Connection to nature in nature based social prescribing: A scoping review of evidence, gaps, and policy implications

Nature-based social prescribing (NBSP) is gaining traction as an approach to support health and wellbeing (HWB). Yet the role of Connection to Nature (CTN) within NBSP remains poorly understood. This scoping review examined how CTN is conceptualised, measured and integrated into NBSP interventions and its impact on HWB outcomes. Following PRISMAScR guidelines, we searched four databases (APA PsycInfo, CINAHL, EMBASE and MEDLINE) for studies published between 2016 and 2025, identifying 21 eligible papers. Studies were grouped into four categories: review papers; gardening and horticulture; green care; and structured nature engagement and educational interventions. Across intervention types, CTN was consistently associated with improvements in mood, stress regulation, confidence, social connectedness, and overall wellbeing. CTN appeared malleable and responsive to meaningful or reflective nature engagement, suggesting it may function as a pathway linking nature contact to HWB. Findings indicate that intentionally incorporating CTN into NBSP design, practitioner training, and evaluation may enhance intervention impact and promote equitable access to nature based wellbeing benefits. CTN was rarely defined consistently or measured using validated tools and was often inferred qualitatively rather than assessed directly. This variability limits understanding of CTN's unique contribution relative to other NBSP mechanisms such as social connection, physical activity, and immersive sensory experiences. To advance the field, future research should adopt clearer CTN definitions, use conceptually aligned measures, distinguish between state and trait CTN, and employ longitudinal or mixed methods designs. Embedding CTN within NBSP policy and practice offers potential to strengthen both individual wellbeing and broader public and environmental health goals.