopus, Medline, PsycINFO and GreenFile. Two blinded reviewers used Rayyan AI and a predefined criteria for article inclusion and exclusion. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS). This review is registered with PROSPERO, ID # CRD42021231619.<h4>Results & discussion</h4>Of 2565 articles retrieved, 31 articles met the inclusion criteria, and overall had a low risk of bias. 26 articles studied cardiovascular related outcomes and 5 studied cancer-related outcomes. Interventions were coded into 4 categories: forest bathing, green exercise, gardening, and nature viewing. Outcomes included blood pressure (BP), cancer-related quality of life (QoL) and (more infrequently) biomarkers of CVD risk. Descriptions of findings are presented as well as visual presentations of trends across the findings using RAW graphs. Overall studies included have a low risk of bias; and alluvial chart trends indicated that NBIs may have beneficial effects on CVD and cancer-related outcomes.<h4>Conclusions & implications</h4>(1) Clinical implication: Healthcare providers should consider the promotion of nature-based programs to improve health outcomes. (2) Policy implication: There is a need for investment in equitable greenspaces to improve health outcomes and build climate resilient neighborhoods. (3) Research or academic implication: Research partnerships with community-based organizations for a comprehensive study of benefits associated with NBIs should be encouraged to reduce health disparities and ensure intergenerational health equity. There is a need for investigation of the mechanisms by which NBIs impact CVD and exploration of the role of CVD biological markers of inflammation among cancer survivors.https://doi.org/10.1371/journal.pone.0276517
spellingShingle Jean C Bikomeye
Joanna S Balza
Jamila L Kwarteng
Andreas M Beyer
Kirsten M M Beyer
The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.
PLoS ONE
title The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.
title_full The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.
title_fullStr The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.
title_full_unstemmed The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.
title_short The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies.
title_sort impact of greenspace or nature based interventions on cardiovascular health or cancer related outcomes a systematic review of experimental studies
url https://doi.org/10.1371/journal.pone.0276517
work_keys_str_mv AT jeancbikomeye theimpactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT joannasbalza theimpactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT jamilalkwarteng theimpactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT andreasmbeyer theimpactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT kirstenmmbeyer theimpactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT jeancbikomeye impactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT joannasbalza impactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT jamilalkwarteng impactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT andreasmbeyer impactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies
AT kirstenmmbeyer impactofgreenspaceornaturebasedinterventionsoncardiovascularhealthorcancerrelatedoutcomesasystematicreviewofexperimentalstudies