The Alarm Bells Ring…

“Silent Spring” = “Last Child in the Woods” (2005)
Kids spend an average of 7 hours screen time/day; less than
1 hr/day in unstructured outdoor play
Obesity, Attention Deficit Disorder, asthma increasing in
Prescriptions children
for Outdoor Activity:
Improving Mental,
and Emotional Health
–80+% urban;
Oxford’s Junior Dictionary removed “buttercup”, “minnows”
and “acorns”
and added “analogue”,
and “cutNational Environmental
Justice Conference
and Training
March 2016
National Environmental Education Foundation (NEEF); ©2016 Dimensions Foundation; USDA Forest Service

The Alarm Bells Ring…
• Kids spend >1 hour per day of
unstructured outdoor play
• Sedentary lifestyle and physical inactivity
contribute to health problems
• Demographics are shifting
• Oxford’s Junior Dictionary removed
“buttercup,” “minnows,” and “acorns,”
added “analogue,” “broadband,” and

State of Children’s Health
• >1 in 3 children in the U.S. are obese or
overweight; minority and low-income
children are disproportionately affected
• 3,700 children are diagnosed with type 2
diabetes each year
• 7 million kids have asthma; overweight
children are at higher risk
• 70% of US children and adolescents have
insufficient levels of Vitamin D

Nature is Good for Us!
• Restorative/therapeutic
• Increases physical
• Reduces stress
• Coping tool for
• Developmental benefits

Rx for Outdoor Activity
• Prevent serious health
conditions related to
indoor, sedentary
• Connect children and
families to nature for
good health, enjoyment,
and environmental

Rx for Outdoor Activity
• Educate pediatric health
care providers about
prescribing outdoor
activities to children and
• Link to nature
programming at local
nature sites in safe and
easily accessible areas

Get into Nature for Better Health!

Nature Explore

What is Nature Explore?

Resources and programs that
support making nature an integral
part of children’s daily lives

All Nature Explore programs are
based on research by Dimensions
Educational Research Foundation

Mission: Transforming children’s lives through meaningful,
daily connections with nature

“The single most
important factor in
developing personal
concern for the
environment was
positive experiences
in the outdoors
during childhood.”
Cross-cultural research study by
J.A. Palmer

Dimensions Foundation Research
Students who spend time in
well-designed Nature Explore
Classrooms with nurturing
adults develop valuable skills
across all learning domains.
(Miller 2007)

Nature-Based Outdoor

“Compared to both indoor and
traditional playgrounds, children
in outdoor natural settings were
reported to be more relaxed,
happier, less impulsive, more
focused, more creative and
better behaved.”
Post-occupancy Study of Nature-based Outdoor
Classrooms, Dennis 2014

Three Requirements for becoming a
Certified Nature Explore Classroom


Follow the Ten Guiding Principles
Create well-designed
outdoor spaces following
the principles in
the Learning With Nature
Idea Book

All Nature Explore Programs are based on research


Staff Development
Nature Explore Educator Workshops

All Nature Explore Programs are based on research


Family Involvement
Nature Explore Families’ Club and At Home With Nature

All Nature Explore Programs are based on research

Warren Village

Denver, CO

Infant/Toddler Area


Warren Village

Denver, CO

Preschool Area


US Forest Service Chief’s Honor Award for
Engaging Urban America

Smith’s Playhouse

Philadelphia, PA

Smith’s Playhouse

Philadelphia, PA

Lone Star Family Medical Center

Green Ambassadors creating a buzz:
Health and Fitness Initiative

Nature Explore Concept Plan

Nature Explore Concept Plan

USFS Educational Resources
Woodsy Owl
Lend a Hand, Care for the Land


Community Partners: Document changes in knowledge,
attitudes, and behaviors related to design and benefits of the
Nature Explore Classroom.
Nature Explore Workshop Pre/Post-Survey
• Pre-training, participants already agreed with many of the
objectives and were generally supportive of the project.
• After training, respondents were in much stronger agreement
with all project objectives.
• Action steps planned by participants demonstrate strong buy-in.

Early Outcomes
• Trees for Texas donating all the trees for the space
• Sam Houston National Forest donating “loose parts”
• Eagle Scout assembling many components under supervision of
Texas A&M Forest Service
• College youth mentored with Nature Explore certified Landscape
• Green Ambassador created a planting plan for the space
• Texas AgriLife will provide classes on healthy eating using plants
grown in the Nature Explore garden beds
• Partners will provide programming at the clinic and at the nearby
forests and parks

Healthcare Providers: Document changes in knowledge,
attitudes, and behaviors related to prescribing nature to patients
and benefits of doing so.
• Pre/post-survey of healthcare providers participating in Rx for
Outdoor Activity training
• Follow-up to track program implementation, number of
prescriptions written, and number of prescriptions fulfilled

Survey of Patients and Nature Explore Classroom
Programming Participants will measure:
• perceived barriers and benefits to spending time in nature;
• overall experience in the Nature Explore Classroom;
• intent to visit the Nature Explore Classroom again and/or visit
another local nature area.

Future Research Opportunities
Identify tools or incentives necessary to increase
participation in Nature Explore or other Park Rx programs

• Needs assessment
◦ Space, access, community partners, demographics
• Prescription/medication-adherence research
◦ Managed Problem-Solving (MAPS) therapeutic

Future Research Opportunities
Which health outcomes can be measured?
• Mental health/cognitive function
• Physical activity & obesity
• Stress and cardiovascular health
• Mobile monitoring - smart phone apps, gps & wearable


Tamberly Conway, Ph.D.
Partnerships, Diversity and Inclusion Specialist, Conservation Education, USDA Forest Service
Sara Espinoza
Managing Director, Research and Best Practices, National Environmental Education Foundation
Michelle Kondo, Ph.D.
Scientist, USDA Forest Service