|12. Green/nature/park/garden prescriptions.||Doctors (or other professionals) ‘prescribe’ or refer patients/clients to outdoor activities (often walks).||P/T||Increase exercise and the associated benefits, stress reduction, reduce blood pressure, improve healing times, reduce depression, increase resilience and other mental health benefits. Some are targeted towards children for purposes such as prevention or treatment of obesity, cancer and diabetes. Some also target quality of life, wellbeing and social support.||Individual patients or groups with a range of conditions.||Individual-level barriers: Geographic accessibility and availability of facilities (e.g., green spaces), affordability of the activity, social acceptability, physical and cognitive capability of individuals, perceived issues such as danger.|
Organisation-level barriers: Acceptability by and lack of knowledge of medical professionals, difficulty in changing behaviours of medical professionals.
Potential unintended impacts: Could present risks for people with some conditions.
|13. Care–farming or farm therapy, including horticulture and animal–assisted therapy.||Therapeutic use of commercial farms and agricultural landscapes as a base for promoting mental and physical health, through normal farming activity or horticulture.||T||Mental health promotion and to reduce distress in people with dementia. Reduce social isolation.||Youth at risk; youth with special needs (e.g., autism); cancer survivors; mental disorders; people with lost functionality; people recovering from serious illness. ||Not assessed in this study.||[83,105,106,107,108,109,110,111,112,113,114]|
|14. Residential retreats.||Multi–modal therapies delivered in a removed natural setting.||T||Holistic wellbeing: physical, but primarily psychological (coping), social, spiritual.||Patients with chronic conditions such as cancer or cardiovascular disease.||Not assessed in this study.|||
|15. Wilderness therapy.||Structured nature–based activities and programmes in ‘wilder’ environments for ‘at risk’ groups or those recuperating or in recovery||P / T||Address social and psychological issues through a range of pathways, including by facilitating positive human–nature interactions, building self–esteem and fostering social connections.||People with severe mental health issues; youth at risk of involvement in crime; individuals who are imprisoned or on probation from crime; ex–offenders; victims of crime; children with ADHD; those living with or recovering from a range of mental and physical conditions; people with post–traumatic stress disorder.||Individual-level barriers: Geographic accessibility and availability of facilities (e.g., green spaces), affordability of the activity, social acceptability, some people may not appreciate the group context, physical ability, time (several days often required).|
Organisational level barriers: Poor system support, lack of financial resources to support the activities.
Potential unintended impacts: Mental distress and physical injury in poorly managed activities, poor follow–on care. Often offered as a once–in–a–lifetime developmental boost, and they may be required more often.
|16. Wilderness programmes.||Programmes designed to challenge participants in natural environments.||P||Personal growth, social skills.||Often youth, but also targeting any interested people and groups.||Not assessed in this study.||[126,127]|
|17. Ecotherapy.||Treatment modalities that include the natural world in relationships|
of mutual healing and growth, and as such are a form of applied ecopsychology.
|T||Positive effects on psychological wellbeing, fitness and self–reported health.||People with symptoms of stress, or other mental health and wellbeing issues.||Not assessed in this study.||[128,129,130,131]|
|18. Pet therapy, or pet–assisted therapy.||Use of pets, especially in hospitals to benefit patients.||T||Psychological wellbeing; social wellbeing.||Hospital inpatients; other vulnerable groups.||Not assessed in this study.||[132,133,134]|
|19. Forest bathing.||Practice of spending time in forest settings, often with emphasis on attention to breathing and other meditative techniques ||P / T||Improved physical and mental wellbeing.||People referred to the program or voluntary participation.||Not assessed in this study.||[95,96,100,135,136]|
|20. Green gyms or environmental volunteering.||Active work in an outdoor environment, often with a focused conservation outcome.||P/T||Provide diverse benefits including physical activity, mental wellbeing, social connection/(re)integration.||People referred to the program or voluntary participation.||Individual-level barriers: Geographic accessibility (including transport) and availability of facilities (e.g., green spaces), affordability of the activity, social acceptability, availability of the programmes.|
Organisation-level barriers: Lack of financial resources, acceptability by and lack of knowledge of health professionals, difficulty in changing behaviours of health professionals.
Potential unintended impacts: Chance of injuries and risk of other negative impacts of nature (e.g., insect bites, allergic responses), conflict in management of green spaces. Limited knowledge by host organisations of how to supervise people with physical or mental impairment.
|21. Outdoor exercise groups.||Groups with the specific aim of exercising in nature (most commonly walking) for health benefits.||P/T||Improve physical, psychological, social and spiritual wellbeing, including better cardio–vascular health, psychological wellbeing. ||Local interested residents, or people referred to the program with a specific health condition, or voluntary participation.||Individual-level barriers: Geographic accessibility and availability of facilities (e.g., green spaces), affordability of the activity, social acceptability, concerns about, e.g., getting muddy or other issues, unfamiliarity with using non–urban environments, personality (e.g., introverts may elect out), mobility issues.|
Organisational-level barriers: Lack of financial resources or certainty, communication preferences for older individuals (e.g., social media).
Potential unintended impacts: Chance of physical injury, group setting may engender negative feelings and interactions.
|22. Nature play/wild play.||Structured programmes designed to facilitate children’s play in natural environments. ||P||Enhance child health and development through provision of social programmes and physical environments that promote varied play opportunities, improved attention and learning, physical activity, mental health.||Children (general). ||Not assessed in this study.||[151,152,153,154,155,156,157]|
|23. Forest Schools/outdoor classrooms/learning environment.||Programme of education in the outdoors (rather than about the outdoors). Typically children spend a period of their schooling (ranging from a couple of hours a week to all their time) undertaking outdoor activities. Forest school is both a pedagogy and a physical entity, with the use often being interchanged.||P||Provide alternative (and sometimes improved) learning environment, increase physical activity and the associated benefits.||Typically children, but has been used with adults and people with special needs.||Not assessed in this study.||[158,159,160,161]|
|24. Children’s kitchen gardens.||Gardens in schools and kindergartens to encourage engagement in growing one’s own food and to increase access to fruit and vegetables||P||Improve nutrition, social connections and psychological benefits (e.g., confidence, team work skills), physical activity, educational outcomes, school–based quality of life.||Children in childcare, nurseries and schools.||Not assessed in this study.||[162,163,164,165,166,167,168,169,170,171]|
|25. Outdoor education schemes.||Schemes designed to introduce children/adults to nature with the purpose of altering their knowledge about, attitudes toward and contact with nature.||P||Increase confidence to use natural environments for physical activity and recreation and promote the health and wellbeing benefits associated with this and increased nature exposure. ||Largely children, but also aimed at adults from vulnerable groups (e.g., rehabilitation) and others. ||Not assessed in this study.|||
|26. Promotion and facilitation campaigns.||Promotional campaigns (e.g., via media) to highlight and encourage engagement with natural environments and potential health benefits. ||P||Increase awareness, engagement, use and experience of natural environments. ||General population, but often targeted at specific groups such as different age groups.||Not assessed in this study.||[128,173]|
|27. Blue gym.||Water– or shoreline–based activities.||P||Improve mental wellbeing.||General population.||Not assessed in this study.|||