Reimagining health care and social connection with asylum seekers and refugees through contextually grounded nature-based social interventions

Nature-based social prescribing (NBSP) is gaining recognition as a means of addressing loneliness and fostering social connection, yet evidence of its effectiveness for socially marginalised groups remains limited. This explorative single-arm, pre-post study examined Friends in Nature (FiN), an eight-week NBSP program co-designed for and with 37 LGBTIQA+ asylum seekers and refugees in Melbourne. Participants were referred by a trusted partner organisation and engaged in shared and socially supported activities, including forest therapy, gardening, and coastal walks, among others. Evaluation methods included pre- and post-quantitative assessment of loneliness, quality of life, nature connectedness, and nature dose scales, as well as qualitative assessment drawing on ethnographic, participatory action research, photo voice, and interviewing approaches. Quantitative findings indicate reduced loneliness, increased nature connectedness, and no statistical change in health-related quality of life. Thematic analysis revealed five key findings: improved mental well-being; stronger social connections and sense of belonging; enhanced cultural sensitivity and confidence-building; appreciation for the interplay between nature, memory, and safety; and the pivotal role of facilitators in sustaining trust and participation. For participants, nature was perceived as an active agent in creating moments of safety, recognition, and shared meaning. The findings highlight the potential of NBSP as a beneficial person-centred public health approach, while underscoring the need for intersectional design that accommodates the complexity of place, culture, and identity.