Operationalizing a nature prescription program in a college health setting: a pilot study on facilitators, barriers, and implementation outcomes

OBJECTIVE: Assess facilitators, barriers, and implementation outcomes (feasibility, adoption, acceptability, and penetration) of a college health center's (CHC) nature prescription (NRx) initiative among student-patients (SPs) and college health providers (CHPs). METHODS: Mixed-methods study analyzed monthly Electronic Health Record (EHR)-documented NRxs by eligible CHPs in one academic year. SP surveys measured: recall of NRxs; compliance; effects on concentration, stress, and mood. Semi-structured interviews with eligible CHPs assessed facilitators and barriers. Qualitative data were analyzed with inductive coding; quantitative data were analyzed using IBM SPSS. RESULTS: Documented NRxs increased by 784% from pilot to study period. 48% of eligible CHPs documented ≥1 nature prescription. Among SP NRx recipients: 52.7% remembered receiving NRx, 70% spent time in nature, and improvements were reported for mood (88.1%), stress (85.1%) and concentration (68.4%). CONCLUSIONS: Implementing a NRx program within an integrated CHC was feasible and acceptable among medical and mental health CHPs and benefited SPs' mental health and well-being.