Happy New Year to all!

As always, thank you for your continued support and interest in PRA. Our wishes for 2025 are: for more providers and patients to spend more time in nature, to close the gap in equitable access to nature, to reduce the burden of chronic disease by spending more time outdoors, and for more people to take action to slow and reverse climate change. Small ask, right?

Our Park Rx America community is making these goals our priorities on a daily basis.

Here are a few highlights of what we have accomplished in 2024, but first we would like to acknowledge the support from the REI Cooperative Action Fund and several donations from individuals around the country, all of which propelled us further into our work in 2024, and closer to our goals.

To begin, we are very excited about a collaborative project with the Trust for Public Land, to expand PRA's current park prescribing platform to include a more comprehensive nationwide parks database! Health care providers will be able to more easily identify and incorporate these parks into their nature prescriptions to amplify their effort to connect patients/clients to nature-rich areas!

We continue our nature and human health research with outcomes focused on provider burnout and improved patient health outcomes.

A research brief describing an employee wellness program in Salt Lake County (SLC), Utah was published in Health Promotion Practice. We worked with Dr. Rich Christianson from Appalachian State University and Ms. Sadie May, employee wellness coordinator at SLC, to evaluate a nature prescription wellness program conducted in 2020 during COVID. We found that most people who participated in the program reported improved mood and energy; decreased stress, sedentary behavior, and anxiety; and better relationships with others.

In collaboration Dr. Jay Maddock and Yanyan Chen at Texas A&M Center for Health and Nature we conducted a survey of PRA providers and analyzed the data (n=135). We found that providers who wrote more prescriptions reported feeling greater connectedness to nature, visited greenspace and nature more often, took workday breaks more frequently, and reported less screen time. Our findings suggest a correlation between frequent exposure to nature, both during and outside of work, and nature prescription writing. We anticipate that targeting providers with these specific characteristics may increase the issuing of nature prescriptions.

PRA's collaboration with Dr. Deb Cohen at Kaiser Permanente Southern California on a 5-year clinical trial on park prescriptions is coming to a close. We are proud to report the following publications so far: Association of children's electronic media use with physical activity, cognitive function, and stress, Association Between Park Use and Moderate-to-Vigorous Activity During COVID-19 Years among a Cohort of Low-Income Youth, and our earliest protocol paper, The Park Rx trial to increase physical activity among low-income youth. Preliminary analysis on moderate to vigorous physical activity and park use is encouraging; please stay tuned for our 2025 publications!

With support from the Mental Insight Foundation, we collaborated with El Centro de Corazón Community Health Center in Houston, Texas to impact provider burnout, by providing nature enhancements and experiences including framed photos of local nature, live plants, desktop photo displays, and a nature therapy experience by an ANFT nature and forest therapy guide. Given the small sample size of 20 providers, we did not observe any pre-post significant difference in provider behavior or attitudes, but we plan to share the rich and meaningful stories from providers in a future publication. We are also applying for funding from the Texas A&M Forest Service to continue this collaboration with El Centro for 2025 in a proposal to provide all 90 staff with quarterly nature therapy experiences, and to plant and tend trees (both during and outside of scheduled staff meetings) at their clinic sites. This proposed project will be embedded into El Centro's existing staff wellness program, and given El Centro's commitment to staff wellness, we predict that these nature-based experiences will continue long after the grant expires.

We are also very proud to report that we are piloting our "Nature Rep" concept (akin to pharmaceutical reps, except that we substitute "marketing" medicines for nature) in Rhode Island with our PRA volunteer, Angelique Onorati. A post-baccalaureate from University of Pennsylvania (and recently accepted to Osteopathic Medicine School!), Angelique has developed relationships with two organizations - THRIVE located in Warwick, RI and TPP based in Massachusetts. So far, thanks to Angelique's volunteer efforts, and funding from the REI Action Fund, we have been able to provide nature and forest therapy experiences for their staff, administer a survey tool (including the connectedness to nature scale) and provide nature enhancements such as indoor plants. We are monitoring any changes in the therapists/counselors, including time spent in nature, provider burnout, and nature prescription issuing.

We continue to collaborate with and educate communities around the country on benefits of nature and nature prescriptions to impact human and planetary health. This includes, but is not limited to working with and providing talks at Brown University, Oklahoma City Parks & Trails Foundation, University of Idaho, Alamosa, CO, Bogota, Columbia, Osher Center in Ohio, and Maryland General Assembly. We have done podcasts with Dr. Mark Campbell and Pullback.

We continue to provide a bimonthly newsletter on issues and topics related to health and nature.

We look forward to working with you in 2025! If you have any questions or want to collaborate with us, please feel free to connect!

And don't forget to take a break and get out into nature!

And now ... a winter poem.