1
|
Cantrell A, Booth A, Chambers D. Signposting services for people with health and care needs: a rapid realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-86. [PMID: 39239879 DOI: 10.3310/gart5103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Background Signposting typically refers to an informal process that involves giving information to patients to enable them to access external services and support. It is perceived to reduce demand on primary care and other urgent care services. Methods This focused realist review was conducted rapidly within time constraints. Searches to identify theory were undertaken on MEDLINE, Cumulative Index to Nursing and Allied Health Literature and Social Sciences Citation Index in June 2022 for research published in English from 2016. We selected 22 publications and extracted programme theories from these to develop three priority questions: Question 1: What do people with health and social care needs require from a signposting service to believe it is valuable? Question 2: What resources do providers require to confidently deliver an effective signposting service? Question 3: Under what circumstances should commissioners commission generic or specialist signposting services? Purposive searching was conducted to find a rich sample of studies. UK studies were prioritised to optimise the applicability of synthesis findings. Results The review included 27 items, 4 reviews and 23 studies, a mix of qualitative, evaluations and case studies. Service users value a joined-up response that helps them to navigate the available resources. Key features include an understanding of their needs, suggestion of different options and a summary of recommended actions. Only a small number of service user needs are met by signposting services alone; people with complex health and social care needs often require extended input and time. Front-line providers of signposting services require appropriate training, ongoing support and supervision, good knowledge of relevant and available activities and an ability to match service users to appropriate resources. Front-line providers need to offer a flexible response targeted at user needs. Commissioned signposting services in England (no studies from Scotland, Wales and Northern Ireland) are highly diverse in terms of client groups, staff delivering the service, referral routes and role descriptions. A lack of service evaluation poses a potential barrier to effective commissioning. A shortage of available services in the voluntary and community sector may limit the effectiveness of signposting services. Commissioners should ensure that referrals target intensive support at patients most likely to benefit in the longer term. Conclusions Signposting services need greater clarity of roles and service expectations to facilitate evaluation. Users with complex health and social care needs require intensive, repeat support from specialist services equipped with specific knowledge and situational understanding. A tension persists between efficient (transactional) service provision with brief referral and effective (relational) service provision, underpinned by competing narratives. Do signposting services represent 'diversion of unwanted demand from primary care/urgent care services' or 'improved quality of care through a joined-up response by health, social care and community/voluntary services'? Limitations This realist review was conducted within a tight time frame with a potential impact on methodology; for example, the use of purposive searching may have resulted in omission of relevant evidence. Future work Signposting services require service evaluation and consideration of the issue of diversity. Study registration This study is registered as PROSPERO CRD42022348200. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130588) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 26. See the NIHR Funding and Awards website for further award information.
Collapse
|
2
|
Saragosa M, Mulligan K, Hsiung S, Biswas S, Card K, Hébert PC, Welch V, Nelson MLA. A Qualitative Study of National Perspectives on Advancing Social Prescribing Using Co-Design in Canada. Health Expect 2024; 27:e14144. [PMID: 38984442 PMCID: PMC11234137 DOI: 10.1111/hex.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/17/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024] Open
Abstract
INTRODUCTION Social prescribing offers a formal pathway of connecting patients in the health system with sources of support within the community to help improve their health and well-being. Since its launch in March 2022, the Canadian Institute for Social Prescribing has acted as a collective impact network to identify, connect and build upon established social prescribing initiatives using a co-design methodology. The institute received input from a participant advisory council, co-design partners and several communities of interest groups. This study aimed to describe the perceptions of the Canadian Institute for Social Prescribing's role in advancing social prescribing using a co-design approach and the barriers and facilitators to implementing social prescribing in Canada. METHODS We used a qualitative descriptive study design, document analysis, participant observation and semi-structured individual interviews (n = 7) with members of the Canadian Institute for Social Prescribing co-design group and the institute's leadership. We also analysed documents, field notes and transcripts using codebook thematic analysis. RESULTS Four themes were developed representing the facilitators of implementing the Canadian Institute for Social Prescribing to support social prescribing: Creating relational mechanisms (i.e., partnerships and connections), Bringing awareness to social prescribing and contributing to the evidence (i.e., values and beliefs), Addressing systemic conditions (i.e., having a common language for social prescribing and organizing the community health sector) and Enabling funding and policy to drive social prescribing initiatives (i.e., shifting evidence into policy and securing sustainable funding). CONCLUSION Participants' reflections on the co-design process demonstrated that the Canadian Institute for Social Prescribing development provided networking opportunities and shared resources relevant to social prescribing. Co-design efforts also fostered relational and informational support, which laid the necessary groundwork in Canada to overcome the complex interplay between the macro- and micro-level settings in which social prescribing is practiced. PATIENT OR PUBLIC CONTRIBUTION The interviews and observations involved participants with lived experience of delivering, receiving or advocating for social prescribing.
Collapse
Affiliation(s)
- Marianne Saragosa
- Science of Care Institute, Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
- Institute of Health Policy, Evaluation and ManagementUniversity of TorontoTorontoOntarioCanada
| | - Kate Mulligan
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Sonia Hsiung
- Canadian Institute for Social PrescribingCanadian Red CrossTorontoOntarioCanada
| | - Srija Biswas
- Canadian Institute for Social PrescribingCanadian Red CrossTorontoOntarioCanada
| | - Kiffer Card
- Faculty of Health SciencesSimon Fraser UniversityVancouverBritish ColumbiaCanada
| | - Paul C. Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
| | - Vivian Welch
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
| | - Michelle L. A. Nelson
- Science of Care Institute, Lunenfeld‐Tanenbaum Research InstituteSinai HealthTorontoOntarioCanada
- Institute of Health Policy, Evaluation and ManagementUniversity of TorontoTorontoOntarioCanada
| |
Collapse
|
3
|
Bos C, de Weger E, Wildeman I, Pannebakker N, Kemper PF. Implement social prescribing successfully towards embedding: what works, for whom and in which context? A rapid realist review. BMC Public Health 2024; 24:1836. [PMID: 38982399 PMCID: PMC11234751 DOI: 10.1186/s12889-024-18688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/23/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Some clients who access healthcare services experience problems due to the wider determinants of health which cannot be addressed (solely) by the medical sector. Social Prescribing (SP) addresses clients ' wider health needs and is based on linkworkers who support primary care clients in accessing social, community and voluntary care services that support their needs. Previous literature has provided valuable insights about what works (or not) in an early stage of implementing SP. However, there is limited insight into what works for the implementation of SP towards embedding. This study provides guiding principles by which SP can be successfully implemented towards the embedding stage and identifies which contextual factors and mechanisms influence these guiding principles. METHODS A Rapid Realist Review was conducted to examine what works, for whom, why, and in which contexts. A local Dutch reference panel consisting of health and care organisations helped to inform the research questions. Additionally, a workshop was held with the panel, to discuss what the international insights mean for their local contexts. This input helped to further refine the literature review's findings. RESULTS Five guiding principles were identified for successful implementation of SP at the embedding stage: • Create awareness for addressing the wider determinants of health and the role SP services can play; • Ensure health and care professionals build trusting relationships with all involved stakeholders to create a cyclical referral process; • Invest in linkworkers' skills and capacity so that they can act as a bridge between the sectors; • Ensure clients receive appropriate support to improve their self-reliance and increase their community participation; • Invest in the aligning of structures, processes and resources between involved sectors to support the use of SP services. CONCLUSION To embed SP, structural changes on a system level as well as cultural changes are needed. This will require a shift in attitude amongst health and care professionals as well as clients towards the use, role and benefit of SP services in addressing the wider determinants of health. It will also require policymakers and researchers to involve communities and include their perspectives.
Collapse
Affiliation(s)
- C Bos
- National Institute for Public Health and the Environment (RIVM), Centre for Public Health, Care and Society, Department of health and Care Nationally, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands.
- Research group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht , 3584 CS, The Netherlands.
| | - E de Weger
- Vrije universiteit Amsterdam, Athena Instituut, de Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - I Wildeman
- TNO child health, Sylviusweg 71, Leiden, 2333 BE, The Netherlands
| | - N Pannebakker
- TNO child health, Sylviusweg 71, Leiden, 2333 BE, The Netherlands
| | - P F Kemper
- National Institute for Public Health and the Environment (RIVM), Centre for Public Health, Care and Society, Department of health and Care Nationally, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
| |
Collapse
|
4
|
Newstead S, Jesurasa A, Jenkins B, Lavans A, Woodall A, Wallace C. Speaking the Same Language - The Development of a Glossary of Terms for Social Prescribing in Wales. Int J Integr Care 2024; 24:3. [PMID: 38974206 PMCID: PMC11225557 DOI: 10.5334/ijic.8591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Social prescribing can facilitate the integration of health, social care and community support but has a diverse and confusing terminology that impairs cross-sectoral communication and creates barriers to engagement. Methods To address this issue a mixed-methods approach that incorporated a scoping review, a group concept mapping study and consultation was employed to identify and classify the terminology associated with social prescribing. The findings were then used to inform the development of a glossary of terms for social prescribing. Results Many terms are used interchangeably to describe the same specific aspects of social prescribing. Much of the terminology originates from the health and social care literature of England. Discussion The terminology used in the academic literature may not accurately reflect the terminology used by the social prescribing workforce. The innovative and interactive glossary of terms identifies the terminology associated with social prescribing and provides additional contextual information. The process of developing the dual language glossary presented several considerations and challenges. Conclusion The glossary of terms will facilitate cross-sector communication and reduce barriers to engagement with social prescribing. It takes an important first step to help clarify and standardise the language associated with social prescribing, for professionals and members of the public alike.
Collapse
Affiliation(s)
- Simon Newstead
- Faculty of Life Sciences and Education, University of South Wales, UK
- Wales School for Social Prescribing Research (WSSPR), UK
| | | | | | | | | | - Carolyn Wallace
- Faculty of Life Sciences and Education, University of South Wales, UK
- Wales School for Social Prescribing Research (WSSPR), UK
| |
Collapse
|
5
|
O'Sullivan DJ, Bearne LM, Harrington JM, Cardoso JR, McVeigh JG. The effectiveness of social prescribing in the management of long-term conditions in community-based adults: A systematic review and meta-analysis. Clin Rehabil 2024:2692155241258903. [PMID: 38863236 DOI: 10.1177/02692155241258903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the effectiveness of social prescribing interventions in the management of long-term conditions in adults. DATA SOURCES Eleven electronic databases were searched for randomised and quasi-randomised controlled trials. REVIEW METHODS Outcomes of interest were quality of life, physical activity, psychological well-being and disease-specific measures. Bias was assessed with the Cochrane Risk of Bias 2 tool. A narrative synthesis and meta-analysis were performed. RESULTS Twelve studies (n = 3566) were included in this review. Social prescribing interventions were heterogeneous and the most common risks of bias were poor blinding and high attrition. Social prescribing interventions designed to target specific long-term conditions i.e., cancer and diabetes demonstrated significant improvements in quality of life (n = 2 studies) and disease-specific psychological outcomes respectively (n = 3 studies). There was some evidence for improvement in physical activity (n = 2 studies) but most changes were within group only (n = 4 studies). Social prescribing interventions did not demonstrate any significant changes in general psychological well-being. CONCLUSION Social prescribing interventions demonstrated some improvements across a range of outcomes although the quality of evidence remains poor.
Collapse
Affiliation(s)
- Declan J O'Sullivan
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Lindsay M Bearne
- Population Health Research Institute, St George's, University of London, London, UK
| | - Janas M Harrington
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Jefferson R Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Brazil
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
6
|
Scarpetti G, Shadowen H, Williams GA, Winkelmann J, Kroneman M, Groenewegen PP, De Jong JD, Fronteira I, Augusto GF, Hsiung S, Slade S, Rojatz D, Kallayova D, Katreniakova Z, Nagyova I, Kylänen M, Vracko P, Jesurasa A, Wallace Z, Wallace C, Costongs C, Barnes AJ, van Ginneken E. A comparison of social prescribing approaches across twelve high-income countries. Health Policy 2024; 142:104992. [PMID: 38368661 DOI: 10.1016/j.healthpol.2024.104992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 12/06/2023] [Accepted: 01/08/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Social prescribing connects patients with community resources to improve their health and well-being. It is gaining momentum globally due to its potential for addressing non-medical causes of illness while building on existing resources and enhancing overall health at a relatively low cost. The COVID-19 pandemic further underscored the need for policy interventions to address health-related social issues such as loneliness and isolation. AIM This paper presents evidence of the conceptualisation and implementation of social prescribing schemes in twelve countries: Australia, Austria, Canada, England, Finland, Germany, Portugal, the Slovak Republic, Slovenia, the Netherlands, the United States and Wales. METHODS Twelve countries were identified through the Health Systems and Policy Monitor (HSPM) network and the EuroHealthNet Partnership. Information was collected through a twelve open-ended question survey based on a conceptual model inspired by the WHO's Health System Framework. RESULTS We found that social prescribing can take different forms, and the scale of implementation also varies significantly. Robust evidence on impact is scarce and highly context-specific, with some indications of cost-effectiveness and positive impact on well-being. CONCLUSIONS This paper provides insights into social prescribing in various contexts and may guide countries interested in holistically tackling health-related social factors and strengthening community-based care. Policies can support a more seamless integration of social prescribing into existing care, improve collaboration among sectors and training programs for health and social care professionals.
Collapse
Affiliation(s)
- Giada Scarpetti
- Technische Universität Berlin, European Observatory on Health Systems and Policies.
| | | | - Gemma A Williams
- European Observatory on Health Systems and Policies, World Health Organization
| | - Juliane Winkelmann
- European Observatory on Health Systems and Policies, World Health Organization
| | - Madelon Kroneman
- Nivel (Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Peter P Groenewegen
- Nivel (Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Judith D De Jong
- Nivel (Netherlands Institute for Health Services Research, Utrecht, Netherlands and Maastricht University
| | - Inês Fronteira
- Global Health and Tropical, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Gonçalo Figueiredo Augusto
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública (ENSP), Universidade NOVA de Lisboa (UNL), Lisboa, Portugal
| | - Sonia Hsiung
- Canadian Institute for Social Prescribing, Canadian Red Cross
| | - Siân Slade
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - Daniela Rojatz
- Austrian National Public Health Institute, Vienna, Austria
| | - Daniela Kallayova
- Ministry of Health of the Slovak Republic, Bratislava, Slovak Republic
| | - Zuzana Katreniakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice and Slovak Public Health Association (SAVEZ), Kosice, Slovak Republic
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice and Slovak Public Health Association (SAVEZ), Kosice, Slovak Republic
| | - Marika Kylänen
- Finnish Best Practice Portal for Health and Wellbeing Promotion, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pia Vracko
- National Institute of Public Health, Ljubljana, Slovenia
| | | | | | - Carolyn Wallace
- University of South Wales, Wales School for Social Prescribing Research (WSSPR), UK
| | | | | | - Ewout van Ginneken
- Technische Universität Berlin, European Observatory on Health Systems and Policies
| |
Collapse
|
7
|
Litt JS, Coll-Planas L, Sachs AL, Masó Aguado M, Howarth M. Current Trends and Future Directions in Urban Social Prescribing. Curr Environ Health Rep 2023; 10:383-393. [PMID: 38087048 DOI: 10.1007/s40572-023-00419-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE OF REVIEW Social prescribing (SP) is defined as a non-medical community referral program to support well-being and health. This review explores the current evidence about the effectiveness of SP. RECENT FINDINGS This review examined existing SP models that have been or are being tested to connect people to these opportunities through direct and indirect referral schemes. The review identified a fifth model that facilitates a group-based approach used to mental well-being and resilience. While the development of SP largely originates from the UK, the global interest in SP has increased, with over 31 nations reporting elements of SP. The main goal of SP is to better integrate care between the traditional medical setting and resources available in the community and voluntary sectors. Although this review found widespread optimism around SP, there remain concerns about its effectiveness and demands for high-quality evaluations to strengthen the evidence base for SP.
Collapse
Affiliation(s)
- J S Litt
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88 08003, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- University of Colorado Boulder, Boulder, CO, USA.
| | - L Coll-Planas
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Carrer de La Sagrada Família, 7 Vic, 08500, Barcelona, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - A L Sachs
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88 08003, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - M Masó Aguado
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Carrer de La Sagrada Família, 7 Vic, 08500, Barcelona, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - M Howarth
- Edgehill University, St Helens Road, Ormskirk, L39 4QP, Lancashire, UK
| |
Collapse
|
8
|
Newstead S, Elliott M, Cavanagh D, Tetlow S, Wallace C. Speaking the same language - a scoping review to identify the terminology associated with social prescribing. Prim Health Care Res Dev 2023; 24:e67. [PMID: 38014624 PMCID: PMC10689092 DOI: 10.1017/s1463423623000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 07/11/2023] [Accepted: 08/30/2023] [Indexed: 11/29/2023] Open
Abstract
AIM To identify the social prescribing-related terminology within the peer-reviewed literature of the UK and the grey literature from Wales. BACKGROUND Social prescribing has seen a period of development that has been accompanied by a proliferation of related terminology and a lack of standardisation in the manner in which it is employed. This creates barriers to engagement and impairs communication, both between professionals and members of the public. The Wales School for Social Prescribing Research and Public Health Wales committed to the development of a glossary of terms for social prescribing, to facilitate the clarification and standardisation of the associated terminology. Here, we describe the first step in that process. METHOD A scoping review of the peer-reviewed UK literature and Welsh grey literature was conducted. The titles and abstracts of 46,242 documents and the full text of 738 documents were screened. Data were charted from 205 documents. Data capture included terminology, the location within the UK of the research or intervention described in the article, and the perspective from which the article was authored. A general inductive approach was used to categorise the terms by theme. FINDINGS This research serves to highlight the breadth and diversity of the terminology associated with social prescribing. Results demonstrate aspects of shared commonality and clear distinction between the terminology from the two literature sources. The greatest contributions of terms were from articles that examined research and/or interventions in England and that were authored from the perspective of health or health and social care. The research indicates that nation- and sector-specific terms may not be adequately represented in the literature at large. Looking forward, it will be important to ensure that social prescribing terminology within the UK literature is culturally relevant and accurately reflects the terminology used by the workforce who encounter and deliver social prescribing.
Collapse
Affiliation(s)
- Simon Newstead
- Life Sciences and Education, University of South Wales, Treforest, UK
- Wales School for Social Prescribing Research (WSSPR), UK
| | - Megan Elliott
- Local Public Health Team, Cwm Taf Morgannwg University Health Board, Cardiff, UK
| | - Dawn Cavanagh
- Life Sciences and Education, University of South Wales, Treforest, UK
| | - Sion Tetlow
- Welsh Institute for Health and Social Care University of South Wales, Treforest, UK
| | - Carolyn Wallace
- Life Sciences and Education, University of South Wales, Treforest, UK
- Wales School for Social Prescribing Research (WSSPR), UK
| |
Collapse
|
9
|
Rapo E, Johansson E, Jonsson F, Hörnsten Å, Lundgren AS, Nilsson I. Critical components of social prescribing programmes with a focus on older adults - a systematic review. Scand J Prim Health Care 2023; 41:326-342. [PMID: 37485982 PMCID: PMC10478612 DOI: 10.1080/02813432.2023.2237078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 07/11/2023] [Indexed: 07/25/2023] Open
Abstract
AIMS The aim of this study was to identify and evaluate critical components within social prescribing programmes that can impact loneliness, health, or well-being among older adults. METHODS A systematic review with a narrative synthesis was conducted by systematically searching five databases. A total of 1193 hits were identified, screened, and assessed. Twelve studies were included, with data being extracted and deductively analysed in an iterative manner and then tabulated together with outcomes in order to find common narratives. RESULTS Three critical components were identified: Assessment before prescription, matching participants with relevant activities, and individualised support from link worker. These critical components seemed important for the success of social prescribing programmes since they had an impact on loneliness, health, and well-being. All together, these results highlight the importance of person-centeredness in the prescribing process. CONCLUSIONS The three critical components identified may prove useful in further research, evaluation, or implementation of social prescribing programmes. Important aspects for further evaluation are discussed.
Collapse
Affiliation(s)
- Emil Rapo
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Erika Johansson
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Frida Jonsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Åsa Hörnsten
- Department of Nursing, Umeå Univesity, Umeå, Sweden
| | | | - Ingeborg Nilsson
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| |
Collapse
|
10
|
Davies M, Elliott M, Wallace S, Wallace C. Enhancing Student Wellbeing Through Social Prescribing: A Rapid Realist Review. Public Health Rev 2023; 44:1605189. [PMID: 37614322 PMCID: PMC10442486 DOI: 10.3389/phrs.2023.1605189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/17/2023] [Indexed: 08/25/2023] Open
Abstract
Objectives: A Rapid Realist Review of social prescribing in Higher Education (HE) was undertaken to determine what works, for whom, how, why, and within what circumstances. The review resulted in the development of a Realist Programme Theory articulating the way in which social prescribing can be implemented within the HE environment. Methods: Searches of 12 electronic databases were supplemented by citation chaining and grey literature surfaced by the Project Advisory Group. The RAMESES Quality Standards for Realist Review were followed, and the retrieved articles were systematically screened and iteratively analysed to develop Context-Mechanism-Outcome Configurations (CMOCs) and an overarching Realist Programme Theory. Results: A total of 57 documents were included. The overarching programme theory was developed from the analysis of these documents and comprised of a social prescribing pathway with the following components: (1) An Accessible Gateway, (2) A Skilled Peer, (3) Trusted-Safe-Credible Resources, and (4) A Healthy Setting. Conclusion: A Realist Programme Theory was developed-this model and associated principles will provide a theoretical basis for the implementation of social prescribing pathways within higher education. Whilst the direct project outputs are of particular significance to the UK HE audience, the underpinning principles can support practice within the global arena.
Collapse
Affiliation(s)
- Mark Davies
- PRIME Centre Wales, University of South Wales, Pontypridd, United Kingdom
| | - Megan Elliott
- PRIME Centre Wales, University of South Wales, Pontypridd, United Kingdom
- Wales School for Social Prescribing Research (WSSPR), University of South Wales, Pontypridd, United Kingdom
| | - Sarah Wallace
- Welsh Institute for Health and Social Care, University of South Wales, Pontypridd, United Kingdom
| | - Carolyn Wallace
- PRIME Centre Wales, University of South Wales, Pontypridd, United Kingdom
- Wales School for Social Prescribing Research (WSSPR), University of South Wales, Pontypridd, United Kingdom
| |
Collapse
|
11
|
Ebrahimoghli R, Pezeshki MZ, Farajzadeh P, Arab-Zozani M, Mehrtak M, Alizadeh M. Factors influencing social prescribing initiatives: a systematic review of qualitative evidence. Perspect Public Health 2023:17579139231184809. [PMID: 37497769 DOI: 10.1177/17579139231184809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
AIMS Social prescribing is a growing health policy agenda to improve the quality and effectiveness of health systems. However, systematically collected knowledge on factors influencing the effective implementation of SP is scarce. A systematic review was conducted to identify and categorize factors influencing social prescribing initiatives. METHODS A search of three electronic databases (PubMed, Scopus, and ISI Web of Knowledge) was carried out to retrieve studies from inception to May 2022, supplemented by grey literature searching and snowballing of the relevant references. The inclusion criteria were original empirical research, qualitative data collection, and a description of factors affecting social prescribing initiatives. Study quality was evaluated using the Critical Appraisal Skills Programme tool. We categorized the results of individual studies using a narrative approach. RESULTS A total of 23 studies were included for analysis. Along with patient-related factors (patient-centeredness, clinical complexity, perception, knowledge), three main settings of social prescribing initiatives (including healthcare providers, link workers, and voluntary and community sectors) are affected by (1) individual characteristics (knowledge, perception, skill mix); (2) interpersonal relations (collaboration, trust, feedback, supportive climate, follow-up, sustained connection, peer support within and across sectors); (3) organizational contingencies (resource adequacy, staffing, training, role description, continuity of support, caseload management, monitoring, affordability, accessibility, referral criteria, and tailored support); and (4) political context (national policy and guidance, stewardship, planning, cocreation, bureaucracy, economic condition, and the number of support organizations). CONCLUSION Many factors influencing social prescribing initiatives were identified. The results of this review can be applied by different stakeholders of social prescribing to guide development, implementation, description, and evaluation.
Collapse
Affiliation(s)
- R Ebrahimoghli
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Nursing, Institute of Health Education, Ardabil University of Medical Sciences, Ardabil, Iran
| | - M Z Pezeshki
- Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - P Farajzadeh
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - M Mehrtak
- School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - M Alizadeh
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Golgasht St, Azadi Avenue, 5166614711, Tabriz, Iran
| |
Collapse
|
12
|
Brooks H, Devereux-Fitzgerald A, Richmond L, Caton N, Cherry MG, Bee P, Lovell K, Downs J, Edwards BM, Vassilev I, Bush L, Rogers A. Exploring the use of social network interventions for adults with mental health difficulties: a systematic review and narrative synthesis. BMC Psychiatry 2023; 23:486. [PMID: 37420228 PMCID: PMC10329398 DOI: 10.1186/s12888-023-04881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/17/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field. METHODS Systematic searches using combinations of synonyms for mental health difficulties and social network interventions were undertaken across 7 databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science) and 2 grey literature databases (EThoS and OpenGrey) from their inception to October 2021. We included studies reporting primary qualitative and quantitative data from all study types relating to the use of social network interventions for people with mental health difficulties. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Data were extracted and synthesised narratively. RESULTS The review included 54 studies, reporting data from 6,249 participants. Social network interventions were generally beneficial for people with mental health difficulties but heterogeneity in intervention type, implementation and evaluation made it difficult to draw definitive conclusions. Interventions worked best when they (1) were personalised to individual needs, interests and health, (2) were delivered outside formal health services and (3) provided the opportunity to engage in authentic valued activities. Several barriers to access were identified which, without careful consideration could exacerbate existing health inequalities. Further research is required to fully understand condition-specific barriers which may limit access to, and efficacy of, interventions. CONCLUSIONS Strategies for improving social networks for people with mental health difficulties should focus on supporting engagement with personalised and supported social activities outside of formal mental health services. To optimise access and uptake, accessibility barriers should be carefully considered within implementation contexts and equality, diversity and inclusion should be prioritised in intervention design, delivery and evaluation and in future research.
Collapse
Affiliation(s)
- Helen Brooks
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
| | - Angela Devereux-Fitzgerald
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Laura Richmond
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Department of Clinical, Education & Health Psychology, University College London, London, UK
| | - Neil Caton
- Patient and Public Involvement Contributor, University of Manchester, Manchester, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
- Linda McCartney Centre, Liverpool University Hospitals NHS Trust, Prescot St, Liverpool, UK
| | - Penny Bee
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Karina Lovell
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Downs
- Patient and Public Involvement Contributor, Cambridge, UK
| | | | - Ivaylo Vassilev
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
13
|
Oster C, Skelton C, Leibbrandt R, Hines S, Bonevski B. Models of social prescribing to address non-medical needs in adults: a scoping review. BMC Health Serv Res 2023; 23:642. [PMID: 37316920 PMCID: PMC10268538 DOI: 10.1186/s12913-023-09650-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The health and wellbeing consequences of social determinants of health and health behaviours are well established. This has led to a growing interest in social prescribing, which involves linking people to services and supports in the community and voluntary sectors to address non-medical needs. However, there is considerable variability in approaches to social prescribing with little guidance on how social prescribing could be developed to reflect local health systems and needs. The purpose of this scoping review was to describe the types of social prescribing models used to address non-medical needs to inform co-design and decision-making for social prescribing program developers. METHODS We searched Ovid MEDLINE(R), CINAHL, Web of Science, Scopus, National Institute for Health Research Clinical Research Network, Cochrane Central Register of Controlled Trials, WHO International Clinical Trial Registry Platform, and ProQuest - Dissertations and Theses for articles and grey literature describing social prescribing programs. Reference lists of literature reviews were also searched. The searches were conducted on 2 August 2021 and yielded 5383 results following removal of duplicates. RESULTS 148 documents describing 159 social prescribing programs were included in the review. We describe the contexts in which the programs were delivered, the program target groups and services/supports to which participants were referred, the staff involved in the programs, program funding, and the use of digital systems. CONCLUSIONS There is significant variability in social prescribing approaches internationally. Social prescribing programs can be summarised as including six planning stages and six program processes. We provide guidance for decision-makers regarding what to consider when designing social prescribing programs.
Collapse
Affiliation(s)
- Candice Oster
- College of Nursing & Health Sciences, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Claire Skelton
- College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| | - Richard Leibbrandt
- College of Science & Engineering, Flinders University, Adelaide, SA, Australia
| | - Sonia Hines
- College of Medicine & Public Health, Flinders Rural and Remote Health, Flinders University, Alice Springs, Northern Territory, Australia
| | - Billie Bonevski
- College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
14
|
Renmans D, Castellano Pleguezuelo V. Methods in realist evaluation: A mapping review. EVALUATION AND PROGRAM PLANNING 2023; 97:102209. [PMID: 36571967 DOI: 10.1016/j.evalprogplan.2022.102209] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/18/2022] [Indexed: 06/19/2023]
Abstract
Realist evaluation is becoming increasingly popular as an evaluation methodology. Its main objective is to uncover the mechanisms that lead to observed outcomes following an intervention and the contextual conditions that enabled this. The focus is on explaining why, for whom and in what circumstances an intervention works. It is a theory-driven approach and is explicitly method neutral, meaning that both quantitative and qualitative data collection methods can be used to unearth the underlying mechanisms that cause the intervention outcomes. In this review, we aim to map the methods used in realist evaluation studies, to draw lessons from the findings and to reflect on ways forward. We found that qualitative methods and interviews specifically are most commonly used in realist evaluations; that theory is often absent behind the methods and sampling techniques used; and that more innovative methods remain underexplored. We conclude the review by proposing four ways forward: (1) developing realist surveys, (2) exploring the relevance of innovative methods, (3) increasing the attention paid to sampling procedures and (4) strengthening the theory-driven nature of method. We believe that these four action points can strengthen the practice of realist evaluation and its outcomes.
Collapse
Affiliation(s)
- Dimitri Renmans
- Ecole de Santé Publique, Université Libre de Bruxelles, Route du Lennik 808, 1070 Brussels, Belgium; Institute of Development Policy (IOB), University of Antwerp, Lange Sint-Annastraat 7, 2000 Antwerp, Belgium.
| | | |
Collapse
|
15
|
Yamashiro S, Kita K. Realist approach to community-based participatory research on a community health break-down in Japan: mechanism reasoning, knowledge and a trust partnership. BMC PRIMARY CARE 2023; 24:81. [PMID: 36959564 PMCID: PMC10037861 DOI: 10.1186/s12875-023-02037-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/14/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Our 10-year programme of community health regeneration and community-based participatory research (CBPR) was initially unknown. However, we succeeded in creating a collaboration between residents, medical staff, and administrative staff. We adopted a realist approach as an evaluation method. METHODS The realist approach evaluates a programme using a Context-Mechanism-Outcome configuration (CMOc), which is a relatively new methodology. First, the programme manager summarised the entire programme, conducted questionnaires and interviews with seven core members, and summarised each into a CMOc. The programme was evaluated with particular focus on mechanistic reasoning. RESULTS The number of doctors and nurses increased and residents became more active. The success factors were the acquisition of participants' knowledge and trust partnerships. In addition, it was important that the timing of the activity was good and that the participants were highly conscious. CONCLUSIONS The 10-year CBPR was examined using a realist evaluation method. Knowledge acquisition and trust partnerships are important for reasoning mechanism.
Collapse
Affiliation(s)
- Seiji Yamashiro
- Department of General Medicine, Toyama University Hospital, Toyama, Japan.
| | - Keiichiro Kita
- Department of General Medicine, Toyama University Hospital, Toyama, Japan
| |
Collapse
|
16
|
Bernard K, Wildman JM, Tanner LM, Stoniute A, Still M, Green R, Eastaugh C, Sowden S, Thomson KH. Experiences of Non-Pharmaceutical Primary Care Interventions for Common Mental Health Disorders in Socioeconomically Disadvantaged Groups: A Systematic Review of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5237. [PMID: 37047854 PMCID: PMC10094719 DOI: 10.3390/ijerph20075237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/07/2023] [Accepted: 03/12/2023] [Indexed: 06/19/2023]
Abstract
Common mental health disorders (CMDs) disproportionately affect people experiencing socioeconomic disadvantage. Non-pharmaceutical interventions, such as 'social prescribing' and new models of care and clinical practice, are becoming increasingly prevalent in primary care. However, little is known about how these interventions work and their impact on socioeconomic inequalities in health. Focusing on people experiencing socioeconomic disadvantage, this systematic review aims to: (1) explore the mechanisms by which non-pharmaceutical primary care interventions impact CMD-related health outcomes and inequalities; (2) identify the barriers to, and facilitators of, their implementation in primary care. This study is a systematic review of qualitative studies. Six bibliographic databases were searched (Medline, ASSIA, CINAHL, Embase, PsycInfo and Scopus) and additional grey literature sources were screened. The included studies were thematically analysed. Twenty-two studies were included, and three themes were identified: (1) agency; (2) social connections; (3) socioeconomic environment. The interventions were experienced as being positive for mental health when people felt a sense of agency and social connection. The barriers to effectiveness and engagement included socioeconomic deprivation and underfunding of community sector organisations. If non-pharmaceutical primary care interventions for CMDs are to avoid widening health inequalities, key socioeconomic barriers to their accessibility and implementation must be addressed.
Collapse
Affiliation(s)
- Kate Bernard
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
| | - Josephine M. Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) for the North-East and North Cumbria (NENC), Newcastle NE4 5TG, UK
| | - Louise M. Tanner
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
- National Institute for Health and Care Research (NIHR) Innovation Observatory, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
| | - Akvile Stoniute
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
- National Institute for Health and Care Research (NIHR) Innovation Observatory, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
| | - Madeleine Still
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
| | - Rhiannon Green
- National Institute for Health and Care Research (NIHR) Innovation Observatory, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
| | - Claire Eastaugh
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
| | - Sarah Sowden
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) for the North-East and North Cumbria (NENC), Newcastle NE4 5TG, UK
| | - Katie H. Thomson
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE2 4AA, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) for the North-East and North Cumbria (NENC), Newcastle NE4 5TG, UK
| |
Collapse
|
17
|
Calderón-Larrañaga S, Greenhalgh T, Clinch M, Robson J, Dostal I, Eto F, Finer S. Unravelling the potential of social prescribing in individual-level type 2 diabetes prevention: a mixed-methods realist evaluation. BMC Med 2023; 21:91. [PMID: 36907857 PMCID: PMC10008720 DOI: 10.1186/s12916-023-02796-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/20/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Social prescribing (SP) usually involves linking patients in primary care with services provided by the voluntary and community sector. Preliminary evidence suggests that SP may offer a means of connecting patients with community-based health promotion activities, potentially contributing to the prevention of long-term conditions, such as type 2 diabetes (T2D). METHODS Using mixed-methods realist evaluation, we explored the possible contribution of SP to individual-level prevention of T2D in a multi-ethnic, socio-economically deprived population in London, UK. We made comparisons with an existing prevention programme (NHS Diabetes Prevention Programme (NDPP)) where relevant and possible. Anonymised primary care electronic health record data of 447,360 people 18+ with an active GP registration between December 2016 and February 2022 were analysed using quantitative methods. Qualitative data (interviews with 11 primary care clinicians, 11 social prescribers, 13 community organisations and 8 SP users at high risk of T2D; 36 hours of ethnographic observations of SP and NDPP sessions; and relevant documents) were analysed thematically. Data were integrated using visual means and realist methods. RESULTS People at high risk of T2D were four times more likely to be referred into SP than the eligible general population (RR 4.31 (95% CI 4.17-4.46)), with adjustment for socio-demographic variables resulting in attenuation (RR 1.33 (95% CI 1.27-1.39)). More people at risk of T2D were referred to SP than to NDPP, which could be explained by the broad referral criteria for SP and highly supportive (proactive, welcoming) environments. Holistic and sustained SP allowed acknowledgement of patients' wider socio-economic constraints and provision of long-term personalised care. The fact that SP was embedded within the local community and primary care infrastructure facilitated the timely exchange of information and cross-referrals across providers, resulting in enhanced service responsiveness. CONCLUSIONS Our study suggests that SP may offer an opportunity for individual-level T2D prevention to shift away from standardised, targeted and short-term strategies to approaches that are increasingly personalised, inclusive and long-term. Primary care-based SP seems most ideally placed to deliver such approaches where practitioners, providers and commissioners work collectively to achieve holistic, accessible, sustained and integrated services.
Collapse
Affiliation(s)
- Sara Calderón-Larrañaga
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
- Bromley By Bow Health Partnership, XX Place Health Centre, Mile End Hospital, Bancroft Rd, Bethnal Green, London, E1 4DG, UK.
| | - Trish Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd, Oxford, OX2 6GG, UK
| | - Megan Clinch
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - John Robson
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - Isabel Dostal
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - Fabiola Eto
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - Sarah Finer
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
- Barts Health NHS Trust, Newham University Hospital, Glen Rd, London, E13 8SL, UK
| |
Collapse
|
18
|
Moffatt S, Wildman J, Pollard TM, Gibson K, Wildman JM, O’Brien N, Griffith B, Morris SL, Moloney E, Jeffries J, Pearce M, Mohammed W. Impact of a social prescribing intervention in North East England on adults with type 2 diabetes: the SPRING_NE multimethod study. PUBLIC HEALTH RESEARCH 2023; 11:1-185. [DOI: 10.3310/aqxc8219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background
Link worker social prescribing enables health-care professionals to address patients’ non-medical needs by linking patients into various services. Evidence for its effectiveness and how it is experienced by link workers and clients is lacking.
Objectives
To evaluate the impact and costs of a link worker social prescribing intervention on health and health-care costs and utilisation and to observe link worker delivery and patient engagement.
Data sources
Quality Outcomes Framework and Secondary Services Use data.
Design
Multimethods comprising (1) quasi-experimental evaluation of effects of social prescribing on health and health-care use, (2) cost-effectiveness analysis, (3) ethnographic methods to explore intervention delivery and receipt, and (4) a supplementary interview study examining intervention impact during the first UK COVID-19 lockdown (April–July 2020).
Study population and setting
Community-dwelling adults aged 40–74 years with type 2 diabetes and link workers in a socioeconomically deprived locality of North East England, UK.
Intervention
Link worker social prescribing to improve health and well-being-related outcomes among people with long-term conditions.
Participants
(1) Health outcomes study, approximately n = 8400 patients; EuroQol-5 Dimensions, five-level version (EQ-5D-5L), study, n = 694 (baseline) and n = 474 (follow-up); (2) ethnography, n = 20 link workers and n = 19 clients; and COVID-19 interviews, n = 14 staff and n = 44 clients.
Main outcome measures
The main outcome measures were glycated haemoglobin level (HbA1c; primary outcome), body mass index, blood pressure, cholesterol level, smoking status, health-care costs and utilisation, and EQ-5D-5L score.
Results
Intention-to-treat analysis of approximately 8400 patients in 13 intervention and 11 control general practices demonstrated a statistically significant, although not clinically significant, difference in HbA1c level (–1.11 mmol/mol) and a non-statistically significant 1.5-percentage-point reduction in the probability of having high blood pressure, but no statistically significant effects on other outcomes. Health-care cost estimates ranged from £18.22 (individuals with one extra comorbidity) to –£50.35 (individuals with no extra comorbidity). A statistically non-significant shift from unplanned (non-elective and accident and emergency admissions) to planned care (elective and outpatient care) was observed. Subgroup analysis showed more benefit for individuals living in more deprived areas, for the ethnically white and those with fewer comorbidities. The mean cost of the intervention itself was £1345 per participant; the incremental mean health gain was 0.004 quality-adjusted life-years (95% confidence interval –0.022 to 0.029 quality-adjusted life-years); and the incremental cost-effectiveness ratio was £327,250 per quality-adjusted life-year gained. Ethnographic data showed that successfully embedded, holistic social prescribing providing supported linking to navigate social determinants of health was challenging to deliver, but could offer opportunities for improving health and well-being. However, the intervention was heterogeneous and was shaped in unanticipated ways by the delivery context. Pressures to generate referrals and meet targets detracted from face-to-face contact and capacity to address setbacks among those with complex health and social problems.
Limitations
The limitations of the study include (1) a reduced sample size because of non-participation of seven general practices; (2) incompleteness and unreliability of some of the Quality and Outcomes Framework data; (3) unavailability of accurate data on intervention intensity and patient comorbidity; (4) reliance on an exploratory analysis with significant sensitivity analysis; and (5) limited perspectives from voluntary, community and social enterprise.
Conclusions
This social prescribing model resulted in a small improvement in glycaemic control. Outcome effects varied across different groups and the experience of social prescribing differed depending on client circumstances.
Future work
To examine how the NHS Primary Care Network social prescribing is being operationalised; its impact on health outcomes, service use and costs; and its tailoring to different contexts.
Trial registration
This trial is registered as ISRCTN13880272.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme, Community Groups and Health Promotion (grant no. 16/122/33) and will be published in full in Public Health Research; Vol. 11, No. 2. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Suzanne Moffatt
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Kate Gibson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Josephine M Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola O’Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Bethan Griffith
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Eoin Moloney
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jayne Jeffries
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mark Pearce
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Wael Mohammed
- Public Health Economics and Decision Science (DTC), Sheffield University, Sheffield, UK
| |
Collapse
|
19
|
Hopkins G, Winrow E, Davies C, Seddon D. Beyond social prescribing-The use of social return on investment (SROI) analysis in integrated health and social care interventions in England and Wales: A protocol for a systematic review. PLoS One 2023; 18:e0277386. [PMID: 36802392 PMCID: PMC9942995 DOI: 10.1371/journal.pone.0277386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/27/2023] [Indexed: 02/23/2023] Open
Abstract
With increasing costs of healthcare in England and Wales following the COVID-19 pandemic, finding alternatives to traditional medical interventions is more important than ever. Social prescribing provides a way of addressing health and well-being through using non-medical methods that may help relieve costs to the NHS. Evaluating interventions, such as social prescribing, which have high social (but not easily quantifiable) value, can be problematic. Social return on investment (SROI) is a method of assigning monetary values to both social value as well as traditional assets, so provides a way of evaluating social prescribing initiatives. This protocol outlines the steps that will be taken in a systematic review of the SROI literature surrounding social prescribing-type integrated health and social care interventions based in the community in England and Wales. Online academic databases such as PubMed Central, ASSIA and Web of Science will be searched, as will grey literature sources such as Google Scholar, the Wales School for Social Prescribing Research (WSSPR) and Social Value UK. Titles and abstracts from the articles returned by the searches will be reviewed by one researcher. Those selected for full text review will be independently reviewed and compared by two researchers. Where the researchers disagree a third reviewer will help resolve any differences. Information collected will include identifying stakeholder groups, assessing the quality of SROI analyses, identifying intended and unintended changes of social prescribing interventions, and comparing social prescribing initiatives in terms of SROI costs and benefits. Quality assessment will be independently conducted on the selected papers by two researchers. The researchers will discuss to obtain consensus. Where there is disagreement, a third researcher will resolve these cases. A pre-existing quality framework will be developed and used to assess the quality of the literature. Protocol registration Prospero registration number: CRD42022318911.
Collapse
Affiliation(s)
- Genevieve Hopkins
- Centre for Health Economics and Medicines Evaluation (CHEME), School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
- * E-mail:
| | - Eira Winrow
- School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| | - Ceryl Davies
- School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| | - Diane Seddon
- Centre for Ageing and Dementia Research, School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| |
Collapse
|
20
|
Lawler C, Sherriff G, Brown P, Butler D, Gibbons A, Martin P, Probin M. Homes and health in the Outer Hebrides: A social prescribing framework for addressing fuel poverty and the social determinants of health. Health Place 2023; 79:102926. [PMID: 36442316 DOI: 10.1016/j.healthplace.2022.102926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 08/18/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022]
Abstract
Health services are increasingly being reshaped with reference to addressing social determinants of health (SDoH), with social prescribing a prominent example. We examine a project in the Outer Hebrides that reshaped and widened the local health service, framing fuel poverty as a social determinant of health and mobilising a cross-sector support pathway to make meaningful and substantive improvements to islanders' living conditions. The 'Moving Together' project provided support to almost 200 households, ranging from giving advice on home energy, finances and other services, to improving the energy efficiency of their homes. In so doing, the project represents an expansion of the remit of social prescribing, in comparison with the majority of services currently provided under this banner, and can be seen as a more systemic approach that engages with the underlying conditions of a population's health. We present a framework through which to understand and shape initiatives to address fuel poverty through a social prescribing approach.
Collapse
Affiliation(s)
- Cormac Lawler
- Salford Social Prescribing Hub, School of Health & Society, University of Salford, Salford, M6 6PU, UK.
| | - Graeme Sherriff
- Sustainable Housing & Urban Studies Unit (SHUSU), School of Health & Society, University of Salford, Salford, M6 6PU, UK.
| | - Philip Brown
- School of Human and Health Sciences, University of Huddersfield, HD1 3DH, UK.
| | - Danielle Butler
- National Energy Action, West One, Forth Banks, Newcastle upon Tyne, NE1 3PA, UK.
| | - Andrea Gibbons
- Sustainable Housing & Urban Studies Unit (SHUSU), School of Health & Society, University of Salford, Salford, M6 6PU, UK.
| | - Philip Martin
- Sustainable Housing & Urban Studies Unit (SHUSU), School of Health & Society, University of Salford, Salford, M6 6PU, UK.
| | - Margaret Probin
- Sustainable Housing & Urban Studies Unit (SHUSU), School of Health & Society, University of Salford, Salford, M6 6PU, UK.
| |
Collapse
|
21
|
Reuter A, Xu W, Iwarsson S, Olsson T, Schmidt SM. Optimising conditions and environments for digital participation in later life: A macro-meso-micro framework of partnership-building. Front Psychol 2023; 14:1107024. [PMID: 36936014 PMCID: PMC10017487 DOI: 10.3389/fpsyg.2023.1107024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
The ongoing digitalisation of societies, exacerbated by the COVID-19 pandemic, has led to increased efforts to ensure the digital inclusion of older adults. Digital inclusion strategies throughout the COVID-19 pandemic predominantly focused on increasing access and basic digital literacy of Information and Communication Technologies (ICTs) for all members of society. Older adults, who are more likely to experience digital exclusion, are amongst the target groups of digital inclusion strategies. We propose that beyond digital inclusion, there is a need to focus on digital participation and optimise opportunities for everyone to participate in communities and society in post-pandemic times. Creative digital skills are the foundation of digital participation and can lead to a variety of contributions. Digital participation offers conditions that support agency and active contributions in a digitalised society. Taking macro-, meso-, and micro-level enablers of digital participation in later life into account, we argue for the establishment and implementation of multi-layered and multisectoral partnerships that address environmental factors (including social and physical dimensions) of digital participation and create opportunities for diverse, meaningful and fulfilling engagement with ICTs in later life. The partnership approach can be used in designing and implementing digital participation programmes and should be further evaluated against the needs and lived experiences of older individuals. Foresighted research is needed to investigate key factors of effective partnerships for optimising environments for digital participation in later life.
Collapse
Affiliation(s)
- Arlind Reuter
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- *Correspondence: Arlind Reuter,
| | - Wenqian Xu
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Susanne Iwarsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Tobias Olsson
- Department of Culture, Languages and Media, Faculty of Education and Society, Malmö University, Malmö, Sweden
| | - Steven M. Schmidt
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
22
|
Lawson JT, Wissing R, Henderson-Wilson C, Snell T, Chambers TP, McNeil DG, Nuttman S. Health empowerment scripts: Simplifying social/green prescriptions. Front Psychol 2022; 13:889250. [DOI: 10.3389/fpsyg.2022.889250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Social prescriptions are one term commonly used to describe non-pharmaceutical approaches to healthcare and are gaining popularity in the community, with evidence highlighting psychological benefits of reduced anxiety, depression and improved mood and physiological benefits of reduced risk of cardiovascular disease and reduced hypertension. The relationship between human health benefits and planetary health benefits is also noted. There are, however, numerous barriers, such as duration and frequencies to participate in activities, access, suitability, volition and a range of unpredictable variables (such as inclement weather, shifting interests and relocating home amongst others) impeding a comprehensive approach to their use on a wider scale. From a multidisciplinary perspective, this commentary incorporates a salutogenic and nature-based approach to health, we also provide a range of recommendations that can be undertaken at the patient level to assist in shifting the acknowledged systemic barriers currently occurring. These include using simple language to explain the purpose of health empowerment scripts, ensuing personal commitment to a minimum timeframe, enabling ease of access, co-designing a script program, providing ongoing motivational support and incorporating mindfulness to counter unexpected disruptions.
Collapse
|
23
|
Sharman LS, McNamara N, Hayes S, Dingle GA. Social prescribing link workers-A qualitative Australian perspective. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6376-e6385. [PMID: 36271695 PMCID: PMC10092430 DOI: 10.1111/hsc.14079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/12/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Social prescribing (or community referral) is a model of healthcare designed to address social needs that contribute to poor health. At the heart of social prescribing programs is the link worker, who liaises between clients, health professionals and community organisations. Social prescribing is newly emerging in Australia but there are already calls for a large-scale roll out. This research, therefore, aimed to understand Australian link workers' role and skills required, to determine where such a workforce could be drawn from in Australia, and to identify what training and resources are needed to support this potential new workforce. To explore these questions, interviews were conducted with 15 link workers in Queensland, New South Wales and Victoria, and the transcripts were analysed using thematic analysis. Participants were predominantly female (87%); and primarily had qualifications in social work (47%) or nursing (27%). Three overarching themes were identified: (1) skills of successful social prescribing, identifying that link work requires multifaceted social and emotional skills; (2) workforce issues, presenting that link workers experienced challenges such as a lack of available support and training, lack of public awareness of social prescribing and a lack of sustained funding; and (3) job fulfilment, related to link workers' sense of reward and accomplishment from the job. We suggest that fostering job fulfilment in conjunction with the provision of increased support, training and security will reduce feelings of overwork and burnout among link workers and likely lead to longevity in the role. Social prescribing has the potential to be hugely beneficial to clients and the community and fulfilling for link workers, provided that sufficient advocacy and resources are put in place.
Collapse
Affiliation(s)
- Leah S. Sharman
- School of PsychologyUniversity of QueenslandSt LuciaAustralia
| | | | - Shaun Hayes
- School of PsychologyUniversity of QueenslandSt LuciaAustralia
| | | |
Collapse
|
24
|
Tierney S, Potter C, Eccles K, Akinyemi O, Gorenberg J, Libert S, Wong G, Turk A, Husk K, Chatterjee HJ, Webster E, McDougall B, Warburton H, Shaw L, Mahtani KR. Social prescribing for older people and the role of the cultural sector during the COVID-19 pandemic: What are link workers' views and experiences? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5305-e5313. [PMID: 35869795 PMCID: PMC9349870 DOI: 10.1111/hsc.13949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/16/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Older people's well-being can be bolstered by engaging with cultural activities and venues. They may be encouraged to try cultural offers by a link worker as part of social prescribing. However, the cultural sector, like all parts of life, was affected by the COVID-19 pandemic; this has had implications for cultural offers available to link workers. A study was conducted to explore the views and experiences of link workers in using the cultural sector within social prescribing, particularly for older people (aged 60+) during the pandemic. An online questionnaire was distributed to and completed by link workers in the UK. Data were analysed mainly using descriptive statistics. Open text responses were clustered into similar ideas to create key concepts. Useable responses were received from 148 link workers. They highlighted a general lack of interaction between link workers and the cultural sector about how the latter could support social prescribing. Results suggested that personal familiarity with cultural offers might prompt link workers to refer to them. Some respondents proposed that cultural offers were regarded as elitist, which deterred them from referring there. However, there was a general acknowledgement that the cultural sector could contribute to social prescribing. Link workers need to regard the cultural sector as accessible, appropriate, adequate, affordable and available before referring older people to cultural offers as part of social prescribing. Link workers may benefit from becoming more familiar with cultural sector staff and offers, including online resources, so they can then propose them to patients with confidence.
Collapse
Affiliation(s)
- Stephanie Tierney
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Caroline Potter
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | | | - Oluwafunmi Akinyemi
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Jordan Gorenberg
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Sebastien Libert
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Geoff Wong
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Amadea Turk
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Kerryn Husk
- Peninsula Medical SchoolUniversity of PlymouthPlymouthUK
| | | | - Emma Webster
- Gardens, Libraries and MuseumsUniversity of OxfordOxfordUK
| | - Beth McDougall
- Gardens, Libraries and MuseumsUniversity of OxfordOxfordUK
| | | | - Lucy Shaw
- Gardens, Libraries and MuseumsUniversity of OxfordOxfordUK
| | - Kamal R. Mahtani
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| |
Collapse
|
25
|
White C, Bell J, Reid M, Dyson J. More than signposting: Findings from an evaluation of a social prescribing service. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5105-e5114. [PMID: 35915879 DOI: 10.1111/hsc.13925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/03/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
This paper presents findings from an evaluation of a social prescribing service, undertaken between January 2019 and December 2020. Data was collected through interviews and focus groups with a range of groups including social prescribing managers, link workers (LWs), referrers (GPs and social work practitioners), clients, Voluntary and Community Sector (VCS) agencies and groups. Thematic analysis of data was undertaken, and findings were presented in respect of clients' journeys into social prescribing; the support received from LWs; their onward journeys to VCS support. The findings highlight the challenges for individuals in contacting new agencies/groups and the importance of practitioner referral into and onwards from social prescribing, as well as buddying to support clients on initial agency visits. The depth of the LW role is highlighted, as well as the complexity of client circumstances, highlighting a need for 'more than signposting', and challenging the notion of self-referral as an indicator of motivation. Social prescribing has been positioned as amongst the solutions to the challenges of primary care. However, referrals from GPs were low and significantly outnumbered by those from social workers; this suggests a need to explore in greater depth the use of social prescribing by social workers, who have, to date, been absent from social prescribing research.
Collapse
Affiliation(s)
- Caroline White
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Jo Bell
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Marie Reid
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Judith Dyson
- Faculty of Health Sciences, University of Hull, Hull, UK
- Centre for Social Care, Health and Related Research, Birmingham City University, Birmingham, UK
| |
Collapse
|
26
|
Westlake D, Elston J, Gude A, Gradinger F, Husk K, Asthana S. Impact of COVID-19 on social prescribing across an Integrated Care System: A Researcher in Residence study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4086-e4094. [PMID: 35355347 PMCID: PMC9111657 DOI: 10.1111/hsc.13802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/25/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Emerging evidence suggests that connecting people to non-medical activities in the community (social prescribing) may relieve pressure on services by promoting autonomy and resilience, thereby improving well-being and self-management of health. This way of working has a long history in the voluntary and community sector but has only recently been widely funded by the National Health Service (NHS) in England and implemented in Primary Care Networks (PCNs). The COVID-19 global pandemic coincided with this new service. There is wide variation in how social prescribing is implemented and scant evidence comparing different delivery models. As embedded researchers within an Integrated Care System in the Southwest of England, we examined the impact of COVID on the implementation of social prescribing in different employing organisations during the period March 2020 to April 2021. Data were collected from observations and field notes recorded during virtual interactions with over 80 social prescribing practitioners and an online survey of 52 social prescribing practitioners and middle managers. We conceptualise social prescribing as a pathway comprising access, engagement and activities, facilitated by workforce and community assets and strategic partnerships. We found that these elements were all impacted by the pandemic, but to different degrees according to the way the service was contracted, whether referrals (access) and approach (engagement) were universal ('open') or targeted ('boundaried') and the extent to which practitioners' roles were protected or shifted towards immediate COVID-specific work. Social prescribers contracted in PCNs were more likely to operate an 'open' model, although boundaries were developing over time. We suggest the presence of an explicit, agreed delivery model (whether 'open' or 'boundaried') might create a more coherent approach less likely to result in practitioner role drift, whilst allowing flexibility to adjust to the pandemic and enhancing practitioner satisfaction and well-being. The potential consequences of different models are examined.
Collapse
Affiliation(s)
- Debra Westlake
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
- Centre for Evidence‐Based MedicineNuffield Department of Primary Care Health SciencesUniversity of OxfordRadcliffe Observatory QuarterOxfordUK
- Present address:
Centre for Evidence‐Based MedicineNuffield Department of Primary Care Health SciencesUniversity of OxfordRadcliffe Observatory QuarterOxfordUK
| | - Julian Elston
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
| | - Alex Gude
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
| | - Felix Gradinger
- Community and Primary Care Research GroupFaculty of Health, Medicine, Dentistry and Human SciencesUniversity of PlymouthPlymouthUK
| | - Kerryn Husk
- Applied Research Collaboration South West Peninsula (PenARC)Faculty of Health, MedicineDentistry and Human SciencesUniversity of PlymouthNational Institute for Health ResearchPlymouthUK
| | - Sheena Asthana
- Plymouth Institute of Health and Care ResearchPlymouthUK
| |
Collapse
|
27
|
Sandhu S, Lian T, Drake C, Moffatt S, Wildman J, Wildman J. Intervention components of link worker social prescribing programmes: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3761-e3774. [PMID: 36181384 DOI: 10.1111/hsc.14056] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 08/15/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
In the United Kingdom (UK), link worker social prescribing has emerged as an option to improve long-term condition management and address primary care patients' non-medical needs by linking patients with community-based activities and support. Social prescribing is a complex, heterogenous intervention, and there is currently no taxonomy of components to guide its implementation and evaluation. This study aimed to identify and categorise the components of link worker social prescribing schemes in the United Kingdom. A scoping review of peer-reviewed literature was conducted. Six databases were used to identify papers that met inclusion criteria. Eligible articles were original research studies in the United Kingdom describing interventions that included (1) initial referral of adults with chronic physical health conditions and/or unmet social needs from primary care to a link worker or equivalent role, (2) consultation with a link worker or equivalent role and (3) referral to a community-based or government service. Of the 1078 articles identified, 32 met study eligibility criteria, representing 22 social prescribing schemes. We drew from the template for intervention description and replication (TIDieR) to identify, organise and report intervention components. We found wide variations in geography, target populations and intervention components such as activities and procedures conducted by primary care staff and link workers, organisational and staffing configurations and use of tools and financing approaches to facilitate adoption. Intervention components are summarised into a taxonomy to guide future research, policy and practice efforts in addition to supporting standardised intervention reporting.
Collapse
Affiliation(s)
- Sahil Sandhu
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Harvard Medical School, Boston, Massachusetts, USA
| | - Tyler Lian
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Connor Drake
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Suzanne Moffatt
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - John Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Josephine Wildman
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| |
Collapse
|
28
|
Cresswell-Smith J, Kauppinen T, Laaksoharju T, Rotko T, Solin P, Suvisaari J, Wahlbeck K, Tamminen N. Mental Health and Mental Wellbeing Impact Assessment Frameworks-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13985. [PMID: 36360865 PMCID: PMC9653904 DOI: 10.3390/ijerph192113985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Mental health is largely shaped by the daily environments in which people live their lives, with positive components of mental health emphasising the importance of feeling good and functioning effectively. Promoting mental health relies on broad-based actions over multiple sectors, which can be difficult to measure. Different types of Impact Assessment (IA) frameworks allow for a structured approach to evaluating policy actions on different levels. A systematic review was performed exploring existing IA frameworks relating to mental health and mental wellbeing and how they have been used. A total of 145 records were identified from the databases, from which 9 articles were included in the review, with a further 6 studies included via reference list and citation chaining. Five different mental-health-related IA frameworks were found to be implemented in a variety of settings, mostly in relation to evaluating community actions. A Narrative Synthesis summarised key themes from the 15 included articles. Findings highlight the need for participatory approaches in IA, which have the dual purpose of informing the IA evaluation and advocating for the need to include mental health in policy development. However, it is important to ensure that IA frameworks are user-friendly, designed to be used by laypeople in a variety of sectors and that IA frameworks are operational in terms of time and monetary resources.
Collapse
Affiliation(s)
| | - Tapani Kauppinen
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | | | - Tuulia Rotko
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Pia Solin
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Jaana Suvisaari
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | | | - Nina Tamminen
- Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| |
Collapse
|
29
|
Araki K, Takahashi Y, Okada H, Nakayama T. Social prescribing from the patient's perspective: A literature review. J Gen Fam Med 2022; 23:299-309. [PMID: 36093223 PMCID: PMC9444010 DOI: 10.1002/jgf2.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Social prescribing (SP) has aroused widespread interest across countries. SP is a way of linking patients in primary care with sources of support within the community by empowering patients to coproduce solutions to improve their health and well-being. While previous research has demonstrated that SP contributes to reducing the total cost of the National Health Service, the analysis of its effects on patients is still inadequate. This literature review critically evaluated SP from the patient's perspective through the lens of medical anthropology. The review was made with respect to the three key concepts: treatment evaluation, coproduction, and empowerment. The study revealed that SP services in the UK enabled patients to feel comfort in many cases, but general practitioners, link workers, and patients should be collaborative with each other, and their interrelationships should not be hierarchical. Nevertheless, certain modifications may be needed to introduce SP in other healthcare systems.
Collapse
Affiliation(s)
- Kazuo Araki
- Department of Health Informatics, School of Public HealthKyoto University Graduate School of MedicineKyoto PrefectureKyotoJapan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, School of Public HealthKyoto University Graduate School of MedicineKyoto PrefectureKyotoJapan
| | - Hiroshi Okada
- Department of Health Informatics, School of Public HealthKyoto University Graduate School of MedicineKyoto PrefectureKyotoJapan
| | - Takeo Nakayama
- Department of Health Informatics, School of Public HealthKyoto University Graduate School of MedicineKyoto PrefectureKyotoJapan
| |
Collapse
|
30
|
Kloppe T, Tetzlaff B, Mews C, Zimmermann T, Scherer M. Interprofessional collaboration to support patients with social problems in general practice-a qualitative focus group study. BMC PRIMARY CARE 2022; 23:169. [PMID: 35788186 PMCID: PMC9251943 DOI: 10.1186/s12875-022-01782-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 06/23/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Social problems of patients such as family or work-related conflicts as well as financial difficulties affect the individual health situation and the treatment of diseases in general practice. General practitioners (GPs) would like to have direct access to professionals in social care services. In Germany, there are many different social care facilities for people with a wide range of social problems. As the social and health care systems hardly interact collaborations between social professionals (SPs) and GPs are rare exceptions. This study explored perspectives of GPs regarding their patients with social problems in combination with the perspectives of SPs. Aim of this study was to explore how a systematic interprofessional collaboration between GPs and SPs could be realised. METHODS We carried out a participatory sequential qualitative study design consisting of two focus groups with GPs, two with SPs and two mixed-professional focus groups with GPs and SPs. The focus groups were conducted with semi-structured moderating guidelines and analysed with a qualitative content analysis approach using inductive and deductive categories. RESULTS GPs view themselves as the first point of contact for their patients' social problems. For persistent social problems, they expressed a desire for support and SPs were willing to provide this. We developed a stepped care implementation model for a systematic cooperation consisting of nine collaboration strategies. These strategies included: index or website of social care services, referrals to the social care system, using flyers and posters of social care services, direct contact/hotline to local social care services, participation in meetings of social care facilities, involving physician assistants, external social care advice service in GP rooms, implementation in education and training and access to volunteers. CONCLUSIONS Our stepped care implementation model for a systematic cooperation of GPs and SPs could be a feasible need- and resource-oriented approach for the collaborative care of patients with social problems to improve their medical treatment in most western healthcare systems. GPs and SPs are ready to generate the necessary evidence for policy makers in high quality RCTs.
Collapse
Affiliation(s)
- Thomas Kloppe
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Britta Tetzlaff
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Claudia Mews
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Thomas Zimmermann
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| |
Collapse
|
31
|
Smyth N, Thorn L, Wood C, Hall D, Lister C. Increased Wellbeing following Engagement in a Group Nature-Based Programme: The Green Gym Programme Delivered by the Conservation Volunteers. Healthcare (Basel) 2022; 10:978. [PMID: 35742030 PMCID: PMC9222393 DOI: 10.3390/healthcare10060978] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 12/04/2022] Open
Abstract
The wellbeing benefits of engaging in a nature-based programme, delivered by the Voluntary, Community and Social Enterprise sector, were examined in this study. Prior to attending The Conservation Volunteers' Green Gym™, attendees (n = 892) completed demographics, health characteristics and the Warwick Edinburgh Mental Wellbeing Short-Form Scale. Attendees (n = 253, 28.4%) provided a measure on average 4.5 months later. There were significant increases in wellbeing after engaging in Green Gym, with the greatest increases in those who had the lowest starting levels of wellbeing. Wellbeing increases were sustained on average 8.5 months and 13 months later in those providing a follow up measure (n = 92, n = 40, respectively). Attendees who continued to engage in Green Gym but not provide follow up data (n = 318, 35.7%) tended to be more deprived, female and self-report a health condition. Attendees who did not continue to engage in Green Gym (n = 321, 36.0%) tended to be less deprived and younger. These findings provide evidence of the wellbeing benefits of community nature-based activities and social ('green') prescribing initiatives and indicate that Green Gym targets some groups most in need.
Collapse
Affiliation(s)
- Nina Smyth
- School of Social Sciences, Psychology, University of Westminster, London W1W 6UW, UK;
| | - Lisa Thorn
- School of Social Sciences, Psychology, University of Westminster, London W1W 6UW, UK;
| | - Carly Wood
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3SQ, UK;
| | - Dominic Hall
- The Conservation Volunteers, Doncaster DN4 8DB, UK;
| | - Craig Lister
- Bedfordshire, Luton and Milton Keynes Integrated Care System, Luton LU1 2LJ, UK;
| |
Collapse
|
32
|
Featherstone C, Sharpe RA, Axford N, Asthana S, Husk K. Health and wellbeing outcomes and social prescribing pathways in community-based support for autistic adults: A systematic mapping review of reviews. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e621-e635. [PMID: 34738679 DOI: 10.1111/hsc.13635] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/08/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Adults on the autism spectrum are affected by health disparities which significantly reduce life expectancy and experience barriers to accessing healthcare. Social prescribing is a holistic approach that diverts patients from primary care to health-enhancing activities in communities. However, there has been a lack of research attention to how autistic people navigate the social prescribing pathway and the ability of these approaches to address existing disparities. This mapping review aimed to synthesise features of non-medical, community-based interventions for autistic adults to assess their suitability for a social prescribing approach. A systematic search and screening process was used to identify literature reviews from medical databases (Embase, Medline, PsycINFO, CINAHL and Cochrane reviews) and grey literature. We extracted data from 24 reviews and 19 studies including types of services, participants, outcomes, settings and procedures. A narrative and visual synthesis is used to map the variety of services and interventions identified, the outcome measures used, and the barriers and facilitators to progression through services in relation to a realist social prescribing framework. The review found that there has been minimal evaluation of holistic, low intensity services for autistic adults, such as those offered in social prescribing approaches. Outcome measures remain focused on features of autism and reveal less about the effects of interventions on health and wellbeing. Aspects of the social prescribing model were identified in the features of service pathways, but findings also suggested how social prescribing could be adapted to improve accessibility for autistic people.
Collapse
Affiliation(s)
- Charlotte Featherstone
- NIHR Applied Research Collaboration (ARC) South West Peninsula, University of Plymouth, Plymouth, UK
| | - Richard A Sharpe
- Public Health, Cornwall Council and European Centre for Environment and Human Health, University of Exeter Medical School, Royal Cornwall Hospital, Truro, UK
| | - Nick Axford
- NIHR Applied Research Collaboration (ARC) South West Peninsula, University of Plymouth, Plymouth, UK
| | - Sheena Asthana
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - Kerryn Husk
- NIHR Applied Research Collaboration (ARC) South West Peninsula, University of Plymouth, Plymouth, UK
| |
Collapse
|
33
|
García-Zapata LM, Alarcón-Gil MT. Mecanismos de evaluaciones realistas en intervenciones de atención primaria en salud en poblaciones rurales y urbanas marginales. Rev Panam Salud Publica 2022; 46:e27. [PMID: 35432499 PMCID: PMC9004694 DOI: 10.26633/rpsp.2022.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/27/2022] [Indexed: 11/24/2022] Open
Abstract
Objetivo.
Identificar los mecanismos reportados en intervenciones de atención primaria en salud (APS) en poblaciones rurales y urbanas marginales entre los años 1997 y 2019.
Métodos.
Se utilizó el método de revisión sistemática exploratoria para identificar la literatura. La búsqueda de literatura fue realizada en las bases de datos Medline (Pubmed y Ovid), Global health, Embase, Web of science, Scopus y Lilacs. La inclusión de literatura consideró estudios de intervención primaria, observacionales con metodologías cualitativas, cuantitativas o mixtas. Se incluyeron artículos en inglés, portugués y español publicados entre 1997 y 2019. Para la selección de documentos definitivos se utilizó Rayyan QCRI, se excluyeron fuentes de información de literatura gris o investigación en progreso.
Resultados.
A nivel individual se identificaron tres grupos de mecanismos: niveles de relaciones entre las intervenciones y los sujetos, transformaciones que pueden generar en los individuos y las relaciones recíprocas. A nivel institucional se relacionaron con la temporalidad, el dinero, relaciones de poder, relaciones de confianza, el sistema de salud, las expectativas y las condiciones administrativas.
Conclusiones.
Los mecanismos individuales son similares en los diferentes contextos, los mecanismos institucionales son susceptibles a la variación del contexto, se representan en la temporalidad, recursos económicos, relaciones de poder y de confianza, el sistema de salud, las expectativas y condiciones administrativas.
Collapse
|
34
|
Abstract
OBJECTIVE The evidence base for social prescribing is inconclusive, and evaluations have been criticised for lacking rigour. This realist review sought to understand how and why social prescribing evaluations work or do not work. Findings from this review will contribute to the development of an evidence-based evaluation framework and reporting standards for social prescribing. DESIGN A realist review. DATA SOURCES ASSIA, CINAHL, Embase, Medline, PsycINFO, PubMed, Scopus Online, Social Care Online, Web of Science and grey literature. ELIGIBILITY CRITERIA Documents reporting on social prescribing evaluations using any methods, published between 1998 and 2020 were included. Documents not reporting findings or lacking detail on methods for data collection and outcomes were excluded. ANALYSIS Included documents were segregated into subcases based on methodology. Data relating to context, mechanisms and outcomes and the programme theory were extracted and context-mechanism-outcome configurations were developed. Meta-inferences were drawn from all subcases to refine the programme theory. RESULTS 83 documents contributed to analysis. Generally, studies lacked in-depth descriptions of the methods and evaluation processes employed. A cyclical process of social prescribing evaluation was identified, involving preparation, conducting the study and interpretation. The analysis found that coproduction, alignment, research agency, sequential mixed-methods design and integration of findings all contributed to the development of an acceptable, high-quality social prescribing evaluation design. Context-mechanism-outcome configurations relating to these themes are reported. CONCLUSIONS To develop the social prescribing evidence base and address gaps in our knowledge about the impact of social prescribing and how it works, evaluations must be high quality and acceptable to stakeholders. Development of an evaluation framework and reporting standards drawing on the findings of this realist review will support this aim. PROSPERO REGISTRATION NUMBER CRD42020183065.
Collapse
Affiliation(s)
- Megan Elliott
- Wales School for Social Prescribing Research, PRIME Centre Wales, Faculty of Life Sciences & Education, University of South Wales, Pontypridd, UK
| | - Mark Davies
- Wales School for Social Prescribing Research, PRIME Centre Wales, Faculty of Life Sciences & Education, University of South Wales, Pontypridd, UK
| | - Julie Davies
- Valleys Regional Park, Bridgend County Borough Council, Bridgend, UK
| | - Carolyn Wallace
- Wales School for Social Prescribing Research, PRIME Centre Wales, Faculty of Life Sciences & Education, University of South Wales, Pontypridd, UK
| |
Collapse
|
35
|
Calderón‐Larrañaga S, Greenhalgh T, Finer S, Clinch M. What does the literature mean by social prescribing? A critical review using discourse analysis. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:848-868. [PMID: 35404485 PMCID: PMC9321825 DOI: 10.1111/1467-9566.13468] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/18/2022] [Indexed: 06/02/2023]
Abstract
Social prescribing (SP) seeks to enhance the role of the voluntary and community sector in addressing patients' complex needs in primary care. Using discourse analysis, this review investigates how SP is framed in the scientific literature and explores its consequences for service delivery. Theory driven searches identified 89 academic articles and grey literature that included both qualitative and quantitative evidence. Across the literature three main discourses were identified. The first one emphasised increasing social inequalities behind escalating health problems and presented SP as a response to the social determinants of health. The second one problematised people's increasing use of health services and depicted SP as a means of enhancing self-care. The third one stressed the dearth of human and relational dimensions in general practice and claimed that SP could restore personalised care. Discourses circulated unevenly in the scientific literature, conditioned by a wider political rationality which emphasised individual responsibility and framed SP as 'solution' to complex and contentious problems. Critically, this contributed to an oversimplification of the realities of the problems being addressed and the delivery of SP. We propose an alternative 'care-based' framing of SP which prioritises (and evaluates) holistic, sustained and accessible practices within strengthened primary care systems.
Collapse
Affiliation(s)
- Sara Calderón‐Larrañaga
- Centre for Primary Care and Mental HealthWolfson Institute of Population HealthQueen Mary University of LondonLondonUK
- Bromley‐by‐Bow Health PartnershipXX Place Health CentreMile End HospitalLondonUK
| | - Trish Greenhalgh
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordRadcliffe Primary Care BuildingRadcliffe Observatory QuarterOxfordUK
| | - Sarah Finer
- Centre for Primary Care and Mental HealthWolfson Institute of Population HealthQueen Mary University of LondonLondonUK
- Barts Health NHS TrustNewham University HospitalLondonUK
| | - Megan Clinch
- Centre for Primary Care and Mental HealthWolfson Institute of Population HealthQueen Mary University of LondonLondonUK
| |
Collapse
|
36
|
Rothe D, Heiss R. Link workers, activities and target groups in social prescribing: a literature review. JOURNAL OF INTEGRATED CARE 2022. [DOI: 10.1108/jica-09-2021-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Social prescribing is a model of integrated care, in which primary healthcare staff can link patients to the social care sector. However, social prescribing can occur in different forms. To better understand the concept of social prescribing, this literature review examines the role of the link workers, activities and target groups.Design/methodology/approach A literature review was conducted. Studies before May 2020 were considered. In total, 1,700 studies were identified using the databases Pubmed, PsycInfo, Cinahl, Web of Science and Cochrane Library. After eligibility checks, 16 studies were included in the final analysis.Findings A few studies warned of a deeper engagement of the link worker due to service dependency, but most studies encouraged an active and supportive role of the link worker. Participants engaged in social, physical and counseling activities. The majority of studies emphasized the importance of linking group activities with personal preferences and identity needs. The main target groups were composed of individuals with psychosocial needs, but some studies also included patients with physical or mental illnesses.Originality/value Social prescribing is widely advocated as an innovative model of integrated care. However, few studies have looked into the complex system of social prescribing. This study analyzes the linking processes, activities and target groups in extant social prescribing programs.
Collapse
|
37
|
Exploring the enablers and barriers to social prescribing for people living with long-term neurological conditions: a focus group investigation. BMC Health Serv Res 2021; 21:1230. [PMID: 34774034 PMCID: PMC8590354 DOI: 10.1186/s12913-021-07213-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/14/2021] [Indexed: 12/03/2022] Open
Abstract
Background People living with Long Term Neurological Conditions (LTNCs) value peer support and social activities. Psychological support and wellbeing enables them to manage their condition. Social prescribing is a formal process of referring patients to a link worker to co-design a plan to improve their health and wellbeing. Intervention involves supporting participation in activities based within the individual’s local community. This study aimed to explore the barriers and enablers to accessing social prescribing for people living with LTNCs (plwLTNCs). Methods A total of four focus groups were carried out with 17 participants, including different neurological conditions such as multiple sclerosis, Fragile X Syndrome, epilepsy, and traumatic brain injury. Two participants were family carers and supported people living with epilepsy and motor neurone disease. Findings were analysed using thematic analysis. Results Five themes were identified: (1) Lack of knowledge; (2) Service provision difficulties; (3) Benefits of social prescribing activities; (4) Physical barriers and (5) Psychological barriers. There was a lack of knowledge about social prescribing and what it actually was. Participants anticipated service provision difficulties relating to funding, link workers need for knowledge of LTNC’s and for activities to be varied and individualised. The potential benefits of social prescribing activities were recognised across the groups especially its potential to tackle loneliness and to offer plwLTNC’s purpose. Participants highlighted a number of physical barriers such as transport and accessibility; and psychological barriers such as anxiety and stigma. Conclusion Social prescribing aims to address the health inequalities of those living with long-term conditions, however currently it is likely to exclude plwLTNCs. Recommendations for practice and future research are made. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07213-6.
Collapse
|
38
|
Affiliation(s)
- Gary Bloch
- Department of Family and Community Medicine (Bloch), University of Toronto; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Inner City Health Associates (Bloch); Independent qualitative health research consultant (Rozmovits), Toronto, Ont.
| | - Linda Rozmovits
- Department of Family and Community Medicine (Bloch), University of Toronto; Department of Family and Community Medicine (Bloch), St. Michael's Hospital; Inner City Health Associates (Bloch); Independent qualitative health research consultant (Rozmovits), Toronto, Ont
| |
Collapse
|
39
|
Hazeldine E, Gowan G, Wigglesworth R, Pollard J, Asthana S, Husk K. Link worker perspectives of early implementation of social prescribing: A 'Researcher-in-Residence' study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1844-1851. [PMID: 33528060 DOI: 10.1111/hsc.13295] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/17/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Social prescribing (SP) is increasing in popularity in the UK and can enable healthcare providers to respond more effectively to a range of non-clinical needs. With the NHS commitment to establish an SP link worker in all GP practices, there is a rapid increase in the number of SP schemes across the country. There is currently insufficient evidence concerning the implementation and acceptability of SP schemes. In this paper, we report our analysis of the descriptions of the experiences of SP link workers, regarding the early implementation of SP link workers in two SP programmes in the South West. Data were gathered using the 'Researcher in Residence' (RiR) model, where the researcher was immersed in the environments in which the SP was managed and delivered. The RiR undertook conversations with 11 SP link workers, 2 SP link worker managers and 1 SP counsellor over six months. The RiR visited seven link workers at their GP practices (service 1) and four at their head office (service 2). The RiR met with the link worker managers at their offices, and the RiR spoke with the SP counsellor on the telephone. Data from these conversations were analysed using Thematic Analysis and six codes were constructed to advance our understanding of the components of early implementation of the SP programmes. Training (particularly around mental health), workforce support, location and SP champions within GP practices were found to be key strategies of SP implementation, link worker involvement acting as a conduit for the impacts of these strategies. This paper suggests that the implementation of SP programmes can be improved by addressing each of these areas, alongside allowing link workers the flexibility and authority to respond to challenges as they emerge.
Collapse
|
40
|
Costa A, Lopes J, Sousa CJ, Santos O, Virgolino A, Nogueira P, Henriques A, Seabra P, Capitão C, Martins R, Arriaga M, Alarcão V. Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging. BMC Health Serv Res 2021; 21:1164. [PMID: 34706718 PMCID: PMC8548849 DOI: 10.1186/s12913-021-07186-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Social Prescribing (SP) is an innovative strategy to respond to the non-clinical health needs of the population. A Social Prescribing Local System (SPLS) can be defined as a set of joined community, health, and social organizations to foster SP-oriented activities. This study aimed to develop and assess the feasibility of an SPLS implemented in a Mediterranean country, to promote health and wellbeing and contribute to active and healthy aging. METHODS A mixed-methods approach was followed, including three sequential components: 1) Cross-sectional online survey targeting health professionals (HP) working in a primary health care cluster, Portugal's southern region; 2) Pilot study implementing an on-the-job training program for HP, designed to meet identified training needs in the survey; 3) Focus group (FG) with the HP who participated in the pilot study, two individual interviews, with an elderly patient and a community provider for assessing the satisfaction with the pilot test. RESULTS Sixty-five HP completed the survey; of these, 13 completed the theoretical part of the on-the-job training program; and six (out of these 13) completed the full program. Five HP participated in the FG, one patient and one community provider were interviewed. The surveyed HP perceived as facilitators to implement SP: an automatic system of notifications to prompt the use of SP, contribute to patient satisfaction, human and community resources' stability. The survey also highlighted barriers to SP implementation: length of appointments, shortage of human resources, data records confidentiality, low patient adherence rates, bureaucratic issues, time constraints, and financial costs. Participants were satisfied with the training. Identified SPLS implementation benefits were grouped into four dimensions (from the qualitative approach): gains for patients' health and wellbeing, support for the health services, sustainability of the community resources, and HP' professional satisfaction. CONCLUSIONS Our study took the first steps towards the implementation of an SPLS. Findings reinforce that training HP in SP and on-the-job training seems feasible. This approach was well received and appears to represent a suitable and sustainable strategy. It can promote professional satisfaction, support health services, contribute to the stability of community resources, improve health and promote active and healthy aging.
Collapse
Affiliation(s)
- A Costa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal.
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal.
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal.
| | - J Lopes
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - C J Sousa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - O Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Unbreakable Idea Research, Lda, 2550-426, Painho, Portugal
| | - A Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - P Nogueira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Laboratório de Biomatemática, Instituto de Medicina Preventiva e Saúde pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Egas Moniz, 1649-028, Lisbon, Portugal
| | - A Henriques
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - P Seabra
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - C Capitão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - R Martins
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - M Arriaga
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal
- Directorate-General for Health, Health Literacy and Wellbeing Division, Alameda Dom Afonso Henriques, 1000-123, Lisbon, Portugal
| | - V Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Centro de Investigação e Estudos de Sociologia, ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Avenida das Forças Armadas, 1649-026, Lisbon, Portugal
| |
Collapse
|
41
|
Laver C, McGrath L, Liebert RJ, Noorani T, Barnes N, Chase M, Hall J, Wakeling B. ‘You don't take things too seriously or un‐seriously’: Beyond recovery to liminal and liminoid possibility in a community arts and mental health project. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1002/casp.2583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Cassie Laver
- School of Psychology University of East London London UK
| | - Laura McGrath
- School of Psychology and Counselling The Open University Milton Keynes UK
| | | | | | - Nick Barnes
- Child and Adolescent Mental Health Services East London NHS Foundation Trust London UK
| | - Mike Chase
- School of Psychology University of the West of England, Frenchay Campus Bristol UK
| | - Jon Hall
- Outsider Music Clarendon Recovery College London UK
| | - Ben Wakeling
- The Outsider Gallery Clarendon Recovery College London UK
| |
Collapse
|
42
|
Badu E, O'Brien AP, Mitchell R, Osei A. A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes. BMC Health Serv Res 2021; 21:1013. [PMID: 34563183 PMCID: PMC8466714 DOI: 10.1186/s12913-021-06993-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 09/07/2021] [Indexed: 02/03/2023] Open
Abstract
Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. Methods A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06993-1.
Collapse
Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, Australia.
| | | | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
| |
Collapse
|
43
|
Creating a transformative space for change: A qualitative evaluation of the RHS Wellbeing Programme for people with long term conditions. Health Place 2021; 71:102654. [PMID: 34419712 DOI: 10.1016/j.healthplace.2021.102654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Our research aimed to evaluate the impact of the RHS Wellbeing (WB) Programme on people with long-term conditions. FINDINGS A thematic analysis identified how the WB programme facilitated improved social connectivity, sense of wellbeing and purpose through the creation of a 'healthy, natural and safe space' predicated on 'person-centred approaches'. Participants felt they were 'part of something larger' which enabled 'transformation of their health and wellbeing'. CONCLUSIONS The WB Programme offered space to grow, heal and reconnect. Losing oneself in a nature-based space can have a lasting transformative impact on individuals.
Collapse
|
44
|
Can an ecological-transactional systems model in occupational therapy contribute to a social prescribing programme? IRISH JOURNAL OF OCCUPATIONAL THERAPY 2021. [DOI: 10.1108/ijot-12-2020-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The spread and level of loneliness is today considered a public health issue. Attempts to promote or reduce the level of loneliness have been made, one of which is social prescribing (SP), developed and extensively used. Complex interventions such as SP are advised to be connected to theory.
Design/methodology/approach
For this purpose, the Person-Environment-Occupation-Participation model (PEOP) will be reviewed and used as an example, both as a way of organize occupational knowledge and as a model for practice.
Findings
Occupational therapy underpinned by transactional system theory such as the PEOP model seems to give comprehensive and relevant support in the SP process. Particularly, this model can guide practitioners through crucial phases when assessing needs, matching interests and goals with relevant occupations, as well as understanding of important components embedded in the program.
Originality/value
This opinion piece offers insights in why and how specific components connected to SP needs to be understood by theory and applied by personnel to facilitate a meaningful and sustainable occupational performance for the individuals.
Collapse
|
45
|
Fixsen A, Barrett S, Shimonovich M. Weathering the storm: A qualitative study of social prescribing in urban and rural Scotland during the COVID-19 pandemic. SAGE Open Med 2021; 9:20503121211029187. [PMID: 34262766 PMCID: PMC8252447 DOI: 10.1177/20503121211029187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/10/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: The non-clinical approach known as social prescribing aims to tackle multi-morbidity, reduce general practitioner (GP) workload and promote wellbeing by directing patients to community services. Usual in-person modes of delivery of social prescribing have been virtually impossible under social distancing rules. This study qualitatively examined and compared the responses of three social prescribing schemes in Scotland to the COVID-19 pandemic. Methods: We interviewed a theoretical sample of 23 stakeholders in urban and rural social prescribing schemes at the start of COVID-19 pandemic. Follow-up interviews with a representative sample were conducted around 10 months later. Interviewees included social prescribing coordinators (SPCs) GPs, managers, researchers and representatives of third sector organizations. Interview transcripts were analysed in stages and an inductive approach to coding was supported by NVivo. Results: Findings revealed a complex social prescribing landscape in Scotland with schemes funded, structured and delivering services in diverse ways. Across all schemes, working effectively during the pandemic and shifting to online delivery had been challenging and demanding; however, their priorities in response to the pandemic had differed. With GP time and services stretched to limits, GP practice-attached ‘Link Workers’ had taken on counselling and advocacy roles, sometimes for serious mental health cases. Community-based SPCs had mostly assumed a health education role, and those on the Western Isles of Scotland a digital support role. In both rural or urban areas, combatting loneliness and isolation – especially given social distancing – remained a pivotal aspect of the SPC role. Conclusion: This study highlights significant challenges and shifts in focus in social prescribing in response to the pandemic. The use of multiple digital technologies has assumed a central role in social prescribing, and this situation seems likely to remain. With statutory and non-statutory services stretched to their limits, there is a danger of SPCs assuming new tasks without adequate training or support.
Collapse
Affiliation(s)
- Alison Fixsen
- College of Liberal Arts and Sciences, University of Westminster, London, UK
| | - Simon Barrett
- Newcastle University, Population Health Sciences Institute, Newcastle Upon Tyne, Tyne and Wear, UK
| | - Michal Shimonovich
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| |
Collapse
|
46
|
Tensions and opportunities in social prescribing. Developing a framework to facilitate its implementation and evaluation in primary care: a realist review. BJGP Open 2021; 5:BJGPO.2021.0017. [PMID: 33849895 PMCID: PMC8278514 DOI: 10.3399/bjgpo.2021.0017] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 11/28/2022] Open
Abstract
Background Social prescribing (SP) involves linking patients in primary care with services provided by the voluntary and community sector (VCS). Despite growing interest within NHS primary care, it remains unclear how and under what circumstances SP might contribute to good practice. Aim To define ‘good’ practice in SP by identifying context-specific enablers and tensions. To contribute to the development of an evidence-based framework for theorising and evaluating SP within primary care. Design & setting Realist review of secondary data from primary care-based SP schemes. Method Academic articles and grey literature were searched for qualitative and quantitative evidence following the Realist And Meta-narrative Evidence Syntheses — Evolving Standards (RAMESES). Common SP practices were characterised in three settings (general practice, link workers, and community sector) using archetypes that ranged from best to worst practice. Results A total of 140 studies were included for analysis. Resources were identified influencing the type and potential impact of SP practices and four dimensions were outlined in which opportunities for good practice arise: 1) individual characteristics (stakeholder’s buy-in, vocation, and knowledge); 2) interpersonal relations (trustful, bidirectional, informed, supportive, and transparent and convenient interactions within and across sectors); 3) organisational contingencies (the availability of a predisposed practice culture, leadership, training opportunities, supervision, information governance, resource adequacy, accessibility, and continuity of care within organisations); and 4) policy structures (bottom-up and coherent policymaking, stable funding, and suitable monitoring strategies). Findings were synthesised in a multilevel, dynamic, and usable SP framework. Conclusion The realist review and resulting framework revealed that SP is not inherently advantageous. Specific individual, interpersonal, organisational, and policy resources are needed to ensure SP best practice in primary care.
Collapse
|
47
|
Reinhardt GY, Vidovic D, Hammerton C. Understanding loneliness: a systematic review of the impact of social prescribing initiatives on loneliness. Perspect Public Health 2021; 141:204-213. [PMID: 34159848 PMCID: PMC8295963 DOI: 10.1177/1757913920967040] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: The aim of this systematic literature review is to assess the impact of social prescribing (SP) programmes on loneliness among participants and the population. Methods: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search EBSCOHost (CINAHL Complete, eBook Collection, E-Journals, MEDLINE with Full Text, Open Dissertations, PsycARTICLES, and PsycINFO), UK National Institute for Health and Care Excellence (NICE), Web of Science Core Collection, and grey literature. We included studies measuring the effectiveness and impact of SP programmes in terms of loneliness. We excluded systematic reviews and studies without evaluations. Due to the absence of confidence intervals and the low number of studies, we conduct no meta-analysis. Results: From 4415 unique citations, nine articles met the inclusion criteria. The studies do not use uniform measures or randomised samples. All nine studies report positive individual impacts; three report reductions in general practitioner (GP), A&E, social worker, or inpatient/outpatient services; and one shows that belonging to a group reduces loneliness and healthcare usage. Conclusion: The findings of this systematic review indicate that individuals and service providers view SP as a helpful tool to address loneliness. However, evidence variability and the small number of studies make it difficult to draw a conclusion on the extent of the impact and the pathways to achieving positive change. More research is needed into the impact of SP programmes on participants, populations, and communities in terms of loneliness, isolation, and connectedness, especially in light of the surge in SP activity as a key part of pandemic response.
Collapse
Affiliation(s)
- G Y Reinhardt
- Department of Government, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, Essex, UK
| | | | | |
Collapse
|
48
|
Johansson E, Jonsson F, Rapo E, Lundgren AS, Hörnsten Å, Nilsson I. Let's Try Social Prescribing in Sweden (SPiS) - an Interventional Project Targeting Loneliness among Older Adults Using a Model for Integrated Care: A Research Protocol. Int J Integr Care 2021; 21:33. [PMID: 34220397 PMCID: PMC8231464 DOI: 10.5334/ijic.5609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/23/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Loneliness and social isolation among older adults (≥65) are an emerging issue of public concern, associated with increased morbidity and mortality. Today there is no systematic intervention developed, implemented or evaluated in Sweden addressing loneliness. The overall aim for this project is to develop, test and refine a person-centred Swedish model for social prescribing (SPiS), and to assess whether and how it reduces loneliness, promotes health and improves well-being among older adults. DESCRIPTION The focus will be to develop, culturally adapt, evaluate and refine the SPiS model. Following the sequential structure of realist evaluation in three consecutive phases qualitative and quantitative data along with subsequent analysis methods will be collected and utilized. The project will provide knowledge of what works with the social prescribing model, for whom, in what conditions and why, in relation to loneliness, health and well-being among older adults. DISCUSSION SPiS has the unique position of providing initial knowledge regarding how to reduce loneliness in the Swedish context. However, evaluation is complex as this research goes beyond the unidimensional question "Is it working?". CONCLUSION Developing, implementing and evaluating such a complex program needs systematic and close evaluation.
Collapse
|
49
|
Scott J, Fidler G, Monk D, Flynn D, Heavey E. Exploring the potential for social prescribing in pre-hospital emergency and urgent care: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:654-663. [PMID: 33704851 DOI: 10.1111/hsc.13337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/22/2021] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
There is a sustained increase in demand for emergency and urgent care services in England. The NHS Long Term Plan aims to reduce the burden on emergency hospital services through changing how pre-hospital care operates, including increased delivery of urgent care. Given the recognised potential of social prescribing to address wider determinants of health and reduce costs in other settings, this study aimed to understand the role that social prescribing can play in pre-hospital emergency and urgent care from the perspectives of staff. Semi-structured interviews (n = 15) and a focus group (n = 3) were conducted with clinical staff (n = 14) and non-clinical health advisors (n = 4) from an English Ambulance Service covering emergency (999) and non-emergency (111) calls. Data were analysed using a pre-defined framework: awareness of social prescribing; potential cohorts suitable for social prescribing; and determinants of social prescribing. Awareness and knowledge of social prescribing was limited, though when social prescribing was explained to participants they almost universally recognised its benefits for their role. Social prescribing was considered to be most beneficial to those calling for reasons relating to mental health, loneliness or social isolation, in particular older people and frequent users of 999 and 111 services. Determinants of social prescribing were identified across the micro (patient and staff acceptability of social prescribing), meso (triage and referral pathways) and macro (commissioning and funding) levels of analysis. This is the first empirical study to explore social prescribing in pre-hospital emergency and urgent care services, which suggests that it has potential to improve quality of care at the point of people accessing these services. There is a pressing need to address the micro, macro and meso level determinants identified within this study, in order to support staff within pre-hospital emergency and urgent care services to socially prescribe.
Collapse
Affiliation(s)
- Jason Scott
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Gayle Fidler
- North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Daniel Monk
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Darren Flynn
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Emily Heavey
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| |
Collapse
|
50
|
The National ReferAll Database: An Open Dataset of Exercise Referral Schemes Across the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094831. [PMID: 33946537 PMCID: PMC8124854 DOI: 10.3390/ijerph18094831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 02/01/2023]
Abstract
In 2014, The National Institute for Health and Care Excellence (NICE) called for the development of a system to collate local data on exercise referral schemes (ERS). This database would be used to facilitate continued evaluation of ERS. The use of health databases can spur scientific investigation and the generation of evidence regarding healthcare practice. NICE’s recommendation has not yet been met by public health bodies. Through collaboration between ukactive, ReferAll, a specialist in software solutions for exercise referral, and the National Centre for Sport and Exercise Medicine, which has its research hub at the Advanced Wellbeing Research Centre, in Sheffield, data has been collated from multiple UK-based ERS to generate one of the largest databases of its kind. This database moves the research community towards meeting NICEs recommendation. This paper describes the formation and open sharing of The National ReferAll Database, data-cleaning processes, and its structure, including outcome measures. Collating data from 123 ERSs on 39,283 individuals, a database has been created containing both scheme and referral level characteristics in addition to outcome measures over time. The National ReferAll Database is openly available for researchers to interrogate. The National ReferAll Database represents a potentially valuable resource for the wider research community, as well as policy makers and practitioners in this area, which will facilitate a better understanding of ERS and other physical-activity-related social prescribing pathways to help inform public health policy and practice.
Collapse
|