Green Health Partnerships in Scotland; Pathways for Social Prescribing and Physical Activity Referral

Abstract

Increased exposure to green space has many health benefits. Scottish Green Health Partnerships (GHPs) have established green health referral pathways to enable community-based interventions to contribute to primary prevention and the maintenance of health for those with established disease. This qualitative study included focus groups and semi-structured telephone interviews with a range of professionals involved in strategic planning for and the development and provision of green health interventions (n = 55). We explored views about establishing GHPs. GHPs worked well, and green health was a good strategic fit with public health priorities. Interventions required embedding into core planning for health, local authority, social care and the third sector to ensure integration into non-medical prescribing models. There were concerns about sustainability and speed of change required for integration due to limited funding. Referral pathways were in the early development stages and intervention provision varied. Participants recognised challenges in addressing equity, developing green health messaging, volunteering capacity and providing evidence of success. Green health interventions have potential to integrate successfully with social prescribing and physical activity referral. Participants recommended GHPs engage political and health champions, embed green health in strategic planning, target mental health, develop simple, positively framed messaging, provide volunteer support and implement robust routine data collection to allow future examination of success.

How Has the COVID-19 Pandemic Affected the Way We Access and Interact with the Countryside and the Animals within It?

“…A smaller number of respondents reported interactions with wildlife (31%) or other animals (15%) as a reason for their enjoyment. The physical and mental health benefits of getting outside and engaging with nature are being increasingly recognized and promoted through initiatives such as ecotherapy [ 36 , 37 ] and green and blue social prescribing [ 38 , 39 ]. Reconnecting with the natural world in this way is only likely to gain momentum as we move on from the pandemic.…”

Public mental health and nature: a paradigm shift

“…The paradigm shift I am beseeching is paramount in the area of green prescriptions or green health prescriptions (McHale et al , 2020). Having observed the definitive outcomes through my research, it is clear that sustainability education, multicultural integration and interdisciplinary networks are integrative and participatory processes.…”

“…Therefore, there is still a great deal of paradigm shifting required in how “holistic natural health services”, which involve both public mental health and ecosystem health outcomes combined, are approached and delivered. It would be short-sighted to endorse the “use of the natural environment to promote good health” (McHale et al , 2020), without considering that the natural environment, more than ever, is also in need of reciprocal care for it to be “used” by us all for our health.…”

Where next for the design, delivery, and evaluation of community-based physical activity prescription? Emerging lessons from the United Kingdom

“…While guidelines 2, recommend access to activities alongside use of behaviour change techniques (e.g., goals, action and coping plans), work has demonstrated how delivery can be challenged by issues of technique fidelity, 18,19 time pressures on the workforce, 20 and poor attendance. 21 Innovations in this area are trialling new delivery methods, including theory-based behaviour change consultations, 14 referral to "green" physical activity in outdoor environments, 22 and home-based delivery. 23 Such diversification of delivery may be particularly important amidst the changing climate of the Covid-19 pandemic, where home-based or outdoor PA could offer accessible alternatives to the traditional gym environment for elderly or clinically vulnerable populations.…”