Nature-based social prescribing programmes: opportunities, challenges, and facilitators for implementation
Environment International, vol. 190, pp. 108801
Abstract
BACKGROUND: Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems. METHODS: This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP. RESULTS: We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation. CONCLUSIONS: NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could help inform the development and evaluation of NBSP programmes to support planetary health from local and global scales.
Authors 30
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Siân de Bell corresponding
Affiliation as printed
Exeter HSDR Evidence Synthesis Centre, University of Exeter, 79 Heavitree Rd, Exeter EX2 4TH, United Kingdom. Electronic address: s.c.de-bell@exeter.ac.uk
Exeter HSDR Evidence Synthesis Centre, University of Exeter, 79 Heavitree Rd, Exeter EX2 4TH, United Kingdom
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Glasgow Caledonian University · University of Edinburgh
Affiliation as printed
University of Edinburgh, Edinburgh, United Kingdom
Glasgow Caledonian University, Glasgow, United Kingdom
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Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau
Affiliation as printed
Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Landau, Germany
Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany
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Rita Sousa‐Silva Aachen Institute of Environmental Sciences (CML) Department of Environmental Biology
Leiden University · University of Freiburg
Affiliation as printed
Young Academy for Sustainability Research, Freiburg Institute for Advanced Studies, University of Freiburg, Albertstraße 19, 79104 Freiburg im Breisgau, Germany; Institute of Environmental Sciences, Department of Environmental Biology, Leiden University, P.O. Box 9518, 2300 RA Leiden, the Netherlands
Institute of Environmental Sciences, Department of Environmental Biology, Leiden University, P.O. Box 9518, 2300 RA Leiden, the Netherlands
Young Academy for Sustainability Research, Freiburg Institute for Advanced Studies, University of Freiburg, Albertstraße 19, 79104 Freiburg im Breisgau, Germany
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Affiliation as printed
Institute of Ecology, Technische Universität Berlin, 12165 Berlin, Germany
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Affiliation as printed
Black Forest National Park, Schwarzwaldhochstraße 2, 77889 Seebach, Germany
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Affiliation as printed
KLUG (German Alliance for Climate Change and Health), Hainbuchenstr. 10a, 13465, Berlin, Germany
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University of Leeds · Imperial College London
Affiliation as printed
Imperial College London, London, United Kingdom
Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds LS2 9JT, United Kingdom
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Affiliation as printed
Centre for Regional Economic and Social Research, Sheffield Hallam University, Sheffield S1 2LX, United Kingdom
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Affiliation as printed
Durrell Institute of Conservation and Ecology, University of Kent, Canterbury CT2 7NR, United Kingdom
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Affiliation as printed
Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, Sheffield S1 4DA, United Kingdom
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University of Cologne · Heidelberg University · University Hospital Heidelberg · University Hospital Cologne · Heidelberg Institute of Global Health
Affiliation as printed
Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Institute for General Practice, University Hospital Cologne, Medical Faculty University of Cologne, Cologne, Germany
Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
Institute for General Practice, University Hospital Cologne, Medical Faculty University of Cologne, Cologne, Germany
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Ludwig-Maximilians-Universität München
Affiliation as printed
Chair of Public Health and Health Services Research, Faculty of Medicine, LMU Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
Chair of Public Health and Health Services Research, Faculty of Medicine, LMU Munich, Germany
Pettenkofer School of Public Health, Munich, Germany
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Humboldt-Universität zu Berlin · Immanuel Krankenhaus · Charité - Universitätsmedizin Berlin
Affiliation as printed
Institute of Social Medicine, Epidemiology and Health Economy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Department of Internal Medicine and Nature-based Therapies, Immanuel Hospital Berlin, Berlin, Germany
Department of Internal Medicine and Nature-based Therapies, Immanuel Hospital Berlin, Berlin, Germany
Institute of Social Medicine, Epidemiology and Health Economy, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
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Affiliation as printed
Institut für Gesundheit in Natur, Leipzig, Germany
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Royal College of Surgeons in Ireland
Affiliation as printed
Faculty of Nursing & Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
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Affiliation as printed
Dundee City Council, Dundee, United Kingdom
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Humboldt-Universität zu Berlin · Immanuel Krankenhaus · Charité - Universitätsmedizin Berlin
Affiliation as printed
Institute of Social Medicine, Epidemiology and Health Economy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Department of Internal Medicine and Nature-based Therapies, Immanuel Hospital Berlin, Berlin, Germany
Department of Internal Medicine and Nature-based Therapies, Immanuel Hospital Berlin, Berlin, Germany
Institute of Social Medicine, Epidemiology and Health Economy, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
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World Health Organization Regional Office for Europe
Affiliation as printed
WHO Regional Office for Europe, European Centre for Environment and Health, Bonn, Germany
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Humboldt-Universität zu Berlin · Charité - Universitätsmedizin Berlin
Affiliation as printed
Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Norwegian Institute for Water Research
Affiliation as printed
Norwegian Institute for Water Research, Økernveien 94, 0579 Oslo, Norway
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Affiliation as printed
NHS Highland, Inverness, United Kingdom
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Heidelberg University · University Hospital Heidelberg · Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau · Heidelberg Institute of Global Health
Affiliation as printed
Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany
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Affiliation as printed
Wildfowl & Wetlands Trust (WWT), Slimbridge, United Kingdom
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Helmholtz Centre for Environmental Research · German Centre for Integrative Biodiversity Research · Friedrich Schiller University Jena · Leipzig University
Affiliation as printed
Friedrich Schiller University Jena, Institute of Biodiversity, Dornburger Straße 159, 07743 Jena, Germany; Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Leipzig University, Wilhelm Wundt Institute for Psychology, Neumarkt 9, 04109 Leipzig, Germany
Friedrich Schiller University Jena, Institute of Biodiversity, Dornburger Straße 159, 07743, Jena, Germany
German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103, Leipzig, Germany
Helmholtz Centre for Environmental Research -UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318, Leipzig, Germany
Leipzig University, Wilhelm Wundt Institute for Psychology, Neumarkt 9, 04109, Leipzig, Germany
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Affiliation as printed
Umweltbundesamt (German Environment Agency), Wörlitzer Pl. 1, 0684 Dessau-Roßlau, Germany
Umweltbundesamt (German Environment Agency), Wörlitzer Pl. 1, 0684, Dessau-Roßlau, Germany
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University of Exeter · University of Edinburgh
Affiliation as printed
University of Edinburgh, Edinburgh, United Kingdom
Exeter HSDR Evidence Synthesis Centre, University of Exeter, 79 Heavitree Rd, Exeter, EX2 4TH, UK, s
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University of Exeter · University of Surrey
Affiliation as printed
Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, United Kingdom
Exeter HSDR Evidence Synthesis Centre, University of Exeter, 79 Heavitree Rd, Exeter, EX2 4TH, UK, s
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Helmholtz Centre for Environmental Research · German Centre for Integrative Biodiversity Research · Leipzig University
Affiliation as printed
Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany
Institut für Gesundheit in Natur, Leipzig, Germany
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Helmholtz Centre for Environmental Research · German Centre for Integrative Biodiversity Research · Friedrich Schiller University Jena
Affiliation as printed
Friedrich Schiller University Jena, Institute of Biodiversity, Dornburger Straße 159, 07743 Jena, Germany; Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany
Friedrich Schiller University Jena, Institute of Biodiversity, Dornburger Straße 159, 07743, Jena, Germany
German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103, Leipzig, Germany
Helmholtz Centre for Environmental Research -UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318, Leipzig, Germany
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