A mixed methods feasibility and acceptability study to test a brief nature-based intervention to improve university students’ mental wellbeing

• A novel nature-based intervention (NBI) to improve wellbeing was evaluated. • Focus groups found benefits including improved cognitive functioning. • Students reported improved wellbeing and nature relationships after the NBI. • Students self-reported better sleep, reduced rumination and stress. • The NBI is feasible and acceptable, and a fully-powered trial is now needed. The adolescent mental health crisis is well documented, with mental health services unable to meet growing need, resulting in many adolescents being unsupported. There is an emerging body of evidence on the benefits of nature in improving mental health and wellbeing, with nature-based interventions (NBIs) gaining momentum as a viable alternative to support clinical treatments and aid in prevention. University students are typically at the upper end of adolescence, and at high risk of poor mental health and wellbeing. To counter this, Roots and Shoots©, a brief self-guided NBI, has been developed to improve the mental wellbeing of university students. This mixed methods study tested the feasibility and acceptability of the intervention using a single-arm design. Change in mental wellbeing was also assessed. Thirty-four university students took part in the two-week study and engaged in prescribed activities, as set-out in the Roots and Shoots guidebook, that encouraged them to spend time in nature daily, develop positive coping strategies and habits, and practice nature-based mindfulness. The guidebook also signposted mental health support. Two short surveys were undertaken by participants: pre-intervention (T0) and on intervention completion (T1), and included measures on mental wellbeing, nature-relationship, stress, sleep, and rumination. The second survey also included quantitative and qualitative items on acceptability and feasibility. Feasibility and acceptability were obtained from positive feedback in the survey post-intervention (T1) and from thematic analysis produced from focus group discourse, from a representative subgroup of 10 students. The preliminary results showed self-reported improvements in mental wellbeing, and also nature-relationship, stress, sleep, and rumination. The current study supports a fully powered randomised control trial to test the efficacy of the intervention and shows promise that brief NBIs could improve the mental wellbeing of university students in challenging times.