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Background: 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., Methods: 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., Results: 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., Conclusions: 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., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [JA – member of the Steering Group of the Scottish Social Prescribing Network; associate member of the One Health Breakthrough Partnership; and member of the Pharma Pollution Hub. ML – director of Social Prescribing Evidence Hub in Ireland and author of the first social prescribing book. GI − scientific and therapeutic interest in NBSP, its implementation into the German health system to foster nature-based intervention for prevention and therapy. KK − offers nature-based and sustainable interventions in the field of prevention and therapy at VERDE in Leipzig, Germany. SP – co-founder of One Health Breakthrough Partnership in Scotland, and advisor to the Pharma Pollution Hub in England. JR − active and ongoing interest in NBSP, its implementation, and how NBSP can benefit wetland conservation. KW − Clinical Supervisor for the Active Health Link Worker Project, Velocity Cafe & Bicycle Workshop social enterprise, funded by NHS Highland and Transport Scotland.]., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: It is now universally acknowledged that climate change constitutes a major threat to human health. At the same time, some of the measures to reduce greenhouse gas emissions, so-called climate change mitigation measures, have significant health co-benefits (e.g., walking or cycling more; eating less meat). The goal of limiting global warming to 1,5° Celsius set by the Conference of the Parties to the United Nations Framework Convention on Climate Change in Paris in 2015 can only be reached if all stakeholders, including households, take actions to mitigate climate change. Results on whether framing mitigation measures in terms of their health co-benefits increases the likelihood of their implementation are inconsistent. The present study protocol describes the transdisciplinary project HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) that investigates the role of health co-benefits in households' decision making on climate change mitigation measures in urban households in France, Germany, Norway and Sweden., Methods: HOPE employs a mixed-methods approach combining status-quo carbon footprint assessments, simulations of the reduction of households' carbon footprints, and qualitative in-depth interviews with a subgroup of households. Furthermore, a policy analysis of current household oriented climate policies is conducted. In the simulation of the reduction of households' carbon footprints, half of the households are provided with information on health co-benefits of climate change mitigation measures, the other half is not. Households' willingness to implement the measures is assessed and compared in between-group analyses of variance., Discussion: This is one of the first comprehensive mixed-methods approaches to investigate which mitigation measures households are most willing to implement in order to reach the 1,5° target set by the Paris Agreement, and whether health co-benefits can serve as a motivator for households to implement these measures. The comparison of the empirical data with current climate policies will provide knowledge for tailoring effective climate change mitigation and health policies.

The negative health effects of climate change are becoming increasingly evident. At the same time, climate change mitigation offers great potential for health promotion. In the medical setting, climate change and health issues can be integratedinto counselling of patients in order to promote and protect individual and public health and to possibly pursue other climate- and health-relevant aims. Such "climate-sensitive health counseling" (CSHC) may concern the health impacts of climate change and related measures of health protection, counseling on healthy and climate-friendly lifestyles as well as societal aspects. When integrating CSHC into routine healthcare activities, communication strategies known from health as well as climate change communication can be used, such as patient-centered communication,motivational interviewing and a differentiated and open approach in addressing climate-related feelings. [ABSTRACT FROM AUTHOR]