PONE-D-24-32661Nature-based interventions for individual, collective and planetary wellbeing: A protocol for a scoping reviewPLOS ONE

Dear Dr. Isham,

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This manuscript presents a protocol for a scoping review that seeks to investigate the impacts of nature-based interventions (NBIs) on individual, collective, and planetary wellbeing. The topic is highly relevant and timely, particularly given the growing interest in the intersections between human health, social wellbeing, and environmental sustainability. The study has the potential to contribute significantly to this emerging field, but there are several critical areas where the manuscript requires substantial improvement to enhance its clarity, comprehensiveness, and methodological rigor.

Major Issues:

1. The current search strategy, while it includes multiple databases, does not provide enough detail to ensure that the literature review will be comprehensive. The manuscript should elaborate on the development of the search terms, including how keywords were selected and refined. Moreover, it would be beneficial to include additional sources, such as grey literature, theses, and conference papers, to minimize publication bias.

2. The protocol does not adequately address how the expected heterogeneity among studies will be managed. Given the broad scope of the review, which includes various study designs, populations, and outcomes, it is crucial to outline a clear strategy for synthesizing different types of evidence. This could involve subgroup analyses, sensitivity analyses, or the use of narrative synthesis to handle variability in study designs and outcomes.

3. While the manuscript references several theoretical frameworks, including the GENIAL framework, it falls short in explaining how these frameworks will be applied in the analysis and interpretation of data. Theoretical frameworks are critical in guiding the synthesis of findings and ensuring that the review’s conclusions are grounded in a robust conceptual foundation. The authors should provide more detailed explanations of how these frameworks will be operationalized in the review process. This would significantly enhance the theoretical rigor of the study and provide a clearer roadmap for interpreting the results.

4. The manuscript discusses individual, collective, and planetary wellbeing, but the integration of these concepts into a coherent framework is somewhat lacking. It is important to clarify how these dimensions of wellbeing will be assessed and integrated within the context of NBIs. A more detailed conceptual framework that explicitly connects these dimensions would help to unify the review and make its contributions more substantial.

Minor Issues:

1. The manuscript currently limits the scope of the literature review to English-language studies. However, some published reviews in this field have included studies in multiple languages, such as Portuguese, French, English, and Spanish. If possible, expanding the language scope of the review to include these and potentially other languages could enhance the comprehensiveness of the review. By incorporating studies in additional languages, the authors could potentially uncover relevant research that might be overlooked due to language barriers, thereby providing a more global perspective on the impact of nature-based interventions on wellbeing.

2. The manuscript contains minor inconsistencies in terminology, such as the alternation between "wellbeing" and "well-being."

Reviewer #2: I think this manuscript presents an exciting and much-needed framework for studying Nature-Based Interventions (NBIs) with a holistic view. It stands out because it goes beyond traditional reviews by incorporating a focus on collective and planetary wellbeing, which hasn’t received enough attention in previous work. The methodology is sound, well-structured, and adheres to well-recognized frameworks such as the Joanna Briggs Institute (JBI) and PRISMA guidelines. However, there are a few areas where the manuscript could be more transparent and detailed to maximize its impact.

Strengths:

Novel Scope and Holistic Approach: The focus on a tri-dimensional view of wellbeing—individual, collective, and planetary—is a significant advancement in the study of NBIs. I really appreciate the expansion of the concept of wellbeing beyond individual health. It’s clear that the authors aim to break away from the narrow, individualistic focus that dominates current literature, which is refreshing and forward-thinking.

Clear and Rigorous Methodology: The authors have established a detailed methodology, with clear adherence to established protocols. The inclusion of multiple types of studies (RCTs, quasi-experimental designs, interviews) is a positive aspect of the review, making the protocol robust and inclusive. Using the Covidence platform for data screening also adds an extra layer of rigor and transparency, which I find commendable.

Addressing Knowledge Gaps: One major strength of this protocol is that it directly addresses the gaps in the existing literature, particularly the omission of social and planetary wellbeing in previous reviews. The use of a more diverse set of search terms—like community cohesion, environmental attitudes, and pro-environmental behaviors—shows that the authors have really thought through how to capture these neglected dimensions.

Consultation Exercise: Including a consultation phase with stakeholders and experts adds value to the review, ensuring that the outcomes are both academically sound and practically relevant. This is an innovative addition that I believe will increase the review's credibility and usefulness for policymakers and practitioners.

Areas for Improvement:

Search Strategy Clarification: The inclusion of multiple search terms for various wellbeing domains is a great idea, but I feel the strategy could benefit from some fine-tuning. For instance, there are several overlapping terms in the list (e.g., “environmental attitudes” vs. “ecological attitudes”), and I worry this could lead to redundancy or a dilution of focus. The authors could consider consolidating some of these terms to ensure the review remains focused and concise.

Handling Study Heterogeneity: Given the wide variety of studies that will be included, it’s likely that there will be considerable heterogeneity in terms of intervention types, outcomes measured, and populations studied. While the authors acknowledge this, I think they should be more explicit about how they will handle this during data synthesis. Will they consider subgroup analyses based on factors like study design or NBI type? Clarifying this would help the reader understand how the results will be interpreted in light of such variability.

Definitions of Key Concepts: Although the authors have done a great job introducing the tri-dimensional framework of wellbeing, I think it would help if they provided a bit more clarity around some of the terms. For example, “planetary wellbeing” is a relatively new concept and could be confusing for readers unfamiliar with this area. A clearer, more operational definition would improve the accessibility of the manuscript.

Potential for Bias: The authors plan to include studies from various methodologies, which is great for inclusivity. However, I think it would be beneficial if they were more upfront about how they will assess the risk of bias in these studies. Will there be any formal bias assessment tools applied, or is this not a focus for this review? Clarifying this point would make the review more robust.

Specific Suggestions:

Consultation Process: The authors mention a consultation exercise but don’t provide enough detail on how it will be conducted. I think it would be helpful to know how the feedback from the consultation will be integrated into the final review. Will it simply validate the findings, or could it result in changes to the data synthesis? A bit more transparency here would be useful.

Timelines and Feasibility: The proposed timeline (Table 1) looks ambitious. Completing the entire review, including data extraction, collation, and the consultation exercise, in just six months might be too optimistic, particularly if they encounter unexpected challenges. The authors may want to revise the timeline to reflect a more realistic completion date, or provide a contingency plan in case of delays.

Data Presentation: I feel the authors could give more detail on how they plan to present the data, especially across the three domains of wellbeing (individual, collective, planetary). Will these be analyzed separately or together? It’s important to know this, as it will impact the interpretation of the findings.

Conclusion:

This protocol is well-written and tackles a very relevant and underexplored area. With minor adjustments—particularly around the search strategy, handling heterogeneity, and a more detailed consultation process—this protocol will be ready for publication. I believe it will make a valuable contribution to the literature on NBIs, particularly with its novel focus on collective and planetary wellbeing.

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Reviewer #1: No

Reviewer #2: Yes:  Xiaoyi Zhang, MD

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Nature-based interventions for individual, collective and planetary wellbeing: A protocol for a scoping review

PONE-D-24-32661R1 

Dear Dr. Amy Isham,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Cho-Hao Howard Lee, M.D.

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors' responses have addressed my concerns, and I support the publication of their work. Thanks. Good luck!

Reviewer #2: Thank you for the opportunity to review this revision. It’s clear that you’ve carefully addressed previous feedback, and the result is a strong, well-structured protocol. Your focus on exploring the impacts of nature-based interventions (NBIs) across individual, collective, and planetary wellbeing adds valuable breadth to the existing literature. This approach is both timely and impactful, and I believe your work will make a meaningful contribution to the field. Here are a few minor suggestions that could further enhance clarity and coherence.

Merits

1. Comprehensive Framework: The use of the GENIAL model to assess NBIs across multiple domains of wellbeing is a significant asset. It provides a holistic perspective, which will likely be of interest to a broad audience, from clinicians to policymakers.

2. Clear and Detailed Methodology: Your protocol is meticulously outlined, with transparent steps for database selection, inclusion/exclusion criteria, and data charting. This rigor enhances the replicability of your study and its potential for future use as a foundational work in the area.

3. Inclusive Approach to NBI Types: By including various forms of NBIs, from green and blue spaces to animal-assisted interventions, the protocol ensures a wide-ranging analysis, which will make the review’s findings broadly applicable.

Minor Suggestions for Revision

1. Clarify Definitions of Wellbeing Domains: Although you define the three domains of wellbeing, adding a brief example of each (e.g., individual wellbeing as mood improvement, collective wellbeing as community cohesion, and planetary wellbeing as pro-environmental behavior) could enhance reader understanding and make the distinctions even clearer.

2. Elaborate Slightly on Data Presentation for Each Domain: The data presentation plan is well-organized. Including a short description of how results will be grouped within each domain, perhaps through sample table headers or an illustrative example, could help readers visualize the final data structure.

3. Address the Exclusion of Grey Literature: Since this decision was made in the interest of focusing on validated sources, a brief acknowledgment of how this might impact the findings—alongside the reasoning you provided—would help address any lingering questions on potential publication bias.

4. Expand Briefly on the Consultation Exercise: The inclusion of a final consultation exercise is a great step for ensuring methodological soundness. A sentence or two on the types of expertise represented in this group would strengthen readers' understanding of how the consultation adds to the review's rigor.

5. Consider a Note on Expected Limitations Due to Heterogeneity: Given the broad scope of NBIs, you may encounter a high degree of heterogeneity. A brief note on how this will be handled, with an emphasis on narrative synthesis or alternative grouping methods if meta-analysis isn’t feasible, would set clear expectations for readers.

Recommendation: Minor Revision

Overall, this is a well-developed protocol that thoughtfully incorporates feedback from previous reviews. The minor revisions suggested are intended to further clarify and enhance the manuscript’s readability and impact. I am excited to see the completed review and the valuable insights it will bring to the field. Thank you for your hard work, and best of luck as you finalize this important study!

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

Reviewer #2: Yes:  Xiaoyi Zhang, M.D.

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