Prevalence and effectiveness of nature-based interventions to impact adult health-related behaviours and outcomes: A scoping review

Abstract Evidence supports the positive influence of nature on population health, which has led to increased interest in nature-based interventions (NBIs). This scoping review explored how NBIs were currently being implemented to change adult health-related behaviours and outcomes linked with international public health indicators. Fifty-two of the 618 studies initially screened met the inclusion criteria. The review reinforced nature’s potential to improve multiple health and wellbeing outcomes relevant to environment and public health disciplines. However, NBI effects were typically small, assessed short-term, and often based on comparisons between natural and highly urbanised settings. Vague NBI descriptions, an absence of theoretical frameworks guiding NBI design, and limited exploration of differences by socio-demographic or clinical group limited the conclusions. Based on the review findings, future NBIs should include clear, full descriptions of the settings and intervention techniques. The theoretical framework(s) utilised in the design and evaluation process should also be specified. NBIs duration should also be systematically investigated to establish if doseresponse relationships differ by health outcomes to inform public health guidance on the “minimum duration for maximum benefit” for nature users. Another recommendation is for health behaviour change frameworks to be considered along with environment-health theories in NBI design and evaluation. This complementary approach could establish the full range of environment and health benefits associated with NBIs and better evidence the environmental, health and social impact.