Indoor Versus Outdoor Research (IVOR) Study
Research type
Research Study
Full title
Indoor Versus Outdoor group psychological therapy for older adults in NHS inpatient settings; a feasibility study of a pragmatic, cluster Randomized Controlled Trial (RCT).
IRAS ID
362658
Contact name
Stephanie Howarth
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of the Study
A growing body of research highlights the mental health benefits of spending time outdoors, yet psychological therapies within the NHS are predominantly delivered indoors. Emerging evidence suggests that outdoor therapy may enhance emotional wellbeing, reduce stress, and improve engagement with therapy, yet there is limited quantitative research exploring this within NHS settings.
This study is a feasibility trial exploring the delivery of indoor versus outdoor group psychological therapy for older adults in NHS inpatient settings.
The study aims to assess the feasibility of a future larger-scale pragmatic, cluster Randomized Controlled Trial (RCT). Participants will be service users who are currently under the care of the dementia and frailty inpatient units at Birmingham and Solihull Mental Health NHS Foundation Trust, such as the Juniper Centre and Reservoir Court, who have been invited to attend group psychological therapy and consent to take part in the research study. Participants will be randomized in clusters, according to their ward, to receive either indoor or outdoor group psychological therapy.
Feasibility will be assessed through recruitment and retention rates, session adherence, protocol compliance, and acceptability of the intervention, measured through standardised questionnaires completed by both service users and staff. Effectiveness will be explored using the CORE-10 outcome measure at baseline, post-intervention, and 3-month follow-up.
Staff perspectives on delivering therapy outdoors will also be assessed using validated measures of feasibility and appropriateness. Findings will inform the viability of a full-scale RCT, including suitability of outcome measures, adherence to protocol, and participant and staff acceptability ratings.
If outdoor psychological therapy is found to be acceptable, practical, and potentially effective, this may have important implications for how psychological therapies are delivered within NHS inpatient services.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
26/EM/0054
Date of REC Opinion
19 Feb 2026
REC opinion
Further Information Favourable Opinion