Climate change and pollution are well known for their negative impact on human health. The health sector represents 1 to 5% of the global ecological footprint, and up to 9% in France. Primary care plays a central role in addressing climate change, through prevention and its close relationship with the population. In this context, in 2019, WONCA called on general practitioners (GP) to take action and be prepared for the health consequences of the climate change. Several theses have studied the ecological actions undertaken by GP in France. Some studies show a reluctance to adopt such measures, largely due to concerns about patients’ views. However, we found limited literature addressing patients’ opinion regarding these ecological actions.Our objective was to assess the opinions of GP patients regarding ecological actions implemented in GP surgeries in xxx.We conducted a quantitative, descriptive study using a questionnaire proposed to patients of participating GP.We collected 553 responses between July and December 2025. Of the respondents 77% were female, and ages ranged from 18 to 94 years (mean 43,2 years ; standard deviation 16,0 years). Participants described themselves as totally (4,9%) or mainly (31,8%) engaged in ecological concerns, with 44,1% reporting moderate engagement. Regarding the use of cleaned or disinfected medical supplies, respondents “totally agreed” or “rather agreed” at the following rates : 71,1% for ear specula, 41,8% for vaginal specula, 49,2% for spatulas, and 60,6% for suturing instruments. Additionally, 74,7% of patients agreed to be examine without disposable examination sheet and 71,8% agreed to replace it by bringing a personal towel. A large majority (83,5%) supported modifying their treatment for a more ecological alternative, and 78,3% were open to dematerialized prescriptions.This study suggests that patients are generally supportive of ecological changes in their doctor’s practice. However, several biases must be considered (recruitment and social desirability bias): the sample is not representative of the general population nor of the typical patient population of a GP.These findings may encourage more GP to adopt ecological measures, knowing that patient opinion (one of their main concern) appears largely favourable.

Health promotion is a key lever for improving population health while supporting the sustainability of healthcare systems. In primary care, physical activity is recognised for its physical, psychological, and social benefits. Within some coordinated primary care structures, walking groups have been developed as health promotion initiatives outside the formal framework of prescribed adapted physical activity. However, participants’ lived experiences of these groups remain underexplored, particularly regarding social connection and health promotion.To explore the lived experiences of patients participating in walking groups organised within coordinated primary care structures, focusing on their motivations, expectations, and perceived benefits.This is an ongoing qualitative study. To date, seven semi-structured individual interviews have been conducted with walking group participants, along with one participant observation of a walking session. Participants were recruited through purposive sampling. Interviews were audio-recorded and transcribed verbatim. Data collection is ongoing and will continue until data saturation is reached. A thematic analysis will be conducted iteratively, integrating interview and observation data. Final results are expected in the first half of 2026 and will be available at the time of the conference.Preliminary findings suggest that participants primarily value walking groups as opportunities to reduce social isolation and foster social connections, sometimes more than for physical activity itself. Relational and convivial dimensions appear central to participants’ experiences. While physical activity is recognised as beneficial, it often seems secondary to motivations related to meeting others and belonging to a group.These findings suggest that walking groups within coordinated primary care structures may function primarily as social and relational health interventions rather than solely as physical activity programmes. Ongoing analysis will further explore these dynamics and their implications for primary care practice.Exploring participants’ experiences of walking groups in primary care provides insights into their potential role in promoting social connection and global health. Final results will help inform the development of health promotion practices in coordinated primary care.

Climate change is a major public health challenge, to which healthcare systems contribute through greenhouse gas emissions. In primary care, decisions regarding diagnostic tests, paramedical care, medical devices, and care-related transport are frequent and cumulative, yet their environmental impact remains poorly explored from patients’ perspectives. Understanding how patients perceive non-pharmacological care is essential to support sustainable primary care practices without compromising quality or access to care.To explore patients’ perceptions of the carbon footprint associated with non-pharmacological care in primary care, focusing on perceived responsibility, individual agency, and the role of healthcare professionals.A qualitative exploratory study was conducted using semi-structured interviews with adult primary care patients, recruited through purposive sampling to ensure diverse profiles. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. Data collection and analysis were iterative. Data saturation was reached after the tenth interview, and two additional interviews confirmed saturation. Researcher triangulation enhanced analytical credibility. This study is part of a broader two-part qualitative programme examining patients’ perceptions of the carbon footprint of healthcare consumption in primary care.Patients reported heterogeneous awareness of the carbon footprint of non-pharmacological care, often marked by cognitive dissonance between environmental concern and limited perceived capacity to act. Everyday ecological gestures were described as individual responses to an issue perceived as collective, leading to strategies of compensation or personal balance. Individual agency was often perceived as limited, sometimes resulting in inaction. Physicians were identified as central actors in care decisions and key mediators for integrating environmental considerations. While patient autonomy in health was familiar, its extension to environmental dimensions remained emergent. Clear, contextualised information was viewed as a lever for empowerment.Findings highlight tensions between environmental awareness, individual responsibility, and systemic constraints, underscoring the role of the physician–patient relationship in supporting shared decision-making that integrates environmental considerations into routine care.Exploring patients’ perceptions of the carbon footprint of non-pharmacological care provides insights for promoting sustainable practices in primary care. Through information and shared decision-making, general practitioners may strengthen patients’ perceived agency and support care that is appropriate, acceptable, and environmentally sustainable.

There is a growing recognition that nature exposure is beneficial for human health. Nature prescription programs have been implemented in many countries to address the high burden of non-communicable diseases. Nature prescription is a low-cost health intervention which can easily be used on its own or as a complement to drug treatments. Prescribing nature has several co-benefits, such as encouraging pro-environmental behaviours. However, in France, nature prescriptions are not routine in primary care practice.To identify enablers and barriers surrounding nature prescriptions in primary care in XXX, France.For this qualitative study inspired by grounded theory, we interviewed GPs (n=11) in XXX. Purposive sampling was applied until data sufficiency was reached.Facilitators to nature prescribing include awareness of the health benefits of nature, regular personal contact with nature, interest in an alternative to medication, acknowledgment of the important role played by GPs in planetary health, easy, free and local implementation, and positive feedback from patients. Some participants questioned the existence of scientific evidence of the benefits of nature. Some of them feared side effects such as increase in skin cancers. Lack of time, lack of peer support and acceptance of the value of nature as a support for wellbeing, difficulties to access nature for some patients were reported as barriers. Participants identified a need for accessible theoretical resources, policy statements and national guidelines. They would benefit from help by other care givers and an easier access to nature for their patients.The strength of this study lies in addressing an unexplored topic in France and promoting planetary health; limitations include the low number of participants, variable interview depth, and challenges inherent to qualitative analysis. Findings align with international literature.The uptake and delivery of nature prescriptions is influenced by the prescriber’s own relationship with nature, personal experience and/or knowledge of the benefits of nature for health. To lower the barriers we highlighted, it is critical that governments and local decision-makers support the greening of communities especially in urban areas, and that official guidelines be drawn up. Broader public health campaign would allow nature prescription to deploy.

The healthcare sector is responsible for nearly 8% of national greenhouse gas (GHG) emissions, estimated at 48.6 MtCO₂eq. Medicines contribute 29% of these emissions, ahead of medical devices (21%) and transport (13%). General practice accounts for 23% of this total. In Normandy, the GHG footprint of general practitioners (GPs) has been assessed: in 2022, an average practice emitted around 12 tonnes of CO₂eq, excluding prescriptions and patient transport. The objective of this study was therefore to evaluate the GHG emissions associated with prescriptions issued by general practitioners in Normandy.We conducted a quantitative descriptive study using a GP's data warehouse (PRIMEGE). GHG emissions linked to prescribed medicines were calculated using ECOVAMED database, which applies life cycle analysis to assess environmental impacts from production to disposal. Only solid oral dosage forms were included, as data for other forms were unavailable.Prescriptions from 61 GPs were collected in 2022. 181,354 prescriptions were analysed from 151,179 consultations. Their associated emissions totalled 257,101 kgCO₂eq, corresponding to 4,215 kgCO₂eq per GP and 1.7 kgCO₂eq per consultation. Cardiovascular drugs generated the most emissions, followed by nervous system drugs and drugs for the digestive and metabolic systems.GHG emissions from GPs' prescriptions are equivalent to 145 return flights between Paris and New York. Because only solid oral forms were analysed, many frequently prescribed molecules could not be included. Further studies are required to fully determine the environmental impact of GPs' prescriptions. Based on this work and other studies eco-prescription concepts have been developed : deprescribing, ensuring appropriate medication use, take into account environmental toxicity and carbon footprint. For carbon footprint, five main principles have been suggested : favouring dry oral forms, limiting pressurised inhalers, favouring drugs with the lowest effective daily doses within the same therapeutic class, favouring drugs combining several active substances and choosing dosing regimens with minimal necessary dosesGeneral practitioner’s prescriptions generate significant greenhouse gas emissions. Applying its principles of eco-prescription would reduce the carbon footprint of the healthcare system.

Contact with the natural environment has proven benefits for mental and physical health. Nature prescriptions help people who need them to spend more time in nature. This practice is growing in popularity in many countries. The Planetary Health Working Group of the College of General Practitioners (CMG) has produced a guide to help healthcare professionals make use of this simple tool.This CMG guide presents the benefits of experiencing nature, drawing on scientific references, the key concept of co-benefits (including physical activity and healthy eating), the practical aspects of prescribing nature, as well as potential obstacles and ways to overcome them.The benefits of nature prescription are individual (improved physical and mental health) and also collective and global, through their impact on the decisions and behaviours of individuals and population.Given its benefits and the low cost of prescribing nature, healthcare professionals are eagerly awaiting the development of policies tailored to its implementation and management. It would be interesting to continue evaluating this simple intervention.‘Nature prescription is a non-pharmaceutical intervention that is inexpensive and easy to implement in primary care. It is practised in several countries around the world. It has many benefits for human health.’ This guide, which aims to promote its practice, is most welcome.

Artisanal and small-scale gold mining (ASGM) is a major source of environmental contamination in West Africa, particularly in Guinea, where mining activities release substantial amounts of toxic metals into surrounding ecosystems. In Siguiri, where ASGM is widespread, local communities rely heavily on groundwater and river water for daily consumption, increasing their vulnerability to metal exposureThe objective of this study is to comprehensively assess water contamination and associated health risks in the artisanal mining areas of Siguiri, Guinea.A cross-sectional analytical study was conducted during both rainy and dry seasons in Siguiri. We collected 36 water samples (12 boreholes, 24 river points) from three major mining sites. Samples were analyzed for eight heavy metals (mercury, lead, aluminium, cadmium, nickel, manganese, copper, iron) using UV-visible spectrophotometry. Health risk assessments followed the US EPA methodology, calculating Hazard Index (HI) for ingestion and dermal exposure, as well as Cancer Risk (CR_ing). Multivariate statistical analyses identified contamination patterns and vulnerable populations.Heavy metal concentrations exceeded WHO guidelines, particularly during rains. Nickel and manganese exceeded limits by 10-20 fold, while mercury and lead surpassed limits by >50-fold at some sites. Water hazard index peaked at 56.3. Non-carcinogenic ingestion risks for children reached alarming values of 476 (dry season) and 409 (rainy season) far exceeding the acceptable risk threshold of 1. Carcinogenic risks exceeded EPA thresholds (>10⁻⁴) for nickel, lead, and cadmium, with children being 4-10 times more vulnerable than adults. Multivariate analysis identified three contamination clusters: "Low Toxicity (Dry Season)," "Moderate Toxicity (Rainy Season)," and "High Toxicity (Oudoula)."The findings indicate severe and persistent contamination driven by mining runoff, particularly during the rainy season. The disproportionate burden on children underscores their vulnerability due to higher intake per body weight. The magnitude of both non-carcinogenic and carcinogenic risks suggests long-standing, cumulative exposure rather than isolated contamination events.Our findings demonstrate significant health risks, particularly for children, necessitating urgent interventions. We recommend installation of water treatment systems,  tailings containment structures and phytoremediation using local metal-accumulating plants. These measures align with SDGs 3, 6, and 12, supporting Guinea's national development agenda while protecting vulnerable communities.