{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:12:40Z","timestamp":1788347560887,"version":"build-2803163510"},"reference-count":59,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"15th of June Foundation","award":["2023-0651"],"award-info":[{"award-number":["2023-0651"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Nature-based health interventions (NBHIs) are increasingly used in the healthcare system to support people with anxiety, depression and\/or stress, highlighting the need for systematic development and evaluation. This study aims to identify target group, professionals, mechanisms, and outcomes of NBHIs for people with mild to moderate anxiety, depression, and\/or stress. A Delphi-based study was conducted to explore core components of NBHIs in healthcare settings. Thirteen vs. eleven researchers with expertise related to the target group responded in two rounds. Respondents rated statements on a 7-point Likert scale and prioritised core components regarding target group, professionals, mechanisms, and outcomes. A thematic analysis was applied to synthesise qualitative responses. Consensus was achieved on 12 of 21 items across the four domains. Highest agreement concerned core mechanisms (nature interaction, social community, and physical activity), outcome priorities (mental wellbeing and quality of life), and professional competencies. Greater variation was observed regarding group composition and team delivery. Analysis of qualitative expert responses highlighted four key themes: (1) Balancing Group Composition, (2) Adapting Competencies to Context, (3) Core Mechanisms for Change, and (4) Weighing Perspectives in Outcome Selection. By setting out guiding principles for a programme theory, the study lays the foundation for the design and implementation of context-adapted NBHIs. The study underscores the need to approach NBHIs as complex interventions, thus contributing to a paradigm shift towards a new era of a bio-psycho-social health perspective.<\/jats:p>","DOI":"10.3390\/ijerph23010126","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T13:02:07Z","timestamp":1768914127000},"page":"126","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nature-Based Health Interventions for People with Mild to Moderate Anxiety, Depression, and\/or Stress: Identifying Target Groups, Professionals, Mechanisms, and Outcomes Through a Delphi Study"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0919-2454","authenticated-orcid":false,"given":"Louise S.","family":"Madsen","sequence":"first","affiliation":[{"name":"DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-3038","authenticated-orcid":false,"given":"Knud","family":"Ryom","sequence":"additional","affiliation":[{"name":"Department of Public Health, Applied Public Health, Aarhus University, 8000 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-5814","authenticated-orcid":false,"given":"Liv J.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Aarhus University, 8000 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-5424","authenticated-orcid":false,"given":"Dorthe V.","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Department of Geosciences and Natural Resource Management, University of Copenhagen, 1958 Frederiksberg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2032-1691","authenticated-orcid":false,"given":"Nanna H.","family":"Jessen","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Aarhus University, 8000 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: A systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"(2022). 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