IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i2p202-d1580561.html

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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Alessandra Rigo & Elena Pisani & Laura Secco, 2025. "Integrating Green Care Initiatives into Conventional Health Systems: Which Governance Dimensions Can Guide This Process?," IJERPH, MDPI, vol. 22(2), pages 1-30, January.
  • Handle: RePEc:gam:jijerp:v:22:y:2025:i:2:p:202-:d:1580561
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/2/202/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/22/2/202/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Bassett, Lucy & Giannozzi, Sara & Pop, Lucian & Ringold, Dena, 2012. "Rules, roles, and controls : governance in social protection with an application to social assistance," The Social Policy and Labor Discussion Paper Series 67612, The World Bank.
    2. Carly J. Wood & Marie Polley & Jo L. Barton & Claire L. Wicks, 2022. "Therapeutic Community Gardening as a Green Social Prescription for Mental Ill-Health: Impact, Barriers, and Facilitators from the Perspective of Multiple Stakeholders," IJERPH, MDPI, vol. 19(20), pages 1-14, October.
    3. Jan Hassink & Lenneke Vaandrager & Yvette Buist & Simone de Bruin, 2019. "Characteristics and Challenges for the Development of Nature-Based Adult Day Services in Urban Areas for People with Dementia and Their Family Caregivers," IJERPH, MDPI, vol. 16(8), pages 1-15, April.
    4. Ilaria Doimo & Mauro Masiero & Paola Gatto, 2021. "Disentangling the Diversity of Forest Care Initiatives: A Novel Research Framework Applied to the Italian Context," Sustainability, MDPI, vol. 13(2), pages 1-21, January.
    5. Philippe Mongeon & Adèle Paul-Hus, 2016. "The journal coverage of Web of Science and Scopus: a comparative analysis," Scientometrics, Springer;Akadémiai Kiadó, vol. 106(1), pages 213-228, January.
    6. Jake M. Robinson & Anna Jorgensen & Ross Cameron & Paul Brindley, 2020. "Let Nature Be Thy Medicine: A Socioecological Exploration of Green Prescribing in the UK," IJERPH, MDPI, vol. 17(10), pages 1-24, May.
    7. Elena Bozzola & Giulia Spina & Rino Agostiniani & Sarah Barni & Rocco Russo & Elena Scarpato & Antonio Di Mauro & Antonella Vita Di Stefano & Cinthia Caruso & Giovanni Corsello & Annamaria Staiano, 2022. "The Use of Social Media in Children and Adolescents: Scoping Review on the Potential Risks," IJERPH, MDPI, vol. 19(16), pages 1-33, August.
    8. Marina García-Llorente & Radha Rubio-Olivar & Inés Gutierrez-Briceño, 2018. "Farming for Life Quality and Sustainability: A Literature Review of Green Care Research Trends in Europe," IJERPH, MDPI, vol. 15(6), pages 1-18, June.
    9. Fiszbein, Ariel & Ringold, Dena & Rogers, F. Halsey, 2011. "Making services work : indicators, assessments, and benchmarking of the quality and governance of public service delivery in the human development sectors," Policy Research Working Paper Series 5690, The World Bank.
    10. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    11. Qian Sun & Mary Loveday & Saw Nwe & Nike Morris & Emily Boxall, 2023. "Green Social Prescribing in Practice: A Case Study of Walsall, UK," IJERPH, MDPI, vol. 20(17), pages 1-20, September.
    12. Margaret M. Hansen & Reo Jones & Kirsten Tocchini, 2017. "Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review," IJERPH, MDPI, vol. 14(8), pages 1-48, July.
    13. Arnouts, Rikke & van der Zouwen, Mariëlle & Arts, Bas, 2012. "Analysing governance modes and shifts — Governance arrangements in Dutch nature policy," Forest Policy and Economics, Elsevier, vol. 16(C), pages 43-50.
    14. Benedetta Barchielli & Clarissa Cricenti & Francesca Gallè & Elita Anna Sabella & Fabrizio Liguori & Giovanna Da Molin & Giorgio Liguori & Giovanni Battista Orsi & Anna Maria Giannini & Stefano Ferrac, 2022. "Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health?," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    15. Savedoff, William D., 2011. "Governance in the health sector: a strategy for measuring determinants and performance," Policy Research Working Paper Series 5655, The World Bank.
    16. Miika Kumpulainen & Marko Seppänen, 2022. "Combining Web of Science and Scopus datasets in citation-based literature study," Scientometrics, Springer;Akadémiai Kiadó, vol. 127(10), pages 5613-5631, October.
    17. Marta Borgi & Mario Marcolin & Paolo Tomasin & Cinzia Correale & Aldina Venerosi & Alberto Grizzo & Roberto Orlich & Francesca Cirulli, 2019. "Nature-Based Interventions for Mental Health Care: Social Network Analysis as a Tool to Map Social Farms and their Response to Social Inclusion and Community Engagement," IJERPH, MDPI, vol. 16(18), pages 1-14, September.
    18. repec:bla:devpol:v:25:y:2007:i:5:p:533-574 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Morgana Galardi & Marta De Santis & Roberta Moruzzo & Franco Mutinelli & Laura Contalbrigo, 2021. "Animal Assisted Interventions in the Green Care Framework: A Literature Review," IJERPH, MDPI, vol. 18(18), pages 1-14, September.
    2. Mohd Rizaimy Shaharudin & Azyyati Anuar & Preecha Wararatchai & Natapat Areerakulkan & Wissawa Aunyawong, 2025. "Drivers and Constraints of Remanufacturing: A Global Bibliometric Review," Information Management and Business Review, AMH International, vol. 17(4), pages 141-163.
    3. Pedro Antonio Martín-Cervantes & Parisa Ziarati & Pablo de Frutos Madrazo & Iza Gigauri, 2025. "Digital Marketing as a Driver of Change Towards the Circular Economy," Sustainability, MDPI, vol. 17(11), pages 1-24, June.
    4. Mansoureh Beheshti Nejad & Seyed Mahmoud Zanjirchi & Seyed Mojtaba Hosseini Bamakan & Negar Jalilian, 2024. "Blockchain Adoption in Operations Management: A Systematic Literature Review of 14 Years of Research," Annals of Data Science, Springer, vol. 11(4), pages 1361-1389, August.
    5. Abdulkarim. K. Alhowaish, 2025. "The Blue Economy in the Arabian Gulf: Trends, Gaps, and Pathways for Sustainable Coastal Development," Sustainability, MDPI, vol. 17(19), pages 1-24, October.
    6. Simon Zaby, 2019. "Science Mapping of the Global Knowledge Base on Microfinance: Influential Authors and Documents, 1989–2019," Sustainability, MDPI, vol. 11(14), pages 1-21, July.
    7. Dušan Nikolić & Dragan Ivanović & Lidija Ivanović, 2024. "An open-source tool for merging data from multiple citation databases," Scientometrics, Springer;Akadémiai Kiadó, vol. 129(7), pages 4573-4595, July.
    8. Jaspreet Kaur & Madhu Vij & Ajay Kumar Chauhan, 2023. "Signals influencing corporate credit ratings—a systematic literature review," DECISION: Official Journal of the Indian Institute of Management Calcutta, Springer;Indian Institute of Management Calcutta, vol. 50(1), pages 91-114, March.
    9. Turgut Karakose & Ibrahim Kocabas & Ramazan Yirci & Stamatios Papadakis & Tuncay Yavuz Ozdemir & Murat Demirkol, 2022. "The Development and Evolution of Digital Leadership: A Bibliometric Mapping Approach-Based Study," Sustainability, MDPI, vol. 14(23), pages 1-26, December.
    10. Pattarin Sanguankaew & Vichita Vathanophas Ractham, 2019. "Bibliometric Review of Research on Knowledge Management and Sustainability, 1994–2018," Sustainability, MDPI, vol. 11(16), pages 1-20, August.
    11. Lufeng Gou & Wendan Deng & Siwei Yang, 2025. "Research Status and Trend Analysis of Forestry Carbon Sinks: A Systematic Literature Review," Sustainability, MDPI, vol. 17(12), pages 1-17, June.
    12. David Moroz, 2024. "What does terroir mean? A science mapping of a multidimensional concept," Journal of Agricultural Economics, Wiley Blackwell, vol. 75(3), pages 889-913, September.
    13. Tamer Sari & Funda Nayir & Senel Poyrazli, 2025. "Educare, Educere, or Holistic? Exploring Researchers' Educational Approaches in Education for Sustainable Development Research," Sustainable Development, John Wiley & Sons, Ltd., vol. 33(5), pages 6590-6603, October.
    14. Philip Hallinger & Ray Wang, 2020. "The Evolution of Simulation-Based Learning Across the Disciplines, 1965–2018: A Science Map of the Literature," Simulation & Gaming, , vol. 51(1), pages 9-32, February.
    15. Astrid Kainzbauer & Parisa Rungruang & Philip Hallinger, 2021. "How Does Research on Sustainable Human Resource Management Contribute to Corporate Sustainability: A Document Co-Citation Analysis, 1982–2021," Sustainability, MDPI, vol. 13(21), pages 1-21, October.
    16. Christopher Hansen & Holger Steinmetz & Jörn Block, 2022. "How to conduct a meta-analysis in eight steps: a practical guide," Management Review Quarterly, Springer, vol. 72(1), pages 1-19, February.
    17. Viktoriia Vovk & Öznur Taşdöken & Gülden Bölük & Alexandru Stratan & Jan Polcyn, 2025. "Circular Economy in the European Union: A Prisma-Based Systematic Review and Meta-Synthesis," Sustainability, MDPI, vol. 17(3), pages 1-22, February.
    18. Logožar, Klavdij, 2025. "The role of Artificial Intelligence in Supply Chain Management: A systematic Literature Review," Proceedings of the ENTRENOVA - ENTerprise REsearch InNOVAtion Conference (2024), Hybrid Conference, Dubrovnik, Croatia, in: Proceedings of the ENTRENOVA - ENTerprise REsearch InNOVAtion Conference, Hybrid Conference, Dubrovnik, Croatia, 5-7 September, 2024, pages 328-337, IRENET - Society for Advancing Innovation and Research in Economy, Zagreb.
    19. Huixian Shen & Ivan Ka Wai Lai, 2022. "Souvenirs: A Systematic Literature Review (1981–2020) and Research Agenda," SAGE Open, , vol. 12(2), pages 21582440221, June.
    20. Veronica Paul Kundy & Kamini Shah, 2024. "The knowledge base of financial technology: a bibliometric analysis review," SN Business & Economics, Springer, vol. 4(7), pages 1-22, July.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:2:p:202-:d:1580561. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager The email address of this maintainer does not seem to be valid anymore. Please ask MDPI Indexing Manager to update the entry or send us the correct address (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.