{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:09:03Z","timestamp":1788952143297,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Current research supports claims for nature\u2019s role in resilience and healing from toxic stress, adverse childhood experiences (ACEs), and their downstream sequelae. Beyond promoting individual patient health, access to greenspace has broader community-level benefits, including the fostering of community resilience and the reduction of socio-economic and race-driven health inequalities. While these benefits can dovetail with the public health goals of promoting healing, nature and nature contact remain an underutilized resource in the clinical setting with limited previous exploration as to why. The following is an overview of how nature can impact youth and families experiencing ACEs and toxic stress, with a focus on exploring insight from Los Angeles County pediatric providers and opportunities to enhance pediatric health care providers\u2019 roles in connecting youth and families with nature to mitigate toxic stress.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1939130","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:12:27Z","timestamp":1788948747000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Connecting with nature to mitigate toxic stress: an exploratory study of pediatric provider perceptions"],"prefix":"10.3389","volume":"14","author":[{"given":"Candace M.","family":"Gragnani","sequence":"first","affiliation":[{"name":"Division of Medicine-Pediatrics & Preventive Medicine, Department of Medicine, UCLA Health","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Division of Medicine-Pediatrics & Preventive Medicine, Department of Medicine, UCLA Health","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Fregoso","sequence":"additional","affiliation":[{"name":"Division of Medicine-Pediatrics & Preventive Medicine, Department of Medicine, UCLA Health","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Saez","sequence":"additional","affiliation":[{"name":"UCLA Fielding School of Public Health","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Nair","sequence":"additional","affiliation":[{"name":"UCLA Fielding School of Public Health","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malakai","family":"Espinosa","sequence":"additional","affiliation":[{"name":"UCLA College of Letters and Science","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al-Saleem","sequence":"additional","affiliation":[{"name":"UCLA College of Letters and Science","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Connecting with Nature Community Advisory Board","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nooshin","family":"Razani","sequence":"additional","affiliation":[{"name":"Division of Medicine-Pediatrics & Preventive Medicine, Department of Medicine, UCLA Health","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref1","volume-title":"ACEs Aware progress Report: 2019\u20132023","author":"Murphy","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"862","DOI":"10.3122\/jabfm.2022.04.2104543","article-title":"Policy considerations for routine screening for adverse childhood events (ACEs)","volume":"35","author":"Shimkhada","year":"2023","journal-title":"J Am Board Fam Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e2021051884","DOI":"10.1542\/peds.2021-051884","article-title":"Screening for adverse childhood experiences in children: a systematic review","volume":"149","author":"Loveday","year":"2022","journal-title":"Pediatrics"},{"key":"ref4","article-title":"The science of ACEs & toxic stress","year":"2026"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.yapd.2016.04.0026","article-title":"Toxic stress in children and adolescents","volume":"63","author":"Bucci","year":"2016","journal-title":"Adv Pediatr Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"999","DOI":"10.15585\/mmwr.mm6844e17","article-title":"Vital signs: estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention - 25 states, 2015-2017","volume":"68","author":"Merrick","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref7","volume-title":"The Roadmap for Resilience: The California Surgeon General\u2019s Report on Adverse Childhood Experiences, Toxic Stress, and Health","author":"Bhushan","year":"2020"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"108234","DOI":"10.1016\/j.envint.2023.1082349","article-title":"Nature-based biopsychosocial resilience: an integrative theoretical framework for research on nature and health","volume":"181","author":"White","year":"2023","journal-title":"Environ Int"},{"key":"ref9","article-title":"Clinical assessment & treatment","year":"2026"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4213","DOI":"10.3390\/ijerph1712421311","article-title":"Nature prescriptions for health: a review of evidence and research opportunities","volume":"17","author":"Kondo","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1136\/jech-2018-21043612","article-title":"Mental health benefits of interactions with nature in children and teenagers: a systematic review","volume":"72","author":"Tillmann","year":"2018","journal-title":"J Epidemiol Community Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1080\/09603123.2021.199839013","article-title":"Nature-based interventions for vulnerable youth: a scoping review","volume":"33","author":"Overbey","year":"2023","journal-title":"Int J Environ Health Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1093\/biosci\/biw173","article-title":"Doses of neighborhood nature: the benefits for mental health of living with nature","volume":"67","author":"Cox","year":"2017","journal-title":"Bioscience"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.pedn.2017.08.02715","article-title":"Does access to green space impact the mental well-being of children: a systematic review","volume":"37","author":"McCormick","year":"2017","journal-title":"J Pediatr Nurs"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"750245","DOI":"10.3389\/fpsyg.2022.75024516","article-title":"A meta-analysis of emotional evidence for the biophilia hypothesis and implications for biophilic design","volume":"13","author":"Gaekwad","year":"2022","journal-title":"Front Psychol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e2020049155","DOI":"10.1542\/peds.2020-049155","article-title":"Nature and children's health: a systematic review","volume":"148","author":"Fyfe-Johnson","year":"2021","journal-title":"Pediatrics"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"075001","DOI":"10.1289\/EHP166318","article-title":"Nature contact and human health: a research agenda","volume":"125","author":"Frumkin","year":"2017","journal-title":"Environ Health Perspect"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2333794X17739193","DOI":"10.1177\/2333794X1773919319h","article-title":"Prescribing outdoor physical activity to children: health care providers' perspectives","volume":"4","author":"Christiana","year":"2017","journal-title":"Glob Pediatr Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.pmedr.2016.12.00520","article-title":"Pediatrician prescriptions for outdoor physical activity among children: a pilot study","volume":"5","author":"Christiana","year":"2016","journal-title":"Prev Med Rep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1007\/s11524-015-9983-y21","article-title":"Nature-based strategies for improving urban health and safety","volume":"92","author":"Kondo","year":"2015","journal-title":"J Urban Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1186\/s12889-020-09411-z22","article-title":"The frequencies and disparities of adverse childhood experiences in the U.S.","volume":"20","author":"Giano","year":"2020","journal-title":"BMC Public Health"},{"key":"ref22","article-title":"Healthy Beginnings\/Reducing Adverse Childhood Experiences","year":"2020"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/s0749-3797(98)00017-8","article-title":"Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study","volume":"14","author":"Felitti","year":"1998","journal-title":"Am J Prev Med"},{"key":"ref24","first-page":"20","volume-title":"Parks and public Health in Los Angeles County: a Cities and Communities Report","year":"2016"},{"key":"ref25","volume-title":"Rapid Community Assessment guide","year":"2023"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2563","DOI":"10.3390\/ijerph18052563","article-title":"Green space and health equity: a systematic review on the potential of green space to reduce health disparities","volume":"18","author":"Rigolon","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref27","article-title":"Inspiring Communities through Movement and Conversation","year":"2026"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"106930","DOI":"10.1016\/j.cct.2022.106930","article-title":"The park Rx trial to increase physical activity among low-income youth","volume":"122","author":"Zarr","year":"2022","journal-title":"Contemp Clin Trials"},{"key":"ref29","first-page":"179","article-title":"Clinic and park partnerships for childhood resilience: a prospective study of park prescriptions","volume-title":"Health Place","author":"Razani","year":"2019"},{"key":"ref30","volume-title":"The Health Belief Model of Behavior Change","author":"Alyafei","year":"2024"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1939130\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:12:29Z","timestamp":1788948749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1939130\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":30,"alternative-id":["10.3389\/fpubh.2026.1939130"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1939130","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1939130"}}