Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems. This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP. We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation. NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could help inform the development and evaluation of NBSP programmes to support planetary health from local and global scales.

Nature-based social prescribing such as “blue prescription” promotes public health and health improvement of individuals with long-term health conditions. However, there is limited evidence explaining the relationship of contexts, mechanisms, and outcomes of implementing blue prescription programmes (BPPs) in health and social care settings that could inform policy and practice. We conducted a systematic realist review by searching PubMed, Web of Science, PsycInfo, Scopus, MEDLINE, and CINAHL for articles published in English between January 2000 and June 2022 about health and social care professionals providing referral to or prescription of blue space activities (e.g., swimming, fishing, surfing, etc.) with health-related outcomes. Components and descriptions of BPP implementation were extracted and used to develop themes of contextual factors used to develop programme theories and a logic model demonstrating the mechanisms of BPP implementation. Sixteen studies with adequate to strong quality were included from 8,619 records. After participating in BPPs referred to or prescribed by health and social care professionals, service users had improvements in their physical, cognitive (mental), social health, and proenvironmental knowledge. Service user-related contextual factors were referral information, free equipment, transportation, social support, blue space environments, and skills of service providers. Programme-related contextual factors were communication, multistakeholder collaboration, financing, and adequate service providers. Programme theories on service user enrolment, engagement, adherence, communication protocols, and programme sustainability explain the mechanisms of BPP implementation. BPPs could promote health and wellbeing if contextual factors and programme theories associated with service users’ characteristics and programme delivery are considered in the design, delivery, and evaluation of BPPs. Our study was registered with PROSPERO (CRD42020170660).

Human pharmaceuticals are increasingly detected in environments around the world, with growing international calls to mitigate the ecological and human health risks posed by these novel entities. Exposure to pharmaceutical pollutants can negatively affect the behaviour, reproduction, and health of wildlife, contributing towards declining ecological health and global biodiversity loss. Pharmaceuticals in the environment are also driving rising levels of antimicrobial resistance, a major public health threat. Developing strategies to mitigate these public and environmental health risks has been greatly limited by diverse and often conflicting stakeholder interests and the need to retain the major human health and socioeconomic benefits that pharmaceuticals provide. In this Personal View, we propose a multistakeholder, systems-based approach for high-income countries to develop transformational national mitigation strategies. Applying this approach to a UK case study highlighted the growing risks caused by the unsustainability of the current UK health-care pharmaceutical system and enabled us to identify 37 synergistic intervention points that target both the tangible easy wins and the deep-rooted social drivers of the issue. We believe our approach will support high-income countries in minimising the public and environmental health risks associated with pharmaceutical pollution, by driving long-term sustainability across the pharmaceutical lifecycle, for a positive pharmaceutical future.

Despite the multifaceted and diverse challenges that refugees, migrants, and asylum-seekers experience when entering a new country, they remain notably underrepresented in the evaluation and understanding of the health and wellbeing impacts of outdoor health interventions. We addressed this knowledge gap by a mixed-methods evaluation (questionnaires, focus groups and photo elicitation activity) facilitated by a community researcher. Qualitative data (focus groups and photo elicitation activity) revealed that the participants saw the social component of outdoor activities as a critical factor in improving their wellbeing, an insight not captured by established quantitative wellbeing scales. Given the diverse backgrounds of refugee, migrant, and asylum-seeker populations, we underline the importance of a transdisciplinary, collaborative, and mixed-methods research approach.

The wave of riots in England in summer 2024 constituted the biggest wave of disorder in the country for more than a decade. These were followed by swift policy responses, based on assumptions about the events and the participants, before any detailed empirical investigation had been carried out. There is a need for detailed description of events as a solid basis for both social psychological theory and policy. This article therefore presents case studies of the disorders in Bristol, Hanley, and Tamworth, using interviews and multiple secondary sources, to understand what happened and who was involved. Our analysis suggests that it is inaccurate to see the events as ‘protests’, since they consisted of collective attacks (on asylum seekers' accommodation and on mosques). Protagonists were ethnically white but not homogeneous. At least four different parties were involved—anti‐immigrant participants, police, counter‐protesters, the targets of the actions (asylum seekers and Muslims), and on one occasion ‘community defenders’. We compare these events to the 2011 English riots, and we specify remaining ‘unknowns’ that future research should address. Please refer to the Supporting Information section to find this article’s community and .

Background Nature-based social prescribing programmes such as ‘bluespace prescription’ may promote public health and health improvement of individuals with long-term conditions. However, there is limited systematically synthesised evidence that investigates the contexts and mechanisms of Bluespace Prescription Programmes (BPPs) that could inform programme theories for policy and practice. Methods We conducted a realist review by searching six databases for articles published between January 2000 and February 2020, in English, about health and social care professionals providing referral to or prescription of blue space activities with health-related outcomes. We developed themes of contextual factors by analysing the contexts of BPPs. We used these contextual factors to develop programme theories describing the mechanisms of BPP implementation. Our study was registered with PROSPERO (CRD42020170660). Results Fifteen studies with adequate to strong quality were included from 6,736 records. Service users had improvements on their physical, mental, social health, and environmental knowledge after participating in BPPs referred to or prescribed by health and social care professionals. Patient-related contextual factors were referral information, free equipment and transportation, social support, blue space environments, and skills of service providers. Programme-related contextual factors were communication, multi-stakeholder collaboration, financing, and adequate service providers. Programme theories on patient enrolment, engagement, adherence, communication protocols, and long-term programme sustainability described the mechanisms of BPP implementation. Conclusion BPPs could support health and social care services if contextual factors and mechanisms of programme theories associated with patients and programme delivery are considered for implementation. Our findings have implications in planning, development, and implementation of similar nature-based social prescribing programmes in health and social care settings.