Page - 271 - in Biodiversity and Health in the Face of Climate Change

271 engage with the complexity rather than attempt to reduce it to measurable outcomes, as is recognised by the UK Medical Research Council’s guidance on evaluating complex interventions (Craig et  al. 2011). Such methods might include natural experiments/quasi-experiments analysed using stepped wedge or interrupted time- series analyses (Hu 2015), and should include a process evaluation to take into account the varying contexts in which the intervention takes place (Moore et  al. 2015). The shift from a medical model has encouraged a rethink of care and care provi- sion and has latterly become established within a ‘Social Prescribing’ movement. As a non-medical approach, social prescribing interventions promote person- centred and asset-based approaches for people with diverse needs (Polley et  al. 2017). Social prescribing can support communities and individuals by placing the “individual or service user in the driving seat so it creates the opportunity for real and lasting behaviour change because it involves learning and making choices” (Jackson 2016: 14). Also referred to as community referral or asset-based, person- centred approaches, there is no agreed single term used to describe social prescrib- ing. Significantly, its definition may be difficult to hone as it is part of a larger social movement, initiated by the UK National Endowment for Science, Technology and the Arts (NESTA), based on ‘people-powered health’ designed to help reduce health inequalities, as highlighted in the influential UK Marmot Report (2010). A social prescription enables a health professional to collaborate with a link worker or community navigator who facilitates a person-centred conversation to design the participant’s own solutions to well-being (Bertotti et  al. 2018). This well- being conversation can prevent unnecessary GP attendance, reduce hospital emer- gency admissions, reduce social isolation, and help support individuals with a range of conditions (Kimberlee et  al. 2014; Chatterjee et  al. 2017). Approaches to social prescribing range from long-term condition management to volunteer opportunities with a focus on well-being through supported activities (Dayson et  al. 2015). Since 2013, four models of social prescribing have emerged: (i) signposting; (ii) linking with specific projects; (iii) joint partnerships; and (iv) holistic referrals (Kimberlee 2013). This includes, but is not exclusive to, therapeutic horticulture- and arts-based approaches. The ways in which these activities occur are diverse and reflect the contemporary public health approach adopted mainly within third-sector organisa- tions, community groups and charities, rather than commissioned health services. Examples of nature-based social prescribing interventions range from arranged walks in forests to conservation volunteering and more structured ‘green-care’ activities such as those observed within therapeutic gardens, all of which fit within the frameworks summarised in Fig.  11.3. Since the more active one becomes with nature, the more likely the exposure to biodiversity, health professionals should work with appropriate bodies to maximise biodiversity enhancement of nature- based social prescriptions. The case study in Box 11.2 explicitly brings people into contact with biodiversity for the benefit of the health of participants and the planet. 11 Biodiversity and  Health in  the  Face of  Climate Change: Implications for  Public…