Delivering green social prescribing: An ethnographic exploration of the place of walking and gardening groups in a social prescribing intervention

Green social prescribing involves link workers referring people from healthcare systems into nature-based activities, expected to offer holistic therapeutic experiences. Using ethnographic methods, we examined the use of referrals and creation of pathways into walking and gardening groups as well as community gyms within a broader social prescribing intervention. We conducted participant observation and interviews with social prescribing clients, link workers and green activity groups. We found that utilising a more disciplinary gym pathway, supporting clients to work on their health, was straightforward for link workers. However, integrating clients into green activity groups that offered a more therapeutic and caring experience depended on attentive coordination efforts from both link workers and activity leaders, and on the conviviality of group members. The reliance of walking and gardening groups on the work of leaders and members, as well as on seasonally changing green spaces, also created instability in groups, in turn making more work for link workers, who had to keep track of an ever-shifting landscape of provision. Finally, green activity groups varied in character and purpose, offering variable fit with individuals and with social prescribing itself. We conclude that the therapeutic and caring promise of walking and gardening groups is challenging to incorporate into social prescribing, while more disciplinary pathways, which work well for some but carry potential to create shame and stigma, may be more accessible.