Background: In modern, urban daily life, natural environments are increasingly recognized as an important resource for stress recovery and general well-being. Aim: the present review aims to provide an overview and synthesis of the past eight years’ research into the psycho-physiological effects of outdoor nature-based interventions, related to stress recovery. Method: a structured search was performed in seven databases, returning 5618 articles. Removal of duplicates and initial screening gave a total of 95 studies. After full text reading, 36 studies were included in the assessment. Results: most of the psychological outcomes were related to different emotional measures. The synthesis of the results points towards outdoor, nature-based exposure having a positive effect on different emotional parameters, related to stress relief. The studies into physiological measures showed more equivocal results. Conclusion: the research, conducted over the past eight years, into outdoor, nature-based exposure has now attained a sound evidence base for psychological and especially emotional effects, but the evidence base for physiological effects within this timeframe shows a great degree of heterogeneity. Limitations: interpretation of the results is limited by the review only covering the past eight years’ research on the subject.

This study systematically evaluated the scientific evidence for health benefits of natural environments for people with mobility impairments. Literature searches based on five categories of terms—target group, nature type, health-related impacts, nature-related activities and accessibility issues—were conducted in four databases (Web of Science, Scopus, CAB ABSTRACT and Medline). Twenty-seven articles from 4196 hits were included in the systematic reviews. We concluded that people with mobility disabilities could gain different health benefits, including physical health benefits, mental health benefits and social health benefits from nature in different kinds of nature contacts ranging from passive contact, active involvement to rehabilitative interventions. Several issues related to the accessibility and use of nature for people with mobility impairments need attention from professionals such as landscape architects, rehabilitative therapists, caregivers and policy makers. The overall quality of methodology of the included studies is not high based on assessment of the Mixed Methods Appraisal Tool (MMAT). Moreover, more randomized controlled trials and longitudinal studies that focus specifically on evidence-based health design of nature for people with mobility impairments in the future are needed.

The work of landscape architects can contribute to the United Nation’s Sustainable Development Goals and the associated ‘Leave no one behind’ agenda by creating accessible and health-promoting green spaces (especially goals 3, 10 and 11). To ensure that the design of green space delivers accessibility and intended health outcomes, an evidence-based design process is recommended. This is a challenge, since many landscape architects are not trained in evidence-based design, and leading scholars have called for methods that can help landscape architects work in an evidence-based manner. This paper examines the implementation of a process model for evidence-based health design in landscape architecture. The model comprises four steps: ‘evidence collection’, ‘programming’, ‘designing’, and ‘evaluation’. The paper aims to demonstrate how the programming step can be implemented in the design of a health-promoting nature trail that is to offer people with mobility disabilities improved mental, physical and social health. We demonstrate how the programming step systematizes evidence into design criteria (evidence-based goals) and design solutions (how the design criteria are to be solved in the design). The results of the study are presented as a design ‘Program’, which we hope can serve as an example for landscape architects of how evidence can be translated into design.

PurposeDuring the past decade, Danish policies and legislation have increasingly focused on accessibility, which, by virtue of adopting the UN Sustainable Development Goals, has spurred new demands for the expertise of Danish landscape architects. Surveys indicate as much as 27% of the Danish population have a physical disability. Therefore, landscape architectural firms play an important role in designing accessible, public and green spaces, which could reduce the number of people who experience disability in their everyday life arising from inaccessible designs. Despite this, peer-reviewed research has not attempted to qualitatively understand how landscape architects approach accessibility in their daily practice.Design/methodology/approachBased on a grounded theory analysis of 15 semi-structured qualitative interviews with randomly selected landscape architectural firms, this study aims to describe how landscape architectural firms approach and perceive accessibility.FindingsThe results of the study show a complex understanding of accessibility among practising landscape architects, with firms focusing on the role of Danish building regulations, the programming of accessibility and professional aesthetic dilemmas. Moreover, accessibility is perceived with some frustration as an element that takes valuable space from green areas due to clients' lack of willingness to provide resources for integrated solutions, landscape architects' own limited expertise and knowledge of integrated accessibility solutions and insufficient regulatory leeway.Originality/valueAs accessibility is a major element of the tasks within contemporary landscape architecture, graduates need additional training in accessibility, which, in turn, necessitates additional research into accessible design solutions.

PurposeThe point of departure for this viewpoint paper is the current development in which landscape architects are working towards achieving the United Nations sustainable development goals and the associated cross-cutting pledge “Leave No One Behind”. The sustainable development goals 3 and 11 can be achieved through landscape projects that are inclusive and health promoting, and the authors argue that an evidence-based design process is needed to ensure that project designs deliver what they promise. However, most landscape architects are not trained in evidence-based design and are therefore unsure of what can be used as evidence. A further challenge is the lack of relevant and applicable research evidence for design processes.Design/methodology/approachThe authors present a process model for evidence-based health design in landscape architecture as an overall framework on which the authors base their arguments. The model includes four topics of evidence: target group, human health, environment and use of nature. For each topic, the authors present their view on what may be considered as evidence and where it can be found or generated. The study view is supported by a detailed presentation of where and how evidence was found and generated in a design project for an accessible and health-promoting forest trail for people with mobility disabilities.FindingsThe authors suggest a broad definition of evidence, and that the design process should draw on evidence from relevant research and practice disciplines. Evidence can be found in multiple sources, for example, scientific articles, theoretical works and design guidelines. It can also be generated by landscape architects themselves, for example, through landscape analyses and stakeholder workshops. The evidence should guide and support the landscape architect and not dictate the design process.Practical implicationsThe authors hope that the knowledge provided on the evidence-based health design process and on where to collect or how to generate evidence may inspire landscape architects in their future health design projects.Originality/valuePeople with mobility disabilities face many health challenges and should potentially be able to benefit from visiting green spaces. The authors hope that the knowledge provided on the evidence-based health design process and on where to collect or how to generate evidence may inspire landscape architects in their future health design projects.