Structural Barriers to Green and Blue Spaces: A Scoping Review Protocol

Background Emerging evidence has demonstrated that nature-based interventions (NBIs) can improve mental and physical health. Considering that the global burden of poor mental health continues to rise, such interventions could be a cost-effective means to improve mental health, as well as reconnect individuals with the natural world, and thus aid efforts. However, the effectiveness of NBIs as a prescriptive intervention is, in part, a function of access to blue and green spaces. Accordingly, this scoping review will explore how structural inequalities influence the effectiveness of nature-based interventions as treatment options for mental and physical ill health. Methods A scoping review will be conducted to identify the barriers and facilitators associated with the utilisation of green and blue spaces. The review will follow the PRISMA-ScR guidelines, in addition to the associated Cochrane guidelines for scoping reviews. A literature search will be performed across five databases, and articles will be selected based on key inclusion/ exclusion criteria. All data will be extracted to a pre-defined charting table. The primary and secondary outcomes will be mental and physical health respectively. Discussion This review will better inform relevant stakeholders of the potential enablers and barriers of nature-based interventions, and thereby improve provision and implementation of NBIs as public health initiatives. Ethics and Dissemination All data rely on secondary, publicly available data sources; therefore no ethical clearance is required. Upon completion, the results of this study will be disseminated via the Imperial College London Community and published in an open access, peer-reviewed journal. Article Summary Strengths and Limitations of this Study This scoping review protocol is the first to focus on the accessibility to green and blue spaces in the context of mental and physical health. This protocol and subsequent review benefit from increased transparency, a systematised strategy (PRISMA-ScR), and a reduction in the risk of bias, through publication in an open access journal. This review will also capture grey literature - studies published outside peer-reviewed journals. Due to the broad nature of the review, the research may unearth more questions than solutions. Registration Number Open Science Framework: 10.17605/OSF.IO/8J5Q3