Integrating Green Care Initiatives into Conventional Health Systems: Which Governance Dimensions Can Guide This Process?

Alessandra Rigo (), Elena Pisani and Laura Secco
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Alessandra Rigo: Department of Land, Environment, Agriculture and Forestry (TESAF), University of Padova, Agripolis—Viale dell’Università 16, 35020 Legnaro, Italy
Elena Pisani: Department of Land, Environment, Agriculture and Forestry (TESAF), University of Padova, Agripolis—Viale dell’Università 16, 35020 Legnaro, Italy
Laura Secco: Department of Land, Environment, Agriculture and Forestry (TESAF), University of Padova, Agripolis—Viale dell’Università 16, 35020 Legnaro, Italy

IJERPH, 2025, vol. 22, issue 2, 1-30

Abstract: Green Care initiatives (GCIs) encompass various interventions that support physical, mental, and social well-being through interaction with nature. Integrating GCIs into conventional healthcare systems is a complex task that requires multi-actor and multi-level governance efforts. This study examines, through a systematized literature review, the relevant governance dimensions to facilitate the inclusion of GCIs in traditional care pathways. From the analysis of the 36 selected studies, four key dimensions were identified: organizational structure, knowledge, legitimacy, and decentralization. The analysis highlights the need to strengthen the responsibility of Green Care actors as healthcare service providers, enhance local authorities’ role in creating new integrated service delivery networks, combine different knowledge perspectives, and legitimize non-healthcare actors. Recommendations are made to address these governance aspects to facilitate the integration of GCIs and channel their benefits in prevention and health promotion. Adopting an adequate governance framework is fundamental for mainstreaming GCIs in current healthcare systems.

Keywords: governance; green care initiatives; healthcare; literature review; nature-based health initiatives; green and blue areas (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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