We look at the whole picture, the entire lived experience that influences health.
Our work examines health through many lenses that intersect, and it often helps people who are underserved or experiencing trauma — for example, veterans suffering from PTSD, children with serious illness, low-income residents grappling with systemic racism and neglect, and others.
Wounded service members receiving medical care at Naval Support Activity Bethesda—home of Walter Reed National Military Medical Center—are fighting to become whole again in the wake of debilitating injuries, like PTSD and Traumatic Brain Injury.
To ease their journey and complement their care, the Nova Institute and its partners have created the Green Road—a woodland garden where service members and their families will find respite amid forest and wildlife, beside a tranquil stream.
Researchers on the project team are conducting studies to scientifically measure the healing effects of spending time on the Green Road.
The Institute for Integrative Health and the TKF Foundation released of the short film, A Road to Wellness, featuring wounded warriors, scholars, and advocates speaking on the importance of this sacred healing space.
The Green Road promotes the communal nature of military life. Wounded service members gain strength and resilience from gathering with one another and their loved ones in this peaceful setting.
According to evidence-based studies, exposure to nature reduces levels of perceived stress, anxiety and depression while boosting self-esteem and a sense of well-being.
Remembering lost comrades is an important part of healing for many warriors. The commemorative pavilion—an element of the project expressly requested by service members—makes this possible.
Nova Institute is a nonprofit organization whose mission is to catalyze new ideas in health, understand the factors that influence health, and promote the well-being of individuals and communities.
Frederick Foote, MD (CAPT, MC, USN, Ret.), Institute for Integrative Health Scholar. Project Officer of The Epidaurus Project. Adjunct Assistant Professor of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences (Department of Defense).
CDM Smith is a consulting, engineering, construction and operations firm that provides lasting and integrated solutions in water, environment, transportation, environmental stewardship, public health protection, commerce, and infrastructure development.
Jack Sullivan is a registered landscape architect, a Fellow of the American Society of Landscape Architects, and an associate professor in the Department of Plant Science and Landscape Architecture at the University of Maryland.
Alt Architecture + Research Associates consists of architects and psychosocial design researchers who have created a comprehensive evidence-based design methodology.
We thank the distinguished members of the Committee for the Green Road for their efforts in promoting this important project and raising funds and awareness. Their actions were critical to making this successful project a reality.
Ask any avid gardener, hiker, or birder why they’re drawn to their hobby, and they’ll probably describe in glowing terms how spending time in nature makes them feel. While individual experiences suggest that nature encounters offer therapeutic benefits, few objective studies have been conducted. The Green Road Project aims to strengthen the base of evidence by scientifically measuring healing effects of exposure to nature.
The Epidaurus Project, an initiative supported by the Institute for Integrative Health and led by Scholar Dr. Fred Foote, developed five metrics for assessing whole-body healing. Researchers from the National Institutes of Health, the Uniformed Health Services University, and the University of Arizona will use three of the metrics to study participants’ responses to spending time on the Green Road.
Studies are examining the biomarkers of stress, using natural language processing to analyze participants’ journals and stories, and examining changes in gene expression. Initial investigations will compare how participants respond to traveling (by foot or wheelchair) on two different routes across the naval base. One is the current high-traffic urban route, and the other takes them along the Green Road. Subsequent studies will chart the effects of longer visits in the Green Road’s garden area and measure responses to spending time in its commemorative pavilion.
The Green Road Project team hopes to scientifically demonstrate the positive impact of nature encounters on human health. Objective evidence will advance the case for increasing community green space and making exposure to nature a therapeutic mainstay.
Other projects supported by the TKF Foundation’s National Nature Sacred Awards Program also have research components, and their teams are using different sets of metrics to measure their impacts. The rich harvest of data resulting from the studies will be of great value, not only for health professionals, but for architects, urban planners, and environmentalists. Ultimately, everyone stands to benefit from this groundbreaking research.
Initial research from the National Institutes and USUHS (Ann Berger, M.D., MSN, and Patricia Deuster, PhD, and colleagues) compared semistructured interviews, and standard distress and mindfulness scores, for subjects spending an hour on the Green Road, versus an hour in a nearby urban environment. In contrast to the urban environment, exposure to the Green Road produced significant increases in themes of safety, privacy, stress relief, and well-being, decreased stress scores, and increased scores for mindfulness (Ameli R, Skeath P, Abraham PA, Panahi S, Kazman JB, Foote F, Deuster PA, Ahmad N, Berger A. 2021. A nature-based health intervention at a military healthcare center: a randomized, controlled, cross-over study. PeerJ 9:e10519 https://doi.org/10.7717/peerj.10519.
Funds for the Green Road Project were provided by Nature Sacred (formerly TKF) as part of the National Open Spaces Sacred Places Initiative. The mission of the Nature Sacred is to provide the opportunity for a deeper human experience by inspiring and supporting the creation of public green spaces that offer a temporary place of sanctuary, encourage reflection, provide solace, and engender peace and well-being.
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Over the past thirty years, we’ve been part of a movement to shift the primary approach to health from a focus on disease to a more complete approach. As reflected in our tagline, “For Health of People, Places, and Planet,” how we are building on “person health” and looking at the context of peoples’ lives and communities as well as the health of the planet we all share.
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Healing is facilitated through safety, persistence, and trust.
Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”
“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad.
When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.)
“When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”
Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.”
Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. “…they gradually found relief from suffering and began to exhibit emergent characteristics: a sense of hope, self-acceptance, and a desire to help others—the immediate precursors to healing.”
In varying degrees, “they were able to transcend their suffering and in some sense to flourish.”
Suffering is the ongoing pain from wounding.
There is debate about whether or not one actually needs to experience suffering on the path to healing.
Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors.
“The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”
Characteristics: How predisposed someone may be to wounding/how many tools and resources someone may have to deal with trauma/illness.
Lifestages: Developmental timing plays an important role in the impact of trauma — young children often do not have the same resources as older adults.
Relationships: Relationships can provide solace and support for those suffering, while lack of healthy relationships can prolong suffering.
