BC Parks Foundation Brings the Great Outdoors to a Prescription Pad Near You

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With the support of 10,000 prescribers as of 2022, the PaRx project is showing that a walk in the woods is just what the doctor ordered.

Sometimes a walk in the woods is just what the doctor ordered, or it should be, but medical professionals were not doing that in Canada – not in 2019, the year nature prescriptions were named one of the top eight global wellness trends.

PaRx Director speaking about PaRx at the 2023 CMA Health Summit

Despite Canada’s stunning natural advantage in this area, we were sitting out on the nature prescription trend. The BC Parks Foundation took notice and decided something outdoorsy needed to be done and so, the PaRx project was born.

Given the huge body of evidence behind the health benefits of time spent in nature, it was clear to the PaRx team that not including green time in patient treatment plans represented a costly gap in the Canadian healthcare system. If, as research indicates, just 30 minutes of time spent in nature per week could prevent up to 7 to 9 percent of depression and hypertension cases, the potential savings to healthcare budgets might be enormous. And that’s just one example.

Graph showing rapid growth of PaRx prescribers since inception

As if that wasn’t enough, doctors consistently rank as some of the topmost trusted professionals globally, and research shows that people who are more connected to nature are more likely to support biodiversity values and engage in pro-environmental behaviours. As the team recognized, nature prescribing has the potential to make for both healthier Canadians, and a healthier Canada, by building support for the country’s commitments to nature protection and sustainability policy.

With all this in mind, the PaRx team set out to grow the nature and health movement, and to inspire national and international conversations about the vital connections between nature, biodiversity, and human health. They knew they wanted to build a community of health professionals who prescribe nature—that it was time for medical professionals to say, “Take a hike.”

PaRx website homepage

Before launching PaRx, the team looked to see how nature prescribing was being carried out globally. A review of the scientific literature helped determine guidelines for nature dosing, and which health conditions would benefit from nature prescriptions. There is strong evidence that spending time in nature, in doses of at least two hours per week, at least 20 minutes each time, would be one of the best things patients could do for their health.

Focus groups with health professionals were also held to determine their practical needs and ideas for successfully implementing the program in Canada, and from all this a specific Canadian model for nature prescribing was developed. This included a succinct, user-friendly website and a system to track and log nature prescriptions as well as other resources, all designed to appeal to busy health professionals.

PaRx Adult Health Handout

PaRx was first launched in British Columbia in November 2020, early in the COVID-19 pandemic when Canadians were more intuitively aware of the health benefits of nature due to people spending more time outside, and when the need for support for mental and physical health was sky-high. Launches soon followed in Ontario, Saskatchewan, Manitoba, Alberta, the Maritime provinces, Quebec, and Newfoundland and Labrador. 

Prior to each launch, the Director of PaRx led health sector and parks organization outreach for the program by engaging her personal and professional networks, with the objective of endorsements from at least one major physicians’ organization and one major nursing organization in each province.

This approach had not been a clear focus in American programs, and likely helps explain how the BC Parks Foundation’s PaRx achieved buy-in to the point of 1,000 prescribers after one year — while ParkRx America, their US counterpart, took three years to reach that milestone, despite having a much larger prescriber and population base.

As the program was being successfully launched throughout the country, with significant media attention, the team worked to gain support from outdoor organizations in order to reduce barriers to nature for PaRx patients.

PaRx Sample Ontario Prescription

As with all prescriptions, time spent in nature is not something that is accessible to everyone. Access to green space is an equity issue, just as it is with all kinds of healthcare. Happily, in addition to the University of British Columbia Botanical Gardens, Parks Canada was PaRx’s first major collaboration announcement in January 2022, involving free Parks Canada Discovery Passes that registered prescribers could prescribe to their patients. This created a wave of national and international media attention that generated an exponential increase in prescriber numbers and international interest in the program.

By the end of 2022, an incredible 10,000 prescribers were on board, and the Canadian Medical Association had officially endorsed PaRx and enshrined nature prescribing in official policy—two global firsts for a national physicians’ association. In 2023, PaRx became a key collaborator in two nature and health research projects headquartered in the EU and Australia, attracting funding of over $10 million.

Project Leaders Melissa Lem (third from left) and Andrew Day (first from right) at COP15

It may not have been easy, but the BC Parks Foundation’s PaRx is making healthcare a walk in the park.