Evidence map›Paper›PMID 42060661›Full record

ArticlePLOS global public health2026

An international and interdisciplinary framework for nature prescribing in healthcare: A modified Delphi study.

Nicole A Struthers, Aleksandra A Zecevic, Jessica Stanhope, Martin F Breed, Lesley Gittings, Anna Gunz, Amy Wagenfeld, Trevor Birmingham, Anita Kothari, Filip Maric

Abstract read
In one paragraph

Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

10 authors.

Nicole A StruthersHealth and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.ORCID https://orcid.org/0000-0003-2626-1535
Aleksandra A ZecevicHealth and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.ORCID https://orcid.org/0000-0002-5116-0464
Jessica StanhopeRheumatology Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-6657-3317
Martin F BreedCollege of Science and Engineering, Flinders University, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0001-7810-9696
Lesley GittingsHealth and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.ORCID https://orcid.org/0000-0002-0463-0478
Anna GunzChildren's Health Research Institute, London, Ontario, Canada.
Amy WagenfeldDepartment of Landscape Architecture, University of Washington, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0003-4995-5820
Trevor BirminghamHealth and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
Anita KothariHealth and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.ORCID https://orcid.org/0000-0003-1533-6976
Filip MaricDepartment of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.ORCID https://orcid.org/0000-0002-1265-6205

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nature prescriptions allow healthcare providers to recommend nature connection and exposure for health and well-being benefits. However, an accepted interdisciplinary shared definition of nature prescription is currently lacking, as are frameworks to guide the use of nature prescription in healthcare. To help fill this knowledge gap, we used an international modified Delphi technique to develop a framework for nature prescribing in healthcare by interdisciplinary experts. Round 1 consisted of virtual focus groups with an expert panel to generate a preliminary framework and framework statements through a qualitative approach, followed by Round 2 to establish agreement, set a priori as ≥75%, on statements to be included in the presented framework. Eight expert panellists participated in the consensus building process, developing and agreeing on 146 statements. The framework consists of: (1) Defining nature prescriptions; (2) Human benefits and risks; (3) Environment benefits and risks; (4) Society and Culture contextual factors and perspectives, acknowledgement of Indigenous knowledges, and equity; (5) Planetary health as a positive feedback loop between the benefits for people and environments; (6) Future directions to aid moving knowledge and implementation of nature prescribing forward. We report an overview of the benefits and risks of nature prescriptions, their potential planetary health impacts, and how they can be equity-driven by incorporating social and cultural differences. This international and interdisciplinary framework for nature prescribing in healthcare offers itself as a guide for the utilization of nature prescriptions in healthcare, and proposes recommendations for research, education, and clinical practice.

Identifiers

PMID42060661
PMCPMC13132205

What OpenQuestion holds

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LicenceCC BY
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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 OpenQuestion graph.