What question did this study set out to answer?

This study aims to explore the effectiveness of nurse-led horticultural activities in reducing depressive symptoms among youth in Hong Kong.

April 16, 2026Open Access

Nurse‑led horticultural activities as an early intervention for mild‑to‑moderate depressive symptoms among youth in Hong Kong: an exploratory randomised controlled trial

Key Points

This study aims to explore the effectiveness of nurse-led horticultural activities in reducing depressive symptoms among youth in Hong Kong.
Randomised controlled trial design
Involved 108 Hong Kong Chinese youth aged 15–24 with depressive symptoms
Intervention group attended four 2-hour horticultural sessions led by nurses
Control group received routine mental health monitoring and an information pamphlet
Outcomes measured at three time points: baseline, post-intervention, and 4 weeks later.
Horticultural activities significantly reduced depressive symptoms (β = −1.207, P = .028)
Most improvement observed between baseline and post-intervention (P = .05)
Intervention demonstrated high feasibility with 94.2% eligibility rate and 77.7% recruitment rate
Retention rates were 88.9% at post-intervention and 69.4% at 4 weeks later.

Abstract

Studies have revealed an increasing prevalence of depressive symptoms among youth globally, including in Hong Kong, posing a serious threat to their mental health and quality of life. While it has been shown that horticultural activities are promising for reducing depressive symptoms in adults and older populations, their effectiveness among youth—particularly in Chinese communities—remains underexplored. This study examined the feasibility, applicability and effectiveness of horticultural activities in reducing depressive symptoms among Hong Kong youth, as well as reducing anxiety and enhancing self-esteem and quality of life. The intervention group attended four weekly 2-h nurse-led structured horticultural sessions on a local farm. The control group received regular mental health parameters monitoring by the researcher and a mental health information pamphlet. Outcomes, including depressive and anxiety symptoms, self-esteem and quality of life, were measured at baseline (T0), post-intervention (T1) and 4 weeks later (T2). The feasibility of the intervention was assessed through recruitment metrics and participants’ feedback. Between October and December 2023, 108 Hong Kong Chinese youth aged 15–24 years who self-reported depressive symptoms, were equally and randomly assigned to either the intervention (n = 54) or control group (n = 54). The intervention was feasible and well accepted, with an eligibility rate of 94.2%, a recruitment rate of 77.7%, and retention rates of 88.9% at T1 and 69.4% at T2. Horticultural activities significantly reduced the severity of depressive symptoms (β = −1.207, 95% CI: −1.820 to − 0.043, P = .028), with the most notable improvement observed between T0 and T1 (P = .05, generalised estimating equation GEE analysis). Horticultural activities are a feasible, low-cost and acceptable intervention for reducing depressive symptoms among Hong Kong youth. Given horticultural activities’ potential to promote mental well-being, their integration into community-based mental health programmes should be considered. Further large-scale trials are recommended to validate their broader psychological benefits. Chinese Clinical Trial Registry ChiCTR2300075575 (registered on 8 September 2023).

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