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Integrating Green Care Initiatives into Conventional Health Systems: Which Governance Dimensions Can Guide This Process?

Author

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  • Alessandra Rigo

    (Department of Land, Environment, Agriculture and Forestry (TESAF), University of Padova, Agripolis—Viale dell’Università 16, 35020 Legnaro, Italy)

  • Elena Pisani

    (Department of Land, Environment, Agriculture and Forestry (TESAF), University of Padova, Agripolis—Viale dell’Università 16, 35020 Legnaro, Italy)

  • Laura Secco

    (Department of Land, Environment, Agriculture and Forestry (TESAF), University of Padova, Agripolis—Viale dell’Università 16, 35020 Legnaro, Italy)

Abstract

Green Care initiatives (GCIs) encompass various interventions that support physical, mental, and social well-being through interaction with nature. Integrating GCIs into conventional healthcare systems is a complex task that requires multi-actor and multi-level governance efforts. This study examines, through a systematized literature review, the relevant governance dimensions to facilitate the inclusion of GCIs in traditional care pathways. From the analysis of the 36 selected studies, four key dimensions were identified: organizational structure, knowledge, legitimacy, and decentralization. The analysis highlights the need to strengthen the responsibility of Green Care actors as healthcare service providers, enhance local authorities’ role in creating new integrated service delivery networks, combine different knowledge perspectives, and legitimize non-healthcare actors. Recommendations are made to address these governance aspects to facilitate the integration of GCIs and channel their benefits in prevention and health promotion. Adopting an adequate governance framework is fundamental for mainstreaming GCIs in current healthcare systems.

Suggested Citation

  • Alessandra Rigo & Elena Pisani & Laura Secco, 2025. "Integrating Green Care Initiatives into Conventional Health Systems: Which Governance Dimensions Can Guide This Process?," IJERPH, MDPI, vol. 22(2), pages 1-30, January.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:2:p:202-:d:1580561
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    References listed on IDEAS

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    1. Bassett, Lucy & Giannozzi, Sara & Pop, Lucian & Ringold, Dena, 2012. "Rules, roles, and controls : governance in social protection with an application to social assistance," Social Protection Discussion Papers and Notes 67612, The World Bank.
    2. Carly J. Wood & Marie Polley & Jo L. Barton & Claire L. Wicks, 2022. "Therapeutic Community Gardening as a Green Social Prescription for Mental Ill-Health: Impact, Barriers, and Facilitators from the Perspective of Multiple Stakeholders," IJERPH, MDPI, vol. 19(20), pages 1-14, October.
    3. Jan Hassink & Lenneke Vaandrager & Yvette Buist & Simone de Bruin, 2019. "Characteristics and Challenges for the Development of Nature-Based Adult Day Services in Urban Areas for People with Dementia and Their Family Caregivers," IJERPH, MDPI, vol. 16(8), pages 1-15, April.
    4. Elena Bozzola & Giulia Spina & Rino Agostiniani & Sarah Barni & Rocco Russo & Elena Scarpato & Antonio Di Mauro & Antonella Vita Di Stefano & Cinthia Caruso & Giovanni Corsello & Annamaria Staiano, 2022. "The Use of Social Media in Children and Adolescents: Scoping Review on the Potential Risks," IJERPH, MDPI, vol. 19(16), pages 1-33, August.
    5. Fiszbein, Ariel & Ringold, Dena & Rogers, F. Halsey, 2011. "Making services work : indicators, assessments, and benchmarking of the quality and governance of public service delivery in the human development sectors," Policy Research Working Paper Series 5690, The World Bank.
    6. Qian Sun & Mary Loveday & Saw Nwe & Nike Morris & Emily Boxall, 2023. "Green Social Prescribing in Practice: A Case Study of Walsall, UK," IJERPH, MDPI, vol. 20(17), pages 1-20, September.
    7. Arnouts, Rikke & van der Zouwen, Mariëlle & Arts, Bas, 2012. "Analysing governance modes and shifts — Governance arrangements in Dutch nature policy," Forest Policy and Economics, Elsevier, vol. 16(C), pages 43-50.
    8. Savedoff, William D., 2011. "Governance in the health sector: a strategy for measuring determinants and performance," Policy Research Working Paper Series 5655, The World Bank.
    9. Ilaria Doimo & Mauro Masiero & Paola Gatto, 2021. "Disentangling the Diversity of Forest Care Initiatives: A Novel Research Framework Applied to the Italian Context," Sustainability, MDPI, vol. 13(2), pages 1-21, January.
    10. Philippe Mongeon & Adèle Paul-Hus, 2016. "The journal coverage of Web of Science and Scopus: a comparative analysis," Scientometrics, Springer;Akadémiai Kiadó, vol. 106(1), pages 213-228, January.
    11. Jake M. Robinson & Anna Jorgensen & Ross Cameron & Paul Brindley, 2020. "Let Nature Be Thy Medicine: A Socioecological Exploration of Green Prescribing in the UK," IJERPH, MDPI, vol. 17(10), pages 1-24, May.
    12. Marina García-Llorente & Radha Rubio-Olivar & Inés Gutierrez-Briceño, 2018. "Farming for Life Quality and Sustainability: A Literature Review of Green Care Research Trends in Europe," IJERPH, MDPI, vol. 15(6), pages 1-18, June.
    13. Margaret M. Hansen & Reo Jones & Kirsten Tocchini, 2017. "Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review," IJERPH, MDPI, vol. 14(8), pages 1-48, July.
    14. Benedetta Barchielli & Clarissa Cricenti & Francesca Gallè & Elita Anna Sabella & Fabrizio Liguori & Giovanna Da Molin & Giorgio Liguori & Giovanni Battista Orsi & Anna Maria Giannini & Stefano Ferrac, 2022. "Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health?," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    15. Marta Borgi & Mario Marcolin & Paolo Tomasin & Cinzia Correale & Aldina Venerosi & Alberto Grizzo & Roberto Orlich & Francesca Cirulli, 2019. "Nature-Based Interventions for Mental Health Care: Social Network Analysis as a Tool to Map Social Farms and their Response to Social Inclusion and Community Engagement," IJERPH, MDPI, vol. 16(18), pages 1-14, September.
    16. Miika Kumpulainen & Marko Seppänen, 2022. "Combining Web of Science and Scopus datasets in citation-based literature study," Scientometrics, Springer;Akadémiai Kiadó, vol. 127(10), pages 5613-5631, October.
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