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Nature Prescriptions for Health: A Review of Evidence and Research Opportunities

USDA-Forest Service, Northern Research Station, 100 North 20th Street, Ste 205, Philadelphia, PA 19103, USA
Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
Schuylkill Center for Environmental Education, 8480 Hagys Mill Rd, Philadelphia, PA 19128, USA
Department of Parks, Recreation & Tourism Management, College of Natural Resources, Box 8004, 3028F Biltmore Hall, North Carolina State University, Raleigh, NC 27695-8004, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(12), 4213;
Received: 27 April 2020 / Revised: 8 June 2020 / Accepted: 9 June 2020 / Published: 12 June 2020
Nature prescription programs have emerged to address the high burden of chronic disease and increasingly sedentary and screen-based lifestyles. This study examines the base of evidence regarding such programs. We conducted a narrative review of published literature using four electronic databases. We included case studies, research design articles, and empirical studies that discussed any type of outdoor exposure or activities initiated by a health-care provider from an outpatient clinic. We examined articles for information on target populations, health outcomes, and structural and procedural elements. We also summarized evidence of the effectiveness of nature prescription programs, and discussed needs and challenges for both practice and research. Eleven studies, including eight empirical studies, have evaluated nature prescription programs with either structured or unstructured formats, referring patients either to nearby parks or to formal outdoor activity programs. Empirical studies evaluate a wide variety of health behaviors and outcomes among the most at-risk children and families. Research is too sparse to draw patterns in health outcome responses. Studies largely tested program structures to increase adherence, or patient follow-through, however findings were mixed. Three published studies explore providers’ perspectives. More research is necessary to understand how to measure and increase patient adherence, short and long-term health outcomes for patients and their families, and determinants of provider participation and participation impacts on providers’ own health. View Full-Text
Keywords: nature prescriptions; NatureRx; ParksRx; narrative review; outdoor recreation nature prescriptions; NatureRx; ParksRx; narrative review; outdoor recreation
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Kondo, M.C.; Oyekanmi, K.O.; Gibson, A.; South, E.C.; Bocarro, J.; Hipp, J.A. Nature Prescriptions for Health: A Review of Evidence and Research Opportunities. Int. J. Environ. Res. Public Health 2020, 17, 4213.

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