The Green Prescription (GRx) is an exercise and wellbeing referral programme. Funded by the DHBs, it is run by regional sports trusts, primary health organisations and Māori health organisations. People are generally referred by their GPs or practitioners like paediatricians, midwives and social workers but people can call and ask to take part off their own bat as well.
It begins with a consultation with a GRx worker and then up to six months of fitness classes or workshops and advice around what to eat, with ongoing support via phone and text. It also gives much cheaper entry to gyms and pools owned by councils.
Part of a worldwide response
The Green Prescription concept came about as part of a worldwide response to the US Surgeon General’s call for countries to encourage people to do more physical activity.
It began in New Zealand in 1998 at the Hillary Commission, driven by Diana O’Neill who led it for the next 21 years under various guises and when it moved to the Ministry of Health.
Now retired, Diana O’Neill travelled to various other countries wanting to emulate the success of the green prescriptions here,” explains Deputy Director of Public Health Dr Harriette Carr.
“Part of its success has been its ability to adapt to different communities’ needs – some people like one-on-one attention, while others want to be a part of our group. It’s our GPs, nurses and practitioners, as well as our frontline staff delivering the programme on the ground, who are a huge part of the green prescription working so well. Their ability to tailor classes and activities to their communities’ needs is invaluable.
“Over the years, customer surveys have consistently shown that people feel less anxious, healthier and fitter and say they appreciate the holistic nature of the prescription as opposed to only treating an illness or condition with medication.
“It’s also holistic in that it not only helps people on a personal level but walking for example – the most popular exercise prescribed on the programme – creates a more sustainable environment and counters climate change.
“So the Green Prescription is not ‘you’re overweight, now go for a run and we’ll tick a box’-type programme. It is a highly sophisticated number of nationwide programmes getting whole families off the couch and going on walks together, for example, or young mums at risk of maternal diabetes to do a cooking class together.”
One of those delivering the Green Prescription is Ashleigh Baker, the Healthy Lifestyles Manager for Sport Wellington.
“Often they can be quite nervous when first referred because a conversation with a doctor about exercise and nutrition is not always an easy thing – that’s why the first appointment is so critical to put them at ease and show that we come from a non-judgmental place.
“It’s important we seek to understand what people really want to achieve with their health and wellbeing, rather than tell them what we think they should do, so they feel empowered to take the next steps and on their own terms. When you are told to do something how likely are you to follow up?”
Ashleigh estimates that they see around 3,000 people per year participating in Green Prescription across the wider Wellington region.
“I feel very privileged to work in this area. It’s the little things like having a family tell you they now eat dinner together at night, and seeing an increase in a young mum’s self-esteem.
“Participation in our programmes feeds into other parts of participants’ lives and helps to build social connection; they might get the opportunity to work with a group when they didn’t want to exercise alone and make friends in the process.
“We help people take that sometimes scary first step, put them in an encouraging environment and then keep in touch with them.
“I believe a big part of the programme’s success is because they are whanaungatanga-centred, and seek to build strong connections between like-minded people, and back into the community.”
Ashleigh says she is very proud to be a part of the programme and if she could expand the programme at all it would be to have more one-on-one time with those of us fighting against the odds more than the rest of us.
“A lot of people present with very complex lives. If there is one thing I would add to the prescription it would be the ability to work with families with multiple needs such as insecure housing and low wages or no work in a more intensive way.
“It’s not a level playing field out there and it would be nice to spend more time with people with more complex needs and lives.”