This Medical Center Prescribes Nature, and Fills Prescriptions On-Site

We in the Nature Explore family don’t need a study to tell us that nature has many positive benefits for our physical, mental and spiritual health. We feel these benefits in ourselves, and see them in the children who play in our outdoor classrooms. Yet if nature is so good for our health, why aren’t doctors prescribing time outdoors?

They are, across the country, thanks to the “Rx For Outdoor Activity” training given by The National Environmental Education Foundation (NEEF). Doctors who have taken this training are qualified to write prescriptions for nature and to address children’s health issues as they relate to nature and the environment.

One of these Nature Champions is Daniel Porter, MD, Medical Director of the Lone Star Family Health Center (LSFHC), in Conroe, Texas. Lone Star also has a new Nature Explore Classroom on grounds. Doctors there are writing prescriptions for patients to spend time in the outdoor classroom. These are not simply verbal recommendations, but true prescriptions that are entered into the patient’s electronic health record. This is the first Nature Explore Classroom directly on the grounds of a federally qualified health center, and a model for future replication elsewhere.

LSFHC was founded in 2002 to provide health care to the Conroe area’s underserved, as well as to the community at large. It offers a variety of specialized services, dental and mental health clinics, and a Family Medicine Residency Program. Yearly, LSFHC sees over 80,000 low-cost patient visits, and graduates ten of its thirty resident physicians. 

In 2013 Lone Star partnered with other community organizations to fundraise for an outdoor space in which children and families could begin to fulfill their prescriptions for time in nature. NEEF had already worked with Dr. Porter in the Nature Champions program, so the collaboration between NEEF, Lone Star and the Nature Explore design team made for an ideal fit.  NEEF received seed funding from the US Forest Service, and Nature Explore, working with local partners, designed the classroom. Today, clients of the health center fill their prescriptions for time outdoors in the Nature Explore Classroom, and in nearby local and state parks.

An integral aspect of the Nature Champions model is that physician graduates of the Rx For Outdoor Activity program train other medical professionals upon return to their workplaces. Dr. Porter shares his expertise with Lone Star’s thirty medical resident physicians. The Family Medicine Residency Program attracts medical students nationwide to its three-year program. Each year its ten graduates leave to enter other medical systems. They take with them an understanding of nature’s many health benefits, and the experience of the outdoor classroom.

Sara Espinoza, NEEF’s Managing Director for Research and Best Practices, has even more plans for Lone Star’s outdoor classroom. Medicine is an evidence-based discipline, and Sara wants to add to the mounting evidence that nature holds health benefits for children. Through Lone Star’s outdoor classroom, NEEF is conducting research on patient usage of the outdoor classroom, and their beliefs and attitudes about the health benefits of nature. She hopes that the classroom will be the gateway to the local and state parks in the area, and that it will eventually yield data on the families’ wider experiences with nature.

Marilyn Kasmiersky, Director of Professional and Government Relations at Lone Star, says the outdoor classroom will be widely shared.  The Texas Home Visiting program will soon use it. The US Forest Service, and the local Parks and Recreation will also hold programs there. Texas A&M Agri-Life “Grow! Eat! Go!” is a 5-year school garden, nutrition, and physical activity intervention study targeting childhood obesity among third-grade students in 28 Title 1 schools. They will be there, too.  Local Master Gardeners and Jr. Master Gardeners voted to include Lone Star’s outdoor classroom as a site for their volunteer activities.

If it seems that everyone wants to use the space, that might be because so many had a hand in building it. Texas A&M’s Forest Service and Agri-Life Extension Service, Nature’s Way Resources, the Conroe School District, Texas Parks and Wildlife, Conroe Parks and Rec, Texas Wildscape, Texas Green Ambassadors, Keep Texas Beautiful, and the Sam Houston National Forest all chipped in.

During the past few years we have seen the Nature Explore Classroom model recognized by a widening range of organizations. A city preschool system, state park system and a statewide preschool trade organization have grown to embrace our outdoor classrooms. Along with the widening of this circle has come deepening research into our model. The Lone Star Family Health Center and the National Environmental Education Foundation have developed an outdoor space that is becoming a treasured community resource. It may soon yield research findings that NEEF can use to assist the medical profession in understanding how best to use outdoor classrooms and nature in their practices. We at Nature Explore are grateful to be part of this important project, and expect it to seed other outdoor classrooms within the medical community.


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