Community Health’s Prescriptions for Nature and the Outdoors

While most people their age are busy watching TV or sitting at a computer, Karen and Mike King are outside every day. The retired Rutland couple has their health issues, but that doesn’t stop them from discovering new places to walk, observe, appreciate and breath in the Vermont air.

“I got a NatureRX prescription from my primary care provider at Community Health,” Karen said. “They give you a book where your journal your activity weekly.” Suggested activities are part of the program sponsored by Come Alive Outside (CAO) and Community Health. This year, the program also includes a weekly check-in with a health coach.

Mike and Karen say the “prescription” led them to discover trails, parks, picnic spots and places that they didn’t know existed like Jamaica State Park where the trails are wide; Hubbard Park in Montpelier, a broad flat path that is easy for Karen and the walker she uses. In Pittsfield and Middlebury, they found food co-ops with locally grown produce.

NatureRX is a concept called “social prescribing” that has been in use for a while in Europe, and particularly the UK, where a clinician refers a patient to a community, cultural or outdoor activity to bolster their mental and physical health.

Social prescribing is gaining recognition in the US, said Arwen Turner, Executive Director of Rutland-based Come Alive Outside. “Our NatureRX program is unique because our programs aren’t solely a partnership with a health care provider and a parks system. CAO, a nonprofit, provides the one-on-one coaching which is a different approach to the program than the others have taken around the country. It’s more hands and meets each participant where they are with their goals,” she said.

NatureRX involves a “prescription” from a Community Health primary care provider or a self-referral for out-of-doors activities that are tracked and recorded along with weekly support and direction from a coach.

Community Health and Come Alive Outside partner all year long with a variety of programs that encourage and incentivize outdoor activities including the summer and winter Passport to Wellness, Mile-A-Day walks and NatureRX.

“This year we are seeing a lot bigger reflection of the community participating in the programs in regard to age, lifestyle and background,” Turner said. “For the last few years those involved in the programs were older Vermonters, maybe 95 percent.” Turner said they are now seeing more participants in their 20s and 30s.

“It’s an interesting shift after looking at how this program is benefitting not just physical but also mental health,” she said. “We are seeing different people being attracted to it.”

Come Alive Outside program managers credit the innovative technology and themed events for engaging and exciting new people to join the outdoor activities. “We had 600 people come to Jedi Trails and over 500 at Potterpalooza,” she said. “People like the themes, Star Wars and Harry Potter, while learning about health and wellness in fun ways.”

“Getting outdoors should be fun,” Turner said. “For the past few years, we have been reaching people who were more likely to be driven for health and wellness. Now we are reaching people who also can benefit from the programs, but maybe didn’t feel excited about or were included in our programs at first.  It’s exciting to see the difference in demographics.”

CAO introduced a mobile application to increase communication and to help customize the programs in real-time by monitoring participant needs and engagement.

“Community Health was one of the first sponsors for the Mile-A-Day app,” Turner said. “We have 1000 people doing 100 miles in 100 days using the mobile app and then we have 250 additional folks who are using the physical logbook,” she said.

With the mobile app, CAO program directors are able to see live data, tracking miles or trends in participation. “During the first 30 days of 100 Miles, 100 days people were really engaged, but on day 40 we saw that about half of the participants started skipping days. We have been able to send out notifications and social media posts to re-engage people,” she said.

Community Health has helped bring Come Alive Outside to its next level through a partnership that was created prior to the pandemic. “We wouldn’t have been able to do this without them. Community Health supported the programs and development of the apps,” Turner said. A second app is being developed for passport participants.

CAO introduced the Mile-A-Day mobile app to make the program:

• more attractive
• more accessible
• more immediate for participant response and feedback

“It’s making our program a lot better a lot quicker.”

The Mile-A-Day app has had an additional benefit, particularly for older Vermonters who are not at ease using technology. “Once they are comfortable using the app, we see they are becoming more comfortable and willing to use other applications like grocery store apps and even telehealth apps,” she said. CAO has received grant funds to provide one-on-one training to help seniors and at-risk populations with using the CAO apps.

A post-program survey has consistently shown results in the high 90s when it comes to impacting mental health and physical activity.

“What we are seeing now is that the folks in the NatureRx program want to come back to be coaches. That’s new,” Turner said. “They want to come back and share what they experienced.”

“The Come Alive Outside programs are responding to the real-time needs of the community populations,” said Andrea Wicher, Community Health Director of Quality and Population Health. “We see that we are getting underserved populations outdoors.”

To keep the programs fresh and impactful, Turner said plans are underway to partner with the Vermont Farmers Food Center Farmacy Project which provides locally grown produce to Community Heath patients who are chronically ill.

“Most of the people in the Farmacy would also be a great fit for our NatureRX program,” Turner said. We want to make it easy for them – here’s your physical health component, mental health component, here is your food component.”

In the last three years Come Alive Outside has tripled its impact by reaching 18,000 people in Rutland County, and 25,000 overall through its nationally recognized programs.

CAO is a Vermont-based organization. “Most of our program is done here in Vermont yet we invite people to connect with our mission from all over North America,” Turner said. “We are so grateful for our strong partnership with Community Health.  Strong partnerships like this are why our programs are working.”

Register now for “50 Miles, 50 Days,” October 7-November 25 and try out the Mile-A-Day app.

You can also find all of Come Alive Outside’s fun and free fall programs here.

Come Alive Outside is a 501c3 nonprofit founded in 2014 that works closely with partners in healthcare, public health, outdoor recreation, and the landscape profession to connect individuals, families, and entire communities to the health and wellness benefits of outdoor spaces where they live, work, and play.

Community Health is Vermont’s largest Federally Qualified Health Center (FQHC), a network of primary care, pediatric, behavioral health, dental and pharmacy services with offices in Rutland, Brandon, Castleton, West Pawlet and Shoreham. Community Dental offices are located in Rutland and Shoreham; Community Kids Dental is in Rutland; Community Health Pediatrics is in Rutland and Behavioral Health services are available at all of our locations. Community Health Express Care Centers, open 7 days a week, are located at the Rutland and Castleton Community Health Centers. For more information about Community Health, check our website https://www.chcrr.org/.