Further research is needed to examine healthcare professional provided nature prescriptions, especially for childrenResearch increasingly links connectedness with nature to an array of positive health outcomes. Nature prescriptions are a growing approach for promoting beneficial health outcomes through increased contact with nature. This scoping review was conducted to identify the existing literature on healthcare professional provided nature prescriptions. The objective of the review was to explore “what healthcare professionals are prescribing nature, who the prescriptions are written for, what is being prescribed, and the quality of the existing studies on nature prescriptions.”
A search of three academic databases and Google was conducted to identify peer-reviewed studies of nature prescriptions. Only studies of nature prescriptions that were prescribed by a healthcare professional and were published in English were eligible for inclusion in the review. Healthcare professionals were defined to include healthcare practitioners, providers, and rehabilitation centers. No limitations were placed on the publication year or geographic location of the studies. Based on these criteria, 12 articles were identified and selected for the review. Of these, four were randomized controlled trials, two were observational studies, two were pilot studies, two were pre- and post-questionnare, and one was a longitudinal cohort study and one was a qualitative evaluation.
The nature prescriptions examined by the reviewed studies were prescribed by a rehabilitation center or other medical center in three studies, by a pediatrician in three studies, and by other types of healthcare practitioners or providers in six studies. The studies were mainly conducted in the US and the UK, and single studies were conducted in Denmark and Singapore. Seven studies involved nature prescriptions that were prescribed to adults and five studies reported on nature prescriptions for children (ages 4-18). Types of activities that were prescribed focused on gardening, park visits, physical activity, and water-based activities. Children were mainly prescribed park visits (3 studies), and to a lesser degree outdoor physical activity (one study) and surfing lessons (one study). In studies involving children, the outcomes assessed included children’s resilience, stress, self-esteem, outdoor physical activity, time spent outdoors, frequency of park visits, and emotional, social, and physical well-being. Four studies documented improvements in these outcomes. The other study assessed parents’ stress levels and frequency of park visits and found no changes. Similarly, the majority of studies involving adults reported positive outcomes. The length of the studies varied from several days to several months. Most of the studies indicated that baseline and follow-up data was collected from participants. With 12 eligible studies, and only five of those focused on children, the review revealed a substantial gap in the research of nature prescriptions prescribed by healthcare professionals. Because the studies examined different types of nature prescriptions, the authors caution that findings are not generalizable across studies.
The review provides one of the first explorations of the existing research on healthcare professional provided nature prescriptions. Overall, the review supports nature prescriptions as an approach that can help healthcare professionals encourage patients to take advantage of nature’s health benefits. Findings of the review highlight a need for further research as well as “significant variation worldwide in what healthcare professionals prescribing nature, what they prescribe, and how prescriptions are written.” The review also calls attention to the need to define nature prescription more consistently, as there are discrepancies in how the term is used. Continued research will help to “provide a deeper understanding of nature’s health benefits, increase the number of nature prescriptions being prescribed, and build a more comprehensive body of knowledge on nature prescriptions.”
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