Green Care as Psychosocial Intervention for Depressive Symptoms: What Might Be the Key Ingredients?
Rebecca E Salomon, Alison D Salomon, Linda S Beeber
PMID 28818002WHAT IT FOUND
Psychosocial interventions for adult depression may work through social support, self-efficacy and behavioral activation.
This review found evidence for those links, but it did not show that green care itself reduces depressive symptoms.
Key findings
01Behavioral activation fully mediated intervention effects on depressive symptoms in two studies.
02Two randomized trials found social support mediated improved depressive symptoms.
03Self-efficacy was supported as a mediator in three studies, but one study did not find mediation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only eight studies were included, and they used different interventions, designs and ways of testing mediation. The review was about psychosocial interventions generally, not green care itself, so it cannot show that green care works or that these mediators operate in green care. Publication bias is likely because papers that did not find mediation may not have been published, and mediation was not examined when intervention effects were not significant. Only English-language studies of adults were included, so findings may not apply to children, adolescents or non-English settings.
Declared interests
The article is listed as supported by N.I.H. extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that green care has been shown to reduce depressive symptoms. The review tested mediators in other psychosocial interventions, not green care itself.