Engaging with nature and the outdoors: A scoping review of therapeutic applications in contemporary occupational therapy.

Introduction: Engagement with the natural outdoors is recommended for public health and wellbeing. Occupational therapists are well-placed to promote these therapeutic benefits, yet limited evidence exists of the scope of such applications. Methods: A scoping review was conducted informed by the Joanna Briggs Institute framework. A systematic search was undertaken across five databases, and 64 sources were included following screening. Data were extracted using deductive content analysis, and themes identified through thematic analysis. Findings: Three themes were identified: occupation-based applications; occupation-focused applications; and occupational therapy's contribution. Whilst current applications were evident, most literature explored potential or emerging practice. Outdoor engagement was found to be a complex, therapeutic occupation with the potential to promote mental health and restoration; quality of life and wellbeing; and healthy lifestyles through connection to nature; others; and self Conclusion: Occupational therapists enable outdoor engagement through occupation-focused and occupation-based interventions across a range of practice contexts. Occupational science may offer a valuable contribution to the evidence base, through considering being in nature as a meaningful occupation and outdoor accessibility as a matter of occupational justice. However, evidence of current practice is limited. Further research is recommended to strengthen the evidence-base and inform routine consideration within practice.