Exeter HSDR Evidence Synthesis Centre, University of Exeter, 79 Heavitree Rd, Exeter EX2 4TH, United Kingdom.
University of Edinburgh, Edinburgh, United Kingdom.
Environ Int. 2024 Aug;190:108801. doi: 10.1016/j.envint.2024.108801. Epub 2024 Jun 6.
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.
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.
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.
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.
关于在大自然中度过时间对健康有益的证据强调了提供人们居住的蓝色和绿色空间的重要性。然而，暴露于自然环境中带来的健康益处不仅限于促进健康，还包括治疗健康问题。社会处方将有健康或社会关怀需求的人与以社区为基础、非临床的健康和社会关怀干预措施联系起来，以改善健康和幸福感。基于自然的社会处方（NBSP）是一种变体，它利用在自然环境中进行的活动带来的促进健康的益处，例如园艺和散步。目前，许多 NBSP 实践是在英国发展起来的，全球对其实施的兴趣也在不断增加。这需要根据不同的情况调整干预措施，考虑到人群的需求和医疗保健系统的结构。
本文介绍了一个专家小组参与式研讨会的结果，该研讨会涉及英国和德国卫生和环境部门的 29 名从业者、研究人员和政策制定者。我们使用英国和德国作为案例研究，这两个国家拥有不同的医疗保健系统，处于 NBSP 实践的不同发展阶段，分析了发展和实施 NBSP 的机会、挑战和促进因素。
我们确定了发展、实施和评估 NBSP 的五个总体主题：能力建设；可及性和可接受性；网络和合作；标准化实施和评估；以及可持续性。我们还讨论了每个总体主题的关键优势、劣势、机会和威胁，以了解如何开发它们以支持 NBSP 的实施。
NBSP 可以利用现有的蓝色和绿色空间为公众健康带来重大益处。我们提供了关于如何从更广泛的政策支持到个别方案的设计和评估，来调整 NBSP 实施的指导，以适应不同的情况。这项研究可以帮助为从地方和全球规模支持行星健康的 NBSP 方案的发展和评估提供信息。
