title: Exercise-, nature- and socially interactive-based initiatives improve mood and self-esteem in the clinical population.
abstract: OBJECTIVE
  This study evaluated two existing group-based health promotion initiatives (a social club and a swimming group) and compared these to a new green exercise programme (weekly countryside and urban park walks).
  
  
  METHODS
  Participants represented a clinical population (N = 53) and were all experiencing a range of mental health problems. They only attended one of the three programmes and sessions were held once a week for six weeks in all initiatives. Composite questionnaires incorporating two standardized measures to analyse changes in self-esteem and mood were completed before and after all sessions.
  
  
  RESULTS
  A significant main effect for self-esteem and mood pre and post activity (p < 0.001) was reported after participating in a single session. The change in self-esteem was significantly greater in the green exercise group compared with the social activities club (p < 0.001). Dose responses showed that both self-esteem and mood levels improved over the six-week period and improvements were related to attendance in the green exercise group.
  
  
  CONCLUSIONS
  Green exercise as a health-promoting initiative for people experiencing mental ill health is equally as effective as existing programmes. Combining exercise, nature and social components in future initiatives may play a key role in managing and supporting recovery from mental ill health, suggesting a potential 'green' approach to mental healthcare and promotion.
authors.affiliation: Department of Biological Sciences, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK. jobarton@essex.ac.uk
authors.forename: Jo
authors.initials: J
authors.lastname: Barton
authors.forename: Murray
authors.initials: M
authors.lastname: Griffin
authors.forename: Jules
authors.initials: J
authors.lastname: Pretty
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008603:Mental Health; D008875:Middle Aged; D012649:Self Concept; D013550:Swimming / Q000523:psychology; D016138:Walking / Q000523:psychology; D055815:Young Adult