Table 1 Core domains and parent and clinician themes

Clinical Appropriateness

Parents largely feel that the incorporation of ecology-focused activities into GWCC would be a well received component of clinical care.

Clinicians recommended a personalized approach to implementation that can adapt to include groups of families from differing backgrounds.

Clinicians’ suggestions about ecology-focused GWCC activities are often connected to diverse aspects of pediatric anticipatory guidance in age, timing, and topic.

Educational Support

Parents expressed a desire for their health care professionals to provide more guidance and education on child safety and assessing risk when interacting with nature.

Clinicians want to leverage local resources and knowledge to integrate community characteristics and historical expertise into the ecology-focused activity design in GWCC.

Cultural Understandings of Nature

Clinicians observed variation in perceptions of nature among families and themselves based on personal experiences and cultural contexts.

Independence & Exploration

Parents perceive nature as a valuable experience for themselves and their children to build independence and to explore their surroundings.