Recruiting

Walking in Greenspace

Sponsor:

University of Minnesota

Code:

NCT06365723

Conditions

PreDiabetes

Heart Rate Variability (HRV)

Stress and Anxiety

Stress Biomarkers

Eligibility Criteria

Sex: All

Age: 25 - 64

Healthy Volunteers: Not accepted

Interventions

Nature-based Walking

Built-environment/Commercial Walking

Study Details

Brief summary:

The goal of this randomized crossover trial is to compare the differences in psychological and physiological effects of walking in two different outdoor environments (urban/suburban commercial environments vs. urban/suburban nature areas/preserves) in adults with prediabetes. The main questions it aims to answer are:

  • Do psychological measures of stress, anxiety, and affect improve more in one type of outdoor environment over the other?
  • Do physiological measures of stress improve more in one type of outdoor environment over the other?

As this is a crossover trial, participants will serve as their own controls. Researchers will compare both the psychological and physiological effects walking in the two types of outdoor environments.

Participants will:

  • Walk 150-minutes per week for six weeks in each of the two outdoor conditions.
  • Visit the clinic four times, including before and after each six-week walking period.
  • Collect saliva samples immediately proceeding or following the four clinic visits.
  • Return to their pre-study level of physical activity for a 5-week washout period between each of the two walking interventions.

Conditions

PreDiabetes

Heart Rate Variability (HRV)

Stress and Anxiety

Stress Biomarkers

Study ID

NCT06365723

Start date

Jun 6, 2024

Status verified date

Jun, 2026

Completion date

Nov 30, 2028

Anticipated

Primary completion date

Nov 30, 2028

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 25 - 64

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • 25-64 years old.
  • Classified as overweight or obese with BMI 20.0-39.9 kg/m2 per self-report and a BMI of 20.0- 41.9 kg/m2 upon actual measure.
  • Documentation\* of a PreD diagnosis within one year of enrollment by physician or primary care provider based on lab tests showing a fasted blood glucose of 100-125 mg/dL, a 2-hour oral glucose tolerance test of 140-199 mg/dL, or an HbA1c level of 5.7%-6.49%271; OR a study screening lab value of HbA1C within the aforementioned range.
  • Currently engaged in ≤100 min/week of moderate to vigorous exercise -confirmed via a 7-day activity recall.
  • No exercise contraindications as assessed by the Physical Activity Readiness Questionnaire (PAR-Q) -this Questionnaire involves seven "yes" or "no" questions regarding an individual's health status. Answering "yes" to any one of these questions may require a prospective participant to acquire a written doctor's note stating they can safely participate in the trial's exercise intervention. The participant would not be enrolled until this doctor's note is received.
  • Stable weight over the last 3 months (less than 10% change).
  • Not currently pregnant, planning to become pregnant, or currently breastfeeding.
  • Willing to maintain current dietary and exercise habits, aside from any changes to be made per the study exercise protocol.
  • Must own a smartphone and be willing and able to download the Garmin Connect app
  • Ability to speak and understand English.
  • Any level of income
  • Any race/ethnicity

Exclusion Criteria:

  • Individuals <25 or >64: younger individuals may have not yet reached physiological maturity and in whom PreD prevalence is low; older individuals are more likely to have contraindications to PA and other comorbidities.
  • BMI <20 or ≥42.
  • Individuals with an HbA1c level <5.7% or >6.4%.
  • Currently engaged in >100 min/wk of PA.
  • Individuals with contraindications to exercise participation as indicated by the PAR-Q.
  • A self-reported physical/mental disability that would prevent them from being able to adhere to the intervention.
  • Past or current diagnosis of Diabetes (Type 1, 1.5 or 2) or use of diabetic medications (e.g. medications to control blood sugar)
  • Any history of a cardiovascular disease event (e.g. heart attack, ablation, pacemaker, stroke)
  • Current treatment for cancer or heart disease (lipid and hypertensive medications acceptable but will be tracked closely).
  • Any change within the last 3 months, or anticipated changes, of any medications that would affect study outcomes (e.g. medications for lipids, blood pressure, anxiety, depression)
  • The use of any medication that significantly interferes with the autonomic nervous system
  • Current tobacco or nicotine users, or those who have quit within the last six months
  • Excessive alcohol (on average>1 drinks/day for women and >2 drinks/day for men) or excessive recreational drug use (reported usage of once a week or more).
  • Unstable weight over the last three months (>10% change).
  • Those with major surgery planned or recent history of bariatric surgery (within last 2 years) or a history of other medical interventions that would interfere with study outcomes
  • Currently within one-year postpartum, currently pregnant, or planning to become pregnant during the study period.
  • Currently breastfeeding.
  • Unwilling to comply with study randomization procedures.
  • Unwilling to maintain current dietary and exercise habits, aside from any changes to be made per the study exercise protocol.
  • Current participation in another interventional clinical trial.
  • Previous randomization in this study.

Study Design

Enrollment

216 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Basic Science

Interventions and Outcome Measures

Arms

experimental: Nature-based Walking then Built-environment/Commercial Walking

People with prediabetes randomized to six weeks of nature-based walking followed by a five week washout, and then six weeks of built-environment/commercial-based walking

experimental: Built-environment/Commercial Walking then Nature-based Walking

People with prediabetes randomized to six weeks of built-environment/commercial-based walking followed by a five week washout, and then six weeks of nature-based walking

Interventions

Nature-based Walking

All participants will be asked to walk three to five times per week for 30-50 minutes per walk, totaling 150 min/week, at moderate intensity over a 6-week period in a designated nature-based, or 'green', urban environment.

Built-environment/Commercial Walking

All participants will be asked to walk three to five times per week for 30-50 minutes per walk, totaling 150 min/week, at moderate intensity over a 6-week period in a designated built-environment/commercial, or 'Gray', urban environment.

Primary outcome measure

  • Measure of Anxiety [ Time Frame: Before and after each of the four assessment walks, which occur in weeks 4, 7, 15, and 18 (weeks 3 and 6 of each 6-week walking intervention). ]
  • Perceived stress assessment [ Time Frame: Before and after each of the four assessment walks, which occur in weeks 4, 7, 15, and 18 (weeks 3 and 6 of each 6-week walking intervention). ]
  • Mood assessment [ Time Frame: Before and after each of the four assessment walks, which occur in weeks 4, 7, 15, and 18 (weeks 3 and 6 of each 6-week walking intervention). ]
  • Restorativeness [ Time Frame: Assessment given after each of the four assessment walks, which occur in weeks 4, 7, 15, and 18 (weeks 3 and 6 of each 6-week walking intervention). ]

Central Contacts and Locations

Central contacts

Sarah Rydell, MPH

612-437-6126rydel004@umn.edu

Locations

Lake Forest Hospital

Recruiting

Lake Forest, Illinois, United States, 60045

Contacts

Molly Schau

mschau@nm.org

Central DuPage Hospital

Recruiting

Winfield, Illinois, United States, 60190

Contacts

Molly Schau

mschau@nm.org

Epidemiological Clinical Research Center

Recruiting

Minneapolis, Minnesota, United States, 55415

Contacts

Chris Hoefer

612-626-9199

More Information

Sponsor

University of Minnesota

Last update posted

Jun 18, 2026

Last verified

Jun, 2026

Keywords

  • walking intervention
  • built environment
  • outdoor environment
  • prediabetes
  • stress
  • urban

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by University of Minnesota on 2026-06-18.