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Background: Nature-based interventions (NBIs) contribute to the prevention of non-communicable diseases and support health-enhancing physical activity (HEPA). While NBIs are increasingly integrated into healthcare systems, stakeholder engagement and role remain underrepresented. This scoping review aimed to map and synthesise evidence on stakeholder involvement in the development and implementation of nature-based interventions within healthcare contexts.
Methods: A six-stage scoping review framework was applied in accordance with PRISMA-ScR guidelines. Searches were conducted in MEDLINE (ProQuest), Nursing & Allied Health Database (EBSCO), Scopus, and Web of Science. Inclusion criteria addressed stakeholders (Population), nature-based interventions (Concept), and healthcare settings (Context). The final stage included semi-structured interviews with healthcare professionals (N = 6). Data were analysed using thematic analysis.
Results: From 2,152 screened records and 109 full texts, 28 studies were included. Identified stakeholders comprised healthcare professionals, link workers, community organisations, environmental practitioners, policymakers, researchers, and service users. Engagement across development and implementation stages enhanced accessibility to green spaces, contextual adaptation of HEPA programmes, and cross-sector coordination. Barriers included fragmented governance, limited funding, unequal access to green spaces, and insufficient integration of 24-hour movement behaviour principles.
Conclusions: Effective stakeholder engagement is essential for integrating NBIs into healthcare to promote HEPA and address non-communicable diseases. Cross-sector collaboration, equitable access to green spaces, and sustainable governance structures are critical for embedding nature-based HEPA strategies within 24-hour movement frameworks and urban health policies.
