Perceived Environmental Qualities and Restorativeness as Pathways Between Urban Green Space Use and Mental Health

Johanna Grünewald,Thomas Kistemann, Nico T. Mutters, Timo Falkenberg
University of Bonn, University Hospital Bonn
, Institute for Hygiene and Public Health, GeoHealth Centre

References
  • Ahmadi, E., Baierl, S., Voss, S., Asenkerschbaumer, I., Berndt, U., Bernhard, L., Hennig, A., Würfele, A.-L., & Coenen, M. (2026). Exploring the relationship between mental health and urban green space soundscapes: A scoping review. PLOS One, 21(3), e0344125. https://doi.org/10.1371/journal.pone.0344125
  • Almeida, D. M., Rush, J., Mogle, J., Piazza, J. R., Cerino, E., & Charles, S. T. (2023). Longitudinal change in daily stress across 20 years of adulthood: Results from the national study of daily experiences. Developmental Psychology, 59(3), 515–523. https://doi.org/10.1037/dev0001469
  • Brähler, E., Mühlan, H., Albani, C., & Schmidt, S. (2007). Teststatistische Prüfung und Normierung der deutschen Versionen des EUROHIS-QOL Lebensqualität-Index und des WHO-5 Wohlbefindens-Index. Diagnostica, 53(2), 83–96. https://doi.org/10.1026/0012-1924.53.2.83
  • Bressane, A., Loureiro, A. I. S., & César De Castro Medeiros, L. (2024). Nature-engagement and wellbeing in Brazil: Understanding the dose-effect relationship for designing urban green spaces. Urban Forestry & Urban Greening, 99, 128443. https://doi.org/10.1016/j.ufug.2024.128443
  • Buchel, S., & Frantzeskaki, N. (2015). Citizens’ voice: A case study about perceived ecosystem services by urban park users in Rotterdam, the Netherlands. Ecosystem Services, 12, 169–177. https://doi.org/10.1016/j.ecoser.2014.11.014
  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A Global Measure of Perceived Stress. Journal of Health and Social Behavior, 24(4), 385. https://doi.org/10.2307/2136404
  • Delgado-Serrano, M. M., Melichová, K., Mac Fadden, I., & Cruz-Piedrahita, C. (2024). Perception of green spaces’ role in enhancing mental health and mental well-being in small and medium-sized cities. Land Use Policy, 139, 107087. https://doi.org/10.1016/j.landusepol.2024.107087
  • Dzhambov, A. M., Browning, M. H. E. M., Markevych, I., Hartig, T., & Lercher, P. (2020). Analytical approaches to testing pathways linking greenspace to health: A scoping review of the empirical literature. Environmental Research, 186, 109613. https://doi.org/10.1016/j.envres.2020.109613
  • Gesler, W. M. (1992). Therapeutic landscapes: Medical issues in light of the new cultural geography. Social Science & Medicine, 34(7), 735–746. https://doi.org/10.1016/0277-9536(92)90360-3
  • Gräfe, K., Zipfel, S., Herzog, W., & Löwe, B. (2004). Screening psychischer Störungen mit dem “Gesundheitsfragebogen für Patienten (PHQ-D)“. Diagnostica, 50(4), 171–181. https://doi.org/10.1026/0012-1924.50.4.171
  • Gravitz-Sela, S., Levy, A., Zehavi, S., Bryt, O., Shach-Pinsly, D., & Plaut, P. (2025). Analyzing usage patterns from video data through deep learning: The case of an urban park. Computers, Environment and Urban Systems, 117, 102229. https://doi.org/10.1016/j.compenvurbsys.2024.102229
  • Hartig, T., Mitchell, R., De Vries, S., & Frumkin, H. (2014). Nature and Health. Annual Review of Public Health, 35(1), 207–228. https://doi.org/10.1146/annurev-publhealth-032013-182443
  • Holt, E. W., Lombard, Q. K., Best, N., Smiley-Smith, S., & Quinn, J. E. (2019). Active and Passive Use of Green Space, Health, and Well-Being amongst University Students. International Journal of Environmental Research and Public Health, 16(3), 424. https://doi.org/10.3390/ijerph16030424
  • ISO. (2018). Acoustics—Soundscape—Part 2: Data collection and reporting requirements (ISO/TS 12913-2:2018). International Organization for Standardization. https://www.iso.org/standard/75267.html
  • Jimenez, M. P., DeVille, N. V., Elliott, E. G., Schiff, J. E., Wilt, G. E., Hart, J. E., & James, P. (2021). Associations between Nature Exposure and Health: A Review of the Evidence. International Journal of Environmental Research and Public Health, 18(9), 4790. https://doi.org/10.3390/ijerph18094790
  • Kaplan, R., & Kaplan, S. (1989). The Experience of Nature: A Psychological Perspective. CUP Archive.
  • Kistemann, T., & Falkenberg, T. (2025). Zur Bedeutung von Places und Landschaften für die Gesundheit. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz, 68(10), 1163–1169. https://doi.org/10.1007/s00103-025-04116-3
  • Kodali, H. P., Ferris, E. B., Wyka, K., Evenson, K. R., Dorn, J. M., Thorpe, L. E., & Huang, T. T.-K. (2023). The association of park use and park perception with quality of life using structural equation modeling. Frontiers in Public Health, 11, 1038288. https://doi.org/10.3389/fpubh.2023.1038288
  • Komossa, F., Van Der Zanden, E. H., & Verburg, P. H. (2019). Characterizing outdoor recreation user groups: A typology of peri-urban recreationists in the Kromme Rijn area, the Netherlands. Land Use Policy, 80, 246–258. https://doi.org/10.1016/j.landusepol.2018.10.017
  • Korpela, K. M., Ylén, M., Tyrväinen, L., & Silvennoinen, H. (2008). Determinants of restorative experiences in everyday favorite places. Health & Place, 14(4), 636–652. https://doi.org/10.1016/j.healthplace.2007.10.008
  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  • Lopez-Haro, J., Gómez-Chávez, L. F. J., Pelayo-Zavalza, A. R., & Gómez-Varela, J. F. (2024). Association between Active Use of Urban Green Spaces and Well-Being in Adults Aged 18–65 Years: A Systematic Review. Journal of Health and Pollution, 12(1–4), 016002. https://doi.org/10.1289/JHP1040
  • Ma, K., & Wu, L. (2025). Perceived biodiversity of public greenspace and mental well-being. Environmental Research, 269, 120878. https://doi.org/10.1016/j.envres.2025.120878
  • Ma, L., Shi, W., & Wu, L. (2023). Mediating roles of perceptions and visiting behavior in the relationship between urban greenspace accessibility and personal health: Evidence from Lanzhou, China. Applied Geography, 159, 103085. https://doi.org/10.1016/j.apgeog.2023.103085
  • Markevych, I., Schoierer, J., Hartig, T., Chudnovsky, A., Hystad, P., Dzhambov, A. M., De Vries, S., Triguero-Mas, M., Brauer, M., Nieuwenhuijsen, M. J., Lupp, G., Richardson, E. A., Astell-Burt, T., Dimitrova, D., Feng, X., Sadeh, M., Standl, M., Heinrich, J., & Fuertes, E. (2017). Exploring pathways linking greenspace to health: Theoretical and methodological guidance. Environmental Research, 158, 301–317. https://doi.org/10.1016/j.envres.2017.06.028
  • Menzel, C., Gessler, M., Hoffmann, S. S. C., & Kenst, S. (2024). Knowing and experiencing the benefits: Factors influencing restoration evoked by nature photographs. Journal of Environmental Psychology, 96, 102322. https://doi.org/10.1016/j.jenvp.2024.102322
  • Ohly, H., White, M. P., Wheeler, B. W., Bethel, A., Ukoumunne, O. C., Nikolaou, V., & Garside, R. (2016). Attention Restoration Theory: A systematic review of the attention restoration potential of exposure to natural environments. Journal of Toxicology and Environmental Health, Part B, 19(7), 305–343. https://doi.org/10.1080/10937404.2016.1196155
  • Oksanen, J., Simpson, G. L., Blanchet, F. G., Kindt, R., Legendre, P., Minchin, P. R., O’Hara, R. B., Solymos, P., Stevens, M. H. H., Szoecs, E., Wagner, H., Bedward, M., Bolker, B., Borcard, D., Carvalho, G., De Caceres, M., Durand, S., Evangelista, H. B. A., Hannigan, G., … Weedon, J. (2001). vegan: Community Ecology Package (p. 2.7-5) [Data set]. https://doi.org/10.32614/CRAN.package.vegan
  • R Core Team. (2026). R: A Language and Environment for Statistical Computing (Version 4.6.1) [Computer software]. R Foundation for Statistical Computing. https://www.R-project.org/
  • Reis, D., Lehr, D., Heber, E., & Ebert, D. D. (2019). The German Version of the Perceived Stress Scale (PSS-10): Evaluation of Dimensionality, Validity, and Measurement Invariance With Exploratory and Confirmatory Bifactor Modeling. Assessment, 26(7), 1246–1259. https://doi.org/10.1177/1073191117715731
  • Tingley, D., Yamamoto, T., Hirose, K., Keele, L., & Imai, K. (2014). mediation: R Package for Causal Mediation Analysis. Journal of Statistical Software, 59(5). https://doi.org/10.18637/jss.v059.i05
  • Twohig-Bennett, C., & Jones, A. (2018). The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environmental Research, 166, 628–637. https://doi.org/10.1016/j.envres.2018.06.030
  • Vidal, D. G., Teixeira, C. P., Fernandes, C. O., Olszewska-guizzo, A., Dias, R. C., Vilaça, H., Barros, N., & Maia, R. L. (2022). Patterns of human behaviour in public urban green spaces: On the influence of users’ profiles, surrounding environment, and space design. Urban Forestry & Urban Greening, 74, 127668. https://doi.org/10.1016/j.ufug.2022.127668
  • Wan, C., Shen, G. Q., & Choi, S. (2020). Effects of physical and psychological factors on users’ attitudes, use patterns, and perceived benefits toward urban parks. Urban Forestry & Urban Greening, 51, 126691. https://doi.org/10.1016/j.ufug.2020.126691
  • World Health Organization, R. O. for E. (1998). Wellbeing measures in primary health care/the DepCare Project: Report on a WHO meeting: Stockholm, Sweden, 12–13 February 1998. (WHO/EURO:1998-4234-43993-62027; p. 39). https://iris.who.int/handle/10665/349766
  • Wu, C.-C., O’Keefe, J., Ding, Y., & Sullivan, W. C. (2024). Biodiversity of urban green spaces and human health: A systematic review of recent research. Frontiers in Ecology and Evolution, 12, 1467568. https://doi.org/10.3389/fevo.2024.1467568
  • Zhai, Y., Baran, P. K., & Wu, C. (2018). Spatial distributions and use patterns of user groups in urban forest parks: An examination utilizing GPS tracker. Urban Forestry & Urban Greening, 35, 32–44. https://doi.org/10.1016/j.ufug.2018.07.014

Contact

Johanna Grünewald
Doctoral Researcher Medical Geography
Institute for Hygiene and Public Health, GeoHealth Centre
University Hospital Bonn
Venusberg-Campus 1, 53127 Bonn, Germany

Tel +49 228 287 19872
E-Mail johanna.gruenewald@ukbonn.de

Nach oben scrollen