Page - 238 - in Biodiversity and Health in the Face of Climate Change

238 of relationship to environment and community. J.  Fisher has published several scales that may be useful. For example, in the Spiritual Health and Life Orientation Measure (SHALOM)-generic (Fisher, J.W. 2014) participants select language for the ‘transcendent Other(s)’ to fit their own beliefs. This scale has been administered worldwide with adults. Similar scales for secondary school students (Gomez and Fisher 2003) and primary school children (Fisher, J. 2004) are also available. 10.4.2.2 Measuring Biodiversity Appropriate measures of biodiversity also need to be incorporated into studies that purport to examine how biodiversity affects spiritual well-being. In our review, we encountered several approaches including field-based assessment (e.g. surveying species richness or abundance), use of secondary data (e.g. GIS) and categorisation of natural setting (e.g. wilderness). Within the field of ecology, numerous types of counts can be made. Dallimer et  al. (2012) suggest that the number of animals or plants (i.e. species abundance) may be easiest for humans to recognise as represen- tative of biodiversity. Other aspects of biological complexity which may be impor- tant to consider include species composition, functional organisation, relative abundance and species numbers (see also de Vries & Snep 2018; Marselle et  al. 2018). 10.4.3 Future Directions for  Research on  Biodiversity’s Effect on  Spiritual Well-Being There are continuous calls for upping the science bar, hence the examination here of how the relationship between nature (biodiversity) and health/well-being (spiritual) has been investigated in the literature. As noted in Sect. 10.4.1 and by others (Lovell et  al. 2014; Marselle et  al. 2018), most studies are cross-sectional and yield only associative results. We recommend taking a public health perspective and selecting research designs to more clearly investigate causal relationships. We would argue that activities in nature constitute complex interventions or exposures, including physical activity and group organisational effects, and recommend following sug- gestions about how to think about such interventions (Clark 2013) and the UK Medical Research Council guidance on how to study them (Craig et  al. 2008). There is also a need for mixed methods research that integrates findings from qualitative and quantitative research methods (Fetters et  al. 2013) to unpack the various com- ponents of both exposures and outcomes. Quantitative study designs could be improved by using natural experiments, quasi-experimental and before-and-after repeated measures designs as well as long-term longitudinal studies. Complex anal- yses are also needed, for example, structural equation modelling that allows identi- fication of significant pathways or analyses that test various constructs as moderators, K. N. Irvine et al.