title: Engaging with nature to promote health: new directions for nursing research.
abstract: OBJECTIVE
  The aim of this paper is to offer a conceptual framework for nature-based health promotion in nursing and provide related recommendations for future nursing research.
  
  
  BACKGROUND
  Empirical data suggest that interaction with nature has direct health benefits. When people attend to outdoor habitats, gardens and other forms of nature, they are more likely to engage in physical activity and other behaviours that improve health. Engaging with nature can even cultivate ecological sensibilities that motivate us to protect the health of our planet.
  
  
  METHODS
  Multidisciplinary theoretical and research publications from 1985 to 2008 were examined in the development of the framework.
  
  
  CONCLUSIONS
  As the health of our planet continues to deteriorate, there is a pressing need for theoretically informed, ethical, sustainable ways of engaging with nature to promote human and environmental health. We adapt principles and socio-ecological thinking from the fields of nursing, health promotion and ecological restoration to delineate the essential elements of the proposed framework. Implications for nursing. Although evidence-based knowledge about nature-based health promotion is not readily used in nursing and health care, its development and application are critical to designing effective strategies to strengthen both human and environmental health.
  
  
  CONCLUSIONS
  Nurses can use nature-based health promotion concepts to work with citizens, health practitioners and policymakers to explore and optimize reciprocal, health promoting relationships among humans and the natural environment. To the extent that nurses integrate nature-based health promotion into their research efforts, we can expect to contribute meaningfully to both environmental and human health in communities across the globe.
authors.affiliation: School of Nursing, Saint Francis Xavier University, Antigonish, Nova Scotia, Canada. phketchu@stfx.ca
authors.forename: Patricia
authors.initials: P
authors.lastname: Hansen-Ketchum
authors.forename: Patricia
authors.initials: P
authors.lastname: Marck
authors.forename: Linda
authors.initials: L
authors.lastname: Reutter
mesh_terms: D055669:Ecological and Environmental Phenomena; D004782:Environmental Health; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015399:Nursing Research