Abstract
ISSUE/PROBLEM: Europe is witnessing a surge in mental health disorders, physical inactivity, and social disconnection—challenges intensified by the COVID-19 pandemic, rapid urbanization, and the emerging burden of digital fatigue. Despite growing evidence, nature-based therapies (NBTs) remain largely absent from mainstream health systems. Barriers include low uptake in primary health care (PHC), lack of standardised therapeutic frameworks, fragmented research, and limited policy integration. Reimbursement gaps and the absence of digital pathways further hinder the accessibility and scalability of NBTs for prevention and care. DESCRIPTION: NATURE Rx offers a transdisciplinary approach, with a multi-country implementation initiative spanning 7 EU nations and global partners (US, Chile, Japan), aimed at developing, evaluating, and mainstreaming NBTs tailored to PHC systems. Piloting will initially focus on pre-identified target groups, to include patients with chronic conditions (NCDs), mild-to-moderate mental health issues, socially isolated individuals, and underserved or rural populations. The project integrates mixed methods—meta-analysis, stakeholder consultations, clinical trials, and policy reviews—to co-produce therapeutic typologies. Each partner country will host a Living Lab, engaging PHC professionals and patients in shared decision-making to personalise and assess nature-based prescriptions. A robust digital backbone will support implementation: from e-treatment plans, digital literacy tools, and online monitoring systems to an interactive Atlas App that maps country-specific NBT options; this will also facilitate interprofessional collaboration in case management, systematic follow-up and robust effectiveness evaluation. RESULTS: Preliminary research has enabled the formulation of NBT typologies adapted to diverse socio-cultural and climatic contexts. Early outcomes include tools for evaluating clinical and cost-effectiveness, co-designed digital applications to support uptake, and training materials for health professionals. The project will generate actionable data to support reimbursement models, public health campaigns, and policy recommendations. Core outcomes span improved well-being, reduced care costs, digital empowerment of patients and providers, and increased PHC system resilience. LESSONS: Mainstreaming NBTs requires more than clinical validation—it demands coordinated action across governance, policy, technology, and community engagement. Key lessons include: (i) Developing unified, adaptable NBT protocols; (ii) Integrating digital tools to improve access, data collection, and patient empowerment; (iii) Establishing training and reimbursement structures within PHC; (iv) Leveraging co-creation and citizen science to ensure contextual fit and long-term adoption. KEY MESSAGES: • NBTs are low-risk, cost-effective, and scalable interventions for mental and physical health. • Digital innovation and community co-creation are critical to their successful adoption in PHC. • Policy support, professional training, and integrated health-digital ecosystems are essential to build sustainable, nature-based health pathways in Europe. TOPIC: Nature-based Therapies, Mental Health, Primary Health Care, Stakeholder Engagement, Evidence-based Interventions.