Healthcare settings are increasingly adopting nature-based interventions (NBIs) to support users’ health and well-being, but these interventions are often underutilized. To get a grip on utilization problems, insight into factors that affect use and uptake of NBIs in routine care is needed. This scoping review aimed to provide an overview of factors that facilitate or impede successful implementation of NBIs in hospitals, long-term care facilities for the elderly (LTCF), and rehabilitation centers. Systematic searches were conducted across various databases to identify studies that collected qualitative and/or quantitative data on the implementation of NBIs in healthcare settings. Findings were classified into the five domains of the Consolidated Framework for Implementation Research. A total of 57 articles were included in the review. The articles provide detailed insight into facilitating and impeding implementation factors related to the intervention (e.g., awareness, adaptability, type of natural elements, accessibility, safety, weather conditions, comfort, privacy, supportive design factors, activities). Other found factors related to the inner setting (e.g., culture, implementation climate) and individuals (e.g., characteristics and opportunities of stakeholders). Factors related to the outer setting (e.g., financing) and implementation process (e.g., teaming, assessing needs, planning, engaging, doing, integration in care and therapy, reflection and evaluation, maintenance) also emerged, but to a lesser extent. This review identified a broad range of factors important for the successful implementation of NBIs, which can guide implementation of future NBIs. To complement these findings, future studies should consider conducting implementation studies
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The aim of this study is to determine the contribution of student interventions to urban greening processes. In two Dutch cities action research was conducted, including reflexive interviews a year after the first intervention, to assess factors causing change in the socio-ecological system. Results show that students and network actors were mutually learning, causing the empowerment of actors in that network by adding contextualized knowledge, enlarging the social network, expanding the amount of interactions in the socio-ecological system and speeding up the process. Students brought unique qualities to the process: time, access to stakeholders who tend to distrust the municipality and a certain open-mindedness. Their mere presence made a difference and started a process of change. However, university staff needed to keep the focus on long-term effects and empowerment, because students did not oversee that. After a year, many new green elements had been developed or were in the planning phase. In Enschede, the municipality districtmanagers were part of the learning network, which made it easier to cause changes in the main ecological network. In Haarlem however, no change took place in the main ecological network managed by the municipality, because no political empowerment of the civil society group had developed yet.
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