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However, there is contradictory evidence and few large-scale international studies focused on health inequities. The GreenME project aims to identify ways in which effective green care can be scaled-up to improve adult mental health and well-being equity while contributing to multiple socio-ecological co-benefits across the Global North.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>GreenME\u2019s approach is threefold: (i) to diagnose the current status of green care in project consortium countries through a grey literature review and stakeholder interviews, (ii) to increase scientific evidence on the relationship between green care and mental health and well-being equity using modified randomised controlled trials and a population-level socioecological cross-sectional survey study and (iii) to empower green care actors by co-creating a set of tools with consortium countries\u2019 participating stakeholders. GreenME will: (a) produce a catalogue of identified successful green care models and best practices; (b) design a robust but adaptable protocol for testing the pathways, effectiveness and cost-effectiveness of nature-based therapies; (c) identify the mental health equity impact of green care and (e) co-create solutions for national and EU-level policies and develop online resources for nature-based therapy providers. GreenME is conceptualised and designed to increase the use of green care and its integration within a multi-scalar green care framework which could ultimately promote just and sustainable healthy communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been obtained individually from each partner\/site (UAB CERec 6594, 6851, UAB-CERec180, UAB-CERec178 and CEEAH 7269; UOC CE23-PR29, CE240PR07, CE24-PR59, CE24-PR55; l'Hospital de Matar\u00f3 CEIm 11\/2; CEIm Fundaci\u00f3 Sant Joan de D\u00e9u PIC-82-25; Alma Mater Stadiorum Universita di Bologna, Proj nos. 0157655, 0075975; ILS, no number \u2018Survey in Workpackage 2\u2019, no number \u2018Workshops in Workpackage 5\u2019; Swedish Ethics Review Committee, 2024\u20132810-01, 2025\u20130195401; University of Kent, CREAG064-04-024; University of Salford Ethics Administration, Ref 0189, 4552; Institute of Psychiatry and Neurology Bioethics Committee, no number; Committees on Ethics and Scientific Research, Res no 32\/RKF\/2023U). All study results will be disseminated through peer-reviewed publications, scientific conferences and via reports and workshops for stakeholders at the regional (European Union), national and local levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN13105773\">ISRCTN13105773<\/jats:ext-link>\n                      ,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN71485431\">ISRCTN71485431<\/jats:ext-link>\n                      ,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN11841855\">ISRCTN11841855<\/jats:ext-link>\n                      ,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN14970007\">ISRCTN14970007<\/jats:ext-link>\n                      and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN15381820\">ISRCTN15381820<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114034","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:45:13Z","timestamp":1785325513000},"page":"e114034","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Learning from real-world conditions to advance green care for mental health equity in the Global North: protocol for a transdisciplinary multi-scalar 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