• Thayse Natacha Gomes, Sara Suikkanen, Mabliny Thuany, Ilkka Väänänen, and Alan Donnelly.
• Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland. Electronic address: thayse.gomes@ul.ie.
• Lancet. 2023 Nov 1; 402 Suppl 1: S45S45.

BackgroundPhysical activity and nature exposure provide health benefits. This study aimed to test the feasibility of an intervention designed to examine the effects of environmental quality on physical activity, sleep, and health status.MethodsIn this pilot feasibility study, we included 14 inactive adults from Limerick (Ireland) and Lahti (Finland), recruited using social media. The intervention was an 8-week self-guided programme of physical activity, in which participants were asked to select an outdoor route according to their convenience, engage in physical activity (walking or running) at least three times a week for at least 30 min/session, and record each session using a mobile app. Participants were provided with training sheets, self-adapted according to convenience, in an in-person meeting when detailed information was provided. Reminder messages were sent during the intervention. Time spent in moderate-to-vigorous physical activity (MVPA) was measured through an accelerometer over a 9-day measurement period (considering the 50th percentile: >P50, ≤P50). Sleep quality and general health status were self-reported. Measurements were taken in weeks 1 and 8. We analysed differences, between MVPA percentile groups and general sample, in change from week 1 to 8, using χ2 and paired t-tests, with significance at p values lower than 0·05. The study was approved by the ethics committee from the University of Limerick and Satakunta Universities.Findings26 adults were enrolled in the study between Oct 3, 2022, and Feb 9, 2023, of whom 18 (69%) were women and eight (31%) were men, with a mean age of 46 years (SD 9·7). 14 (54%) of 26 adults completed the 8-week intervention, of whom 11 were women and three were men, with a mean age of 46 years (SD 10·79). On average, participants performed their training sessions 19 times (mean 19·2, SD 9·4). Mean time in MVPA decreased from 49·7 min (SD 27·0) at week 1 to 46·7 min (32·3) at week 8 (p=0·604); mean health status score increased from 66·43 (SD 26·63) to 68·57 (26·63; p=0·586); and the frequency of good sleepers increased from 50% to 64·3% (p=0·266). In both moments, participants classified in the higher MVPA percentile group (>P50) presented higher mean health status score and higher frequency of good sleepers then those in the lower percentile group (≤P50), although the differences were not significant.InterpretationStudy limitations include the absence of a control group and the sample size. Although results were not significant, they were promising, since it might be an easy and low-cost strategy to increase physical activity with potential impact on public health. Lessons learned led to changes in the design, and a larger multicentre study will be carried out to understand the relationship of the variables in groups performing physical activity in green and "paved" spaces.FundingEuropean Union's Horizon 2020.Copyright © 2023 Elsevier Ltd. All rights reserved.

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