Contextual factors and programme theories associated with implementing blue prescription programmes: a systematic realist review

Alejandre, Julius Cesar and Chastin, Sebastien and Irvine, Katherine N. and Georgiou, Michail and Khanna, Preeti and Tieges, Zoe and Smith, Niamh and Chong, Yong-Yee and Onagan, Frances Claire and Price, Lesley and Pfleger, Sharon and Helliwell, Rachel and Singleton, Judith and Curran, Samuel and Estandarte, Allan and Smith, Emily Sophia and Helwig, Karin (2023) Contextual factors and programme theories associated with implementing blue prescription programmes: a systematic realist review. HEALTH & SOCIAL CARE IN THE COMMUNITY, 2023. ISSN 0966-0410, DOI

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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).

Item Type: Article
Funders: Hydro Nation Scholars Programme of the Scottish Government, Scottish Government's Rural and Environment Science and Analytical Services Division (RESAS)
Uncontrolled Keywords: Posttraumatic-Stress-Disorder; Mental-Health; Primary-Care; Coastal Environments; Green; Veterans; Spaces; Depression; Behavior; Participation
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Sports and Exercise Science (formerly known as Centre for Sports & Exercise Sciences)
Depositing User: Ms Zaharah Ramly
Date Deposited: 22 Nov 2023 04:37
Last Modified: 22 Nov 2023 04:37

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