What is the evidence for the impact of gardens and gardening on health and well-being: a scoping review and evidence-based logic model to guide healthcare strategy decision making on the use of gardening approaches as a social prescription

Abstract

ObjectiveTo systematically identify and describe studies that have evaluated the impact of gardens and gardening on health and well-being. A secondary objective was to use this evidence to build evidence-based logic models to guide health strategy decision making about gardens and gardening as a non-medical, social prescription.DesignScoping review of the impact of gardens and gardening on health and well-being. Gardens include private spaces and those open to the public or part of hospitals, care homes, hospices or third sector organisations.Data sourcesA range of biomedical and health management journals was searched including Medline, CINAHL, Psychinfo, Web of Knowledge, ASSIA, Cochrane, Joanna Briggs, Greenfile, Environment Complete and a number of indicative websites were searched to locate context-specific data and grey literature. We searched from 1990 to November 2019.Eligibility criteriaWe included research studies (including systematic reviews) that assessed the effect, value or impact of any garden that met the gardening definition.Data extraction and synthesisThree reviewers jointly screened 50 records by titles and abstracts to ensure calibration. Each record title was screened independently by 2 out of 3 members of the project team and each abstract was screened by 1 member of a team of 3. Random checks on abstract and full-text screening were conducted by a fourth member of the team and any discrepancies were resolved through double-checking and discussion.ResultsFrom the 8896 papers located, a total of 77* studies was included. Over 35 validated health, well-being and functional biometric outcome measures were reported. Interventions ranged from viewing gardens, taking part in gardening or undertaking therapeutic activities. The findings demonstrated links between gardens and improved mental well-being, increased physical activity and a reduction in social isolation enabling the development of 2 logic models.ConclusionsGardens and gardening can improve the health and well-being for people with a range of health and social needs. The benefits of gardens and gardening could be used as a ‘social prescription’ globally, for people with long-term conditions (LTCs). Our logic models provide an evidence-based illustration that can guide health strategy decision making about the referral of people with LTCs to socially prescribed, non-medical interventions involving gardens and gardening.

Enriched gardens improve cognition and independence of nursing home residents with dementia: a pilot controlled trial

“…Previous studies highlighted the beneficial contribution of gardens to Alzheimer’s disease patients [ 17 – 19 ]. Whear et al [ 20 ] published a systematic review in 2014 to assess the effects of gardens on the health of nursing home residents with dementia.…”

“…The gardens in these studies were not specially designed for nursing home residents, except in the study by Edwards [ 21 ] in which the garden that was specially designed for nursing home residents with dementia. In their scoping review, Howarth [ 17 ] et al identified 14 studies which assessed the effects of gardening on patients with dementia and they concluded that it contributes to positive behaviour changes and better quality of life.…”

“…In addition, we did not measure staff attention for the residents which might have been different between groups and might also represent a potential bias. Finally, in our pilot study, we did not assess the effects of enriched gardens on behavioural and psychological symptoms which are an important issue for certain residents with dementia, nor on social inclusion, self-esteem or perceived well-being (Howarth, 2017) [ 17 ].…”

Mental Health, Greenness, and Nature Related Behaviors in the Adult Population of Stockholm County during COVID-19-Related Restrictions

“…However, it is important to remember that having a domestic garden is also strongly associated with socioeconomic status [ 45 ]. Still, the perceived restrictiveness of private gardens has been reported to rank higher than that of other private spaces [ 46 ], and gardening has been associated with reduced anxiety, depression, and many other mental health benefits [ 42 , 47 ].…”

Mental Health, Greenness and Nature Related Behaviours in the Adult Population of Stockholm County during Covid-19-related Restrictions

“…However, it is important to remember that having a domestic garden is also strongly associated with socioeconomic status (46). Still, the perceived restrictiveness of private gardens has been reported to rank higher than of other private spaces (47) and gardening has been associated with reduced anxiety, depression, and many other mental health benefits (43,48).…”