Evidence map›Paper›PMID 42823709›Full record

SynthesisBMC medicine2026

Factors influencing access to green health prescribing in primary care for older adults - a qualitative systematic review.

Jeremiah Donoghue, Furqan Butt, 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 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. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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.

Jeremiah DonoghueCentre for Evidence and Implementation Science, School of Social Policy and Society, University of Birmingham, Birmingham, UK. j.donoghue@bham.ac.uk.ORCID https://orcid.org/0009-0009-0066-509X
Furqan ButtCentre 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, Keele University, Staffordshire, UK.
Nadia CorpSchool of Medicine, Keele University, Staffordshire, 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, Keele University, Staffordshire, UK.

Funding

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

Abstract

backgroundGreen health prescribing (GHP) refers to nature-based interventions (NBIs) prescribed by a clinician or qualified health or social care professional. Given the ageing global population and increasing care needs posing severe challenges for healthcare systems, GHP has emerged as a potentially effective and efficient scheme to support healthy ageing in older people living with long-term conditions. This evidence review aimed to identify the barriers and enablers to access, uptake, implementation and delivery of GHP and associated NBIs.

methodsWe undertook a systematic review of qualitative evidence exploring the barriers and enablers of GHP and engagement with NBIs. Searches from 2000 up to October 2024 were conducted in Medline, PsycINFO, ASSIA (Applied Social Sciences Index and Abstracts), GreenFILE, Web of Science and Dimensions and Overton and Google. Study selection (based on a priori-defined eligibility criteria), data extraction, and quality appraisal were conducted independently by two reviewers and discrepancies were resolved by a third reviewer. Qualitative data were extracted from each article, and we conducted an inductive thematic synthesis of data. We followed reporting guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) and GRIPP2 for patient and public involvement and engagement (PPI-E).

resultsTen overarching factors were identified from 25 included studies representing barriers and enablers of access to or implementation of GHP and NBIs. Key barriers included challenges in programme accessibility, gaps in service provision and healthcare professionals' knowledge, prescriber hesitancy, limited organisational capacity, socioeconomic disparities, and limited evidence of effectiveness. Enablers included accessibility of green spaces, positive experiences in social engagement and connecting to nature and provider's enthusiasm and commitment.

conclusionsOur findings explore factors that can directly influence access and engagement of older people with NBIs, and organisational capacity of service providers and prescribers. To realise the full potential of GHP in supporting healthy ageing and reducing health inequalities, future efforts should prioritise accessible programme design, invest in community provision infrastructure, and improve the integration within primary and community care settings. SYSTEMATIC REVIEW REGISTRATION: CRD42025603199.

Indexed as

Health Services AccessibilityPrimary Health CareAccess to Primary CareAgedHumansQualitative ResearchSocial PrescribingBarriers and enablersGeneral practitionersGreen health prescribingHealth inequalitiesNature-based interventionsOlder adultsPrimary careService providersService users

Identifiers

PMID42823709

What OpenQuestion 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 OpenQuestion graph.