Enhancing Public Health Outcomes: A Qualitative Study of Former Participants' Experiences of the Green Prescription Program in Aotearoa New Zealand

Background Physical activity promotion through primary care represents a key public health strategy. New Zealand's Green Prescription (GRx) program, a nationwide primary care-based physical activity intervention, has operated for over 25 years but lacks comprehensive evaluation of participant experiences and long-term impacts. Methods This qualitative study used semi-structured interviews with 15 former GRx Otago participants (6 male, 8 female, mean age 60 years). Interviews explored experiences of the program, impacts on physical activity, mental health, and quality of life, and recommendations for improvement. Data were analyzed using Interpretive Thematic Analysis following Braun and Clarke's six-step approach. Results Six main themes emerged: barriers to engagement, general experiences, mental health experiences, physical activity experiences, quality of life experiences, and recommendations for program improvement. Most participants (14/15, 93%) reported increased physical activity levels, while 12/15 (80%) experienced mental health improvements. Key barriers included financial constraints (16 participant references), transportation difficulties (9 references), and complex medical conditions (24 references). Participants valued the program's strengths-based approach, social connections, and individually tailored support. Primary recommendations included extending program duration, enhancing in-person support, diversifying activity options, and strengthening community organization partnerships. Conclusions The GRx program demonstrates effectiveness in promoting physical activity and associated health benefits among participants. However, significant opportunities exist for enhancement through addressing identified barriers, extending support duration, and developing more comprehensive community partnerships. These findings provide evidence-based strategies for improving primary care-based physical activity interventions globally.