Realist review of nature-based programmes for men's wellbeing.
Background: Evidence indicates that relative to women, men experience higher rates of premature death, heart disease, mental health issues, and substance use disorders, coupled with lower help-seeking behaviours. They also disproportionately face homelessness and criminal justice involvement. This review, forming the initial phase of a PhD focused on co-producing a nature-based intervention for men experiencing homelessness and problem substance use, aims to investigate the potential of nature-based programmes as tailored wellbeing interventions. These complex programmes, blending nature, physical activities, and social support, are examined for their efficacy, shaped by participants’ psychological profiles and contexts, themselves influenced by gender.
Methods: A realist methodology was employed to examine nature-based programmes for men. The development of initial programme theories was informed by a scoping literature review and expert consultations, followed by a systematic search of both peer-reviewed and grey literatures. Utilising the Context-Mechanism-Outcome framework, data were analysed to comprehensively understand these programmes' effectiveness. The process involved ongoing theory development and refinement, with expert input ensuring the review’s conclusions were relevant and accurate.
Results: Early findings indicate a strong preference among men for 'doing' as opposed to 'being' in nature. Nature-based programmes offering activities that yield a tangible 'product' or involve overcoming physical challenges may be particularly efficacious, providing both physical and mental health benefits. Programmes incorporating philosophical or spiritual narratives help participants to better frame problems and devise solutions, building resilience and spiritual wellbeing. Additionally, peer-led leadership, opportunities for mentorship, and skill transmission between men from diverse backgrounds simultaneously support group cohesion and self-efficacy, developing social connections while encouraging independence.
Conclusions and implications: The early findings underscore the need for active, practical exploration of the potential for nature-based programmes, tailored specifically for men experiencing a range of mental, physical, and social challenges. Service design should prioritise skill-building, problem-solving, and developing supportive community environments which enable independence to maximise engagement and efficacy. Implementing such gender-specific programmes could potentially reduce the burden on specialist health and social care services by providing alternative pathways for health improvement and social reintegration, ultimately contributing to recovery outcomes, cost savings and more targeted healthcare solutions.
