What is needed to improve evidential integrity and advance research?

• More randomised controlled studies, where participants are randomised to receive treatment/rehabilitation or to be part of a control group that does not receive the same.
• More scientific studies comparing nature-based health care with other treatment and rehabilitation methods.
• More participants in each study. The fact that nature-based health studies often have relatively few participants is often down to the fact that funds are often not available for researchers to review large amounts of data. This may also be due to the fact that it can be difficult to get participants to take part because the field of research is sometimes seen as a little unusual and participation takes time and requires a little more work than, for example, participating in a study investigating the efficacy of a particular vitamin preparation.
• More health-economic calculations and analyses. What can society gain by investing in, for example, garden rehabilitation? That would be good to know. Follow-ups with calculations are available for Green Rehab in Gothenburg (in 2019 it took 6.5 months before the person who returned to work had refunded the cost of his or her rehabilitation to society through taxes), but otherwise economic analyses are thin on the ground.
• International standardisation of the content of the nature-based health activities being researched, such as garden rehabilitation. With more structured programmes with equivalent staff, equivalent activities and regularly evaluated participants, it is easier to draw conclusions from the research.
• More research into the appropriate dose of nature for health care and various health conditions.
• An overall official concept for nature-based health activities. Some proposed names include Nature based inventions, Nature based therapies and Green care.
• More money for research. As a researcher, a lot of time has to be spent seeking money, and competition between research disciplines is fierce. Good quality research costs money. More support and acceptance of the research field is needed from authorities, colleges, universities and foundations.

Text/Åsa Ottosson