It Feels Like a Campaign for an Election-Somali-Led Green Social Prescribing

Introduction: Green (nature-based) social prescribing has potential to reduce health inequalities, but may require additional investment to work effectively with marginalised populations. Commissioners need evidence about effectiveness and mechanisms of change to tailor implementation. Methods: We studied what works, for whom, and why, within a Somali-led green social prescribing intervention with disadvantaged refugee, migrant and ethnically diverse families and communities, funded through England’s National Health Service ‘Test and Learn’ green social prescribing initiative. Informed by realist evaluation, this involved ethnographic observations and participant interviews (n=8), followed by interviews (n=2) as part of iterative co-production process with programme providers. Results: We describe three interconnected mechanisms for generating social connection and wellbeing: local and cultural knowledge enables confident outreach to isolated community members; an inclusive, non-judgmental, and solution-focused approach helps develop self-care skills, destigmatising mental health; nature-based activities help participants experience safety and connection outdoors. Conclusion: This intervention initiates positive social connection, confidence exploring nature, and an increased repertoire of wellbeing behaviours. The findings explain how skilled community assets and nature-based opportunities can counter marginalising and isolating processes by instigating a sustainable ‘virtuous cycle’ of mutually reinforcing outcomes.