Household-level surrounding greenspace as a nature-based intervention for health recovery after occupational injury

IntroductionUrban greening has been increasingly discussed as a component of health-supportive environments. While greenspace exposure has been associated with psychological restoration, limited evidence exists regarding household-level responses among families affected by occupational injury. This study examined whether a structured forest-based intervention was associated with short-term changes in psychological burden, resilience, and perceived family relationship quality across household roles.MethodsA single-group pre–post design was applied to injured workers and their cohabiting family members participating in a forest-based rehabilitation program in South Korea. Paired analyses included 1,194 participants. Role-stratified linear mixed-effects models (N = 918) adjusted for age and sex. Exploratory heterogeneity analyses focused on resilience (N = 789). Outcomes included occupational injury distress, resilience (KRQ-27), and family relationship quality. Mean changes, 95% confidence intervals, Holm-adjusted p-values, and paired Hedges’ g were reported. Psychometric outcomes were assessed immediately before program initiation and immediately after completion of the final scheduled session.ResultsOccupational injury distress decreased (Δ = −7.81, g = −0.397, p < 0.001), resilience increased (Δ = +8.51, g = 0.517, p < 0.001), and family relationship quality improved over the immediate post-program period (Δ = +4.38, g = 0.391, p < 0.001). Reductions in distress were numerically larger among injured workers, whereas gains in resilience appeared numerically larger among children and spouses. Pre–post changes were observed across income and age strata, although some subgroup contrasts did not remain statistically significant after multiplicity adjustment.DiscussionForest-based programming within an urban greenspace context was associated with short-term favorable changes in psychological and relational outcomes. Because the design lacked a control group, outcomes were assessed only within an immediate post-program window, and long-term follow-up was not available, the observed changes should be interpreted as short-term associations rather than confirmed causal effects.