61. Intervention study on community-participatory rural tourism for social functional recovery in mental health patients

Abstract Background As mental health services transition from institutional care to community rehabilitation, exploring innovative psychosocial intervention models has become a critical public health priority. While traditional rehabilitation methods control symptoms, they face limitations in promoting patients' social functional recovery and community integration. Previous research indicates that natural environments and meaningful social engagement positively impact mental health, yet studies employing community-participatory rural tourism as a structured intervention remain scarce. To address this gap, this study, grounded in theories of “social therapy” and “environmental psychology,” investigates the impact of community-participatory rural tourism on the social functional rehabilitation of individuals with mental illness. The research aims to enhance their social skills, life competencies, and sense of self-worth by organizing their participation in tourism service activities within rural communities, thereby providing a novel pathway for community-based mental health rehabilitation. Methods A mixed-methods approach was employed, incorporating a 6-month quasi-experimental design. Sixty community-dwelling individuals with mental illness in stable conditions were non-randomly assigned to an intervention group (n = 30) or a control group (n = 30). The intervention group received a 12-week, twice-weekly structured community-based rural tourism program involving: co-planning eco-tourism routes with villagers, serving as rural cultural guides, and participating in collaborative agricultural product processing and sales. The control group received routine community follow-up. Quantitative assessments were conducted using the Social Disability Screening Schedule (SDSS) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) at baseline, at the end of the intervention, and 3 months post-intervention. Semi-structured interviews were conducted with selected participants and villagers to gather qualitative data. Results Post-intervention, the intervention group's SDSS total score significantly decreased from baseline (7.82 ± 1.91) to (4.48 ± 1.21) (t = 9.347, p<.001), while the control group showed no significant change (7.75 ± 1.68 vs. 7.61 ± 1.74, p>.05). Between-group comparisons revealed significantly lower scores in the intervention group (p<.001), with a Cohen's d effect size of 1.24. Regarding SDSS subscales, the intervention group demonstrated improvement rates of 86.7% and 83.3% in “Social Responsibility and Interest” and “Interpersonal Relationships,” respectively. WHODAS 2.0 revealed that the intervention group experienced a 42.5% reduction in difficulty scores on the “Interacting with Others” dimension and a 38.1% reduction on the “Participating in Social Life” dimension, both significantly superior to the control group (p<.01). At the three-month follow-up, the intervention group maintained an SDSS score of (4.83 ± 1.34), showing no statistically significant difference from the end of the intervention (p>.05), confirming the sustainability of the effects. Discussion The findings confirm that community-participatory rural tourism serves as an effective and sustainable psychosocial intervention model. Its success lies in shifting rehabilitation settings from closed institutions to open community environments, where patients are assigned meaningful social roles to rebuild their social functioning through practical engagement. This model provides public health policymakers with an innovative practice template for integrating mental health services with community development and rural revitalization. Future research should expand sample sizes and conduct multicenter randomized controlled trials to validate its generalizability. Additionally, personalized intervention protocols tailored to different disease types and functional levels should be explored, alongside in-depth investigations into long-term benefits and cost-effectiveness to promote broader community adoption of this model. Funding No. CR23Z05; 1 321 007; No. LD2024Z17; No. WRF202427; No. mw2023yb01; No. 2024CS119; No. CAIACDRCXM2025-01; No. 24SDLYAQYB019; No. LD202503; No. 22YJC630171.