Population Health

May 30, 2024

Nature for all: Bridging health equity through the Initiative-funded Project Nature

Children sitting outsideEngaging in outdoor play and exploration can significantly enhance a child’s physical health and mental well-being. However, not all children and families have equitable access to safe, green environments. This deprivation of nature can be tied to several factors, including systemic racism and economic disparities, and hinder a family’s ability to access nature and reap its health benefits. A new program, titled “Project Nature,” seeks to help families overcome barriers so that all children can connect with nature and lead healthier lives.

An initiative of BestStart Washington, Project Nature aims to engage children in nature-rich play starting early in life. This tool is designed for caregivers who may have limited access to outdoor recreation opportunities and connects families with resources on how to incorporate active outdoor nature time into children’s play via a brochure, online resources and an age-appropriate nature toy

After field tests in local Puget Sound clinics, the toolkit has shown early success in increasing physical activity and time spent in nature for children aged 4-10 years old. In a pivotal step toward extending the impact of Project Nature, Dr. Pooja Tandon was awarded a Tier 3 Population Health Initiative Pilot Grant to scale the Project’s work in spring 2023. A pediatrician with Seattle Children’s, and associate professor at the UW School of Medicine, Dr. Tandon aims to broaden the availability of the Project Nature toolkit to clinics throughout Washington state, with a focus on communities predominantly composed of families of color, lower-income communities and those with limited access to nature.

“There are historically driven systemic factors that have led to these inequities in accessing nature. Historical policies, like redlining, have led to some neighborhoods having fewer parks and less green space in communities that have primarily families of color and lower household incomes,” explained Dr. Tandon. “Equity has always been a driving force for my research. So, being a pediatrician, I liked how Project Nature promoted health in our communities and I really was inspired by this model where healthcare providers could promote an activity that we know is good for children’s health.”

To help in the expansion of Project Nature, Dr. Tandon aims to create downloadable and multilingual resources. These materials, customized with input from the pediatric primary care professionals for their patients, will be augmented with training for the entire clinic on how to implement Project Nature for the families they serve. Dr. Tandon and her team then hope to partner with five clinics across Washington State to disseminate Project Nature.

After implementation, the researchers will examine its effectiveness via mixed methods research. “Before the launch of this intervention, we’re planning to survey families from the clinic to gather baseline data. ‘How often do you go outside with your child? What challenges are you experiencing in having more nature time? Did you discuss nature play at your child’s last checkup appointment?’” explained Dr. Tandon.

“Once we roll this program out for a few months, we’ll go back and ask families the same kinds of questions. ‘Did they like the resources? Was this intervention feasible? Did it change their behavior?’” continued Dr. Tandon.

Ultimately, the goal of the expansion of Project Nature is centered around promoting positive health behaviors in children while also considering the systemic inequities and unique barriers that may make these actions difficult. By creating tools, like Project Nature, that address and mitigate these disparities, this interdisciplinary team of researchers can propose culturally appropriate interventions that take into account the needs of all communities.

“The goal is to be able to, someday, scale Project Nature nationally to make it both relevant and accessible to a broader number of clinics, and through that, a broader number of families and children,” shared Dr. Tandon. “We’re still in the early stages of this work, so I’m excited to see how it rolls out and what we learn that will allow us to make the program even better.”