Evidence map›Paper›PMID 42823701›Full record

SynthesisBMC medicine2026

Effectiveness of green health prescribing and nature-based interventions in primary care and community settings for older adults: a systematic review of health, wellbeing and social outcomes.

Furqan Butt, Jeremiah Donoghue, Cameron Ley, Naila Dracup, Sophie Staniszewska, Lena Al-Khudairy, Tilli M Smith, Nadia Corp, Jo Parsons, Helen Frost and 3 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Furqan ButtCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK. f.butt@bham.ac.uk.
Jeremiah DonoghueCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK.
Cameron LeyHealth Determinants Research Collaboration Coventry, Coventry City Council, Coventry, UK.
Naila DracupCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK.
Sophie StaniszewskaWarwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK.
Lena Al-KhudairyCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK.
Tilli M SmithSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, Keele, UK.
Nadia CorpSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, Keele, UK.
Jo ParsonsCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK.
Helen FrostAdvanced Care Research Centre, University of Edinburgh, Edinburgh, UK.
Amy GroveCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK.
Yen-Fu ChenCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK.
Danielle A van der WindtSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, Keele, UK.

Funding

National Institute for Health and Care Research NIHR163510
6 · The paper itself

Abstract

backgroundGreen Health Prescribing involves health and care professionals prescribing structured, nature-based interventions, such as gardening, walking in green spaces, or cultural activities outdoors. With population ageing and increasing pressure on healthcare systems, Green Health Prescribing has been proposed as a potentially cost-effective approach to support healthy ageing in older adults with long-term conditions. This review summarises evidence on the effectiveness of Green Health Prescribing and related nature-based interventions for older adults.

methodsA systematic review was conducted of intervention studies reporting the effectiveness of Green Health Prescribing and nature-based interventions for adults aged 50 years and over in primary or community care settings. Eligible designs included randomised trials, other comparative designs, and before-after studies. Searches up to October 2024 were performed in major medical, psychological, social science, and environmental databases, alongside grey literature sources. Study selection, data extraction, and quality appraisal were undertaken independently by at least two reviewers. Quantitative findings were synthesised narratively using a Grading of Recommendations, Assessment, Development and Evaluation-informed approach, with reporting guided by established systematic review standards. Patient and provider input informed the design and interpretation of findings.

resultsTwenty-one studies, including 11 randomised trials, evaluated interventions among older adults living in the community or residential care. Interventions included activities in nature, exercise in green spaces, indoor gardening, and horticultural therapy. Many studies reported improvements in at least one health or wellbeing outcome; however, statistically significant effects compared with control conditions were uncommon. Evidence suggested potential benefits for quality of life, mental health, physical function, fatigue, loneliness, and social connectedness, but findings were inconsistent. Overall certainty of evidence was low or very low, largely because of small sample sizes, risk of bias, and limited replication across outcomes.

conclusionsEvidence supporting the effectiveness of Green Health Prescribing and nature-based interventions for older adults remains limited. Given continued policy priority and funding for green space prescribing, high-quality pragmatic trials and implementation studies are needed, particularly among older adults, to robustly assess health outcomes, cost-effectiveness, and healthcare resource use in routine practice for Green Health Prescribing as a referral option in primary and community care. SYSTEMATIC REVIEW REGISTRATION: CRD42025603199.

Indexed as

Primary Health CareAgedGardeningHumansQuality of LifeSocial PrescribingGreen health prescribingHealth inequalitiesHorticultural therapyMental healthNature-based interventionsOlder adultsPrimary carePsychosocial wellbeingSocial prescribing

Identifiers

PMID42823701
PMCPMC13631981

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.