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Laverty L, Palmier-Claus J, Harris R, Lodge C, Caton N, Morris A, Lobban F. Mediating candidacy: Qualitative study of a link work intervention to support individuals with severe mental ill health to access dental care. Soc Sci Med 2025; 378:118044. [PMID: 40344794 DOI: 10.1016/j.socscimed.2025.118044] [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: 07/11/2024] [Revised: 02/13/2025] [Accepted: 03/28/2025] [Indexed: 05/11/2025]
Abstract
Vulnerable and socially excluded groups in society persistently experience worse oral health and poorer access to dental services than the mainstream population. This article reports on the qualitative component of a feasibility trial evaluating a link work intervention to support individuals with severe mental illness to access dental healthcare in Northwest England. Using the Candidacy Model as a conceptual framework, interviews with eighteen participants and the three link workers were carried out to explore the challenges individuals face in navigating access to dental services and how this is negotiated with health professionals and systems. The findings show how the consequences and significance of poor mental health impede access to dental care that is already scarce and hard to reach. The link workers mediated candidacy by taking on some of the burdens of access and providing a buffer to power differentials built into the healthcare system. They provided person-centred support that participants valued as holistic and non-judgemental. As a result, participants felt more able and willing to return to dental services in the future. The discussion considers how the literature on candidacy can be helpful in understanding how link work interventions may reduce inequalities in access for vulnerable groups but are dependent on wider organisational conditions and provision.
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Affiliation(s)
| | - Jasper Palmier-Claus
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
| | - Rebecca Harris
- Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Christopher Lodge
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
| | - Neil Caton
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
| | - Abigail Morris
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
| | - Fiona Lobban
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
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Wilson A, Noble H, Galway K, Doherty J. Social prescribing for people living with long-term health conditions: a scoping review. Syst Rev 2025; 14:114. [PMID: 40380249 DOI: 10.1186/s13643-025-02848-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Accepted: 04/08/2025] [Indexed: 05/19/2025] Open
Abstract
INTRODUCTION Social prescribing links people to activities and services typically provided by local voluntary and community sectors to address social determinants of health and wellbeing. People living with long-term health conditions are a target population. This relatively new approach is rapidly expanding, and there is varied evidence regarding how social prescribing is being delivered for people living with long-term conditions. This scoping review aims to report on what is known about the approach for these patient populations. METHODS Electronic databases MEDLINE, CINAHL, Scopus, Web of Science, and PsycINFO were searched in December 2023, and relevant sources of gray literature in January 2024, with both updated in February 2025. Studies eligible for inclusion included adults (18 +) with long-term conditions engaging with social prescribing in health and community contexts. Studies published in English in any year were included. A data charting template captured key characteristics including reasons for referral, referral pathways, activities and services being utilized, and outcome measures. A descriptive narrative synthesis was conducted, guided by the review questions to explore the current evidence. RESULTS Thirty-seven sources of evidence were included. Diabetes was the most common of 65 conditions identified (n = 23). The presence of a long-term condition was the most frequent reason for referral (n = 30), followed by mental health concerns (n = 15), and social isolation or loneliness (n = 11). Most referrals were made within primary care (n = 33), to a link worker or social prescriber (n = 29), who supported participants to access activities and services including exercise (n = 22), information, support, and advice (n = 19), mental health support (n = 15), social and leisure activities (n = 15) and condition-specific support (n = 14). Wellbeing was the most commonly identified measured outcome (n = 23), with studies utilizing the Warwick Edinburgh Mental Wellbeing Scales (n = 7) and Wellbeing Star (n = 7) most frequently. CONCLUSIONS While common factors were identified, there is considerable variation in social prescribing approaches for people living with long-term conditions, reflecting the diversity of needs, availability of community services, and necessity for personalized care. Further research is needed to inform the development of evidence-based practice which addresses the complex needs of diverse patient populations and supports access to a broad range of referral pathways.
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Affiliation(s)
- Anna Wilson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Ireland.
| | - Helen Noble
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Ireland
| | - Karen Galway
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Ireland
| | - Julie Doherty
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Ireland
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Pola-Garcia M, Enríquez Martín N, Turón Lanuza A, Méndez-López F, Gasch-Gallén Á, Lou Alcaine ML, Benedé Azagra CB. Assessing the implementation and impact of a social prescribing protocol in primary care. BMC PRIMARY CARE 2025; 26:169. [PMID: 40380126 PMCID: PMC12083031 DOI: 10.1186/s12875-025-02862-6] [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: 02/24/2025] [Accepted: 04/30/2025] [Indexed: 05/19/2025]
Abstract
BACKGROUND Social prescribing allows clinicians to refer people to resources or activities in their community to improve their abilities and health. Implementation of social prescribing is growing. However, there is not enough evidence on several related issues. The aim of study was to analyse the implementation of the asset-based model in the primary care teams in Aragón and to describe the profile of people who benefit most and are most satisfied with social prescribing. METHODS It is an analytical observational study in the 123 primary healthcare teams of Aragon from September2018 to December2022. The data were obtained from Electronical Health Record, checked and cleaned. A descriptive analysis was performed for qualitative and mean and standard deviation for quantitative variables. To analyse the associations between attendance, satisfaction, and improvement with all variables, several analyses were conducted using different methods. Finally, a cluster analysis was developed with the most benefited and satisfied people. RESULTS During the study period, 2,735 asset recommendations were made to 2,578 different people and 1,050 follow-ups to 552. There was an increase in the use of the protocol over time, except during the COVID pandemic. Most recommendations were made to women (73.3%-2,006). The average age was 65. There were more referrals in the smallest places (3.11 referrals/1000inhabitants). The most frequent linked health issues were psychological problems (572 - 20.9%). Physical skills were the abilities that professionals most tried to promote (28.4-1,709). In the follow-ups, the 81.4%(373) reported attending to the asset regularly. There were differences according to age and health problems. The average of improvement was 3.87/5 with differences by age, municipality size and health problems. For satisfaction, the average was 4.57/5 with differences by age and health problems. The lowest level of improvement and satisfaction was found for social problems. The cluster analysis highlighted several groups. Three profiles were distinguished in terms of high improvement and four of high satisfaction. In both cases, the variables related to areas for enhancement primarily defined the profiles. CONCLUSIONS It is necessary to continue research with strong methodological and complementary approaches. This manuscript is optimistic about the use and impact of the social prescription in primary health care.
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Affiliation(s)
- Marina Pola-Garcia
- Atención Primaria, Sector Zaragoza II, Servicio Aragonés de Salud, Zaragoza, Spain
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria, Sector Zaragoza II, Zaragoza, Spain
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
| | - Natalia Enríquez Martín
- Departamento de Sanidad, Unidad de Calidad y Seguridad, Servicio Aragonés de Salud, Gobierno de Aragón, Zaragoza, Spain
| | - Alberto Turón Lanuza
- Departamento de Economía Aplicada, Facultad de Economía y Empresa, Universidad de Zaragoza, Zaragoza, Spain
- Grupo Decisión Multicriterio Zaragoza S35_23R, Gobierno de Aragón, Zaragoza, Spain
| | - Fátima Méndez-López
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción, de la Salud (RICAPPS) RD21/0016/005, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Ángel Gasch-Gallén
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Grupo GIIS094, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - María Luz Lou Alcaine
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Departamento de Sanidad, Dirección General de Asistencia Sanitaria y Planificación, Gobierno de Aragón, Zaragoza, Spain
- Departamento de Sanidad, Estrategia de Atención Comunitaria en el Sistema de Salud de Aragón Atención Primaria, Gobierno de Aragón, Zaragoza, Spain
| | - Carmén Belén Benedé Azagra
- Atención Primaria, Sector Zaragoza II, Servicio Aragonés de Salud, Zaragoza, Spain.
- Grupo GIIS011, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
- Grupo Aragonés de Investigación en Atención Primaria B21_23R, Gobierno de Aragón, Zaragoza, Spain.
- Departamento de Sanidad, Estrategia de Atención Comunitaria en el Sistema de Salud de Aragón Atención Primaria, Gobierno de Aragón, Zaragoza, Spain.
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de Beus MFM, van de Griend MVM, Kuiper-Meijer KK, Wilson AMA. Regarding the study on workplace sexual harassment and cardiometabolic disease. Eur J Prev Cardiol 2025; 32:352. [PMID: 39167831 DOI: 10.1093/eurjpc/zwae277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 08/19/2024] [Indexed: 08/23/2024]
Affiliation(s)
- M F Margriet de Beus
- Family Medicine, Nederlands Huisartsen Genootschap, Bellestein 61A, Ede, Gelderland 6714 DP, Netherlands
| | - M V Maxime van de Griend
- Family Medicine, Nederlands Huisartsen Genootschap, Bellestein 61A, Ede, Gelderland 6714 DP, Netherlands
| | - K Karianne Kuiper-Meijer
- Family Medicine, Nederlands Huisartsen Genootschap, Bellestein 61A, Ede, Gelderland 6714 DP, Netherlands
| | - A M Avi Wilson
- Family Medicine, Nederlands Huisartsen Genootschap, Bellestein 61A, Ede, Gelderland 6714 DP, Netherlands
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Tierney S, Westlake D, Wong G, Turk A, Markham S, Gorenberg J, Reeve J, Mitchell C, Husk K, Redwood S, Pope C, Baird B, Mahtani KR. Experiences of integrating social prescribing link workers into primary care in England - bolting on, fitting in, or belonging: a realist evaluation. Br J Gen Pract 2025; 75:e195-e202. [PMID: 39317389 PMCID: PMC11800410 DOI: 10.3399/bjgp.2024.0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 08/07/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Following the 2019 NHS Long Term Plan, link workers have been employed across primary care in England to deliver social prescribing. AIM To understand and explain how the link worker role is being implemented in primary care in England. DESIGN AND SETTING This was a realist evaluation undertaken in England, focusing on link workers based in primary care. METHOD The study used focused ethnographies around seven link workers from different parts of England. As part of this, we interviewed 61 patients and 93 professionals from health care and the voluntary, community, and social enterprise sector. We reinterviewed 41 patients, seven link workers, and a link worker manager 9-12 months after their first interview. RESULTS We developed four concepts from the codes developed during the project on the topic around how link workers are integrated (or not) within primary care: (or not) within primary care: centralising or diffusing power; forging an identity in general practice; demonstrating effect; and building a facilitative infrastructure. These concepts informed the development of a programme theory around a continuum of integration of link workers into primary care - from being 'bolted on' to existing provision, without much consideration, to 'fitting in', shaping what is delivered to be accommodating, through to 'belonging', whereby they are accepted as a legitimate source of support, making a valued contribution to patients' broader wellbeing. CONCLUSION Social prescribing was introduced into primary care to promote greater attention to the full range of factors affecting patients' health and wellbeing, beyond biomedicine. For that to happen, our analysis highlights the need for a whole-system approach to defining, delivering, and maintaining this new part of practice.
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Affiliation(s)
- Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Debra Westlake
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Geoffrey Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Amadea Turk
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Steven Markham
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Jordan Gorenberg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Joanne Reeve
- Hull York Medical School, University of Hull, Hull
| | - Caroline Mitchell
- School of Medicine and Population Health, University of Sheffield, Sheffield
| | - Kerryn Husk
- Peninsula Medical School, University of Plymouth, Plymouth
| | - Sabi Redwood
- Bristol Medical School, University of Bristol, Bristol
| | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | | | - Kamal Ram Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
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Gibson K, Robinson L, Bains M, Samsi K, Cîrstea AM, Brittain K. Intersecting social relations of care: a protocol for an ethnographic and interview study with South Asian people ageing in place with dementia. BMJ Open 2024; 14:e092946. [PMID: 39653559 PMCID: PMC11628994 DOI: 10.1136/bmjopen-2024-092946] [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: 08/27/2024] [Accepted: 10/22/2024] [Indexed: 12/12/2024] Open
Abstract
INTRODUCTION People living at home with dementia are often cared for by family members, especially those from minority ethnic groups. Many people living with dementia from minority ethnic communities face barriers to accessing formal care. However, there is a paucity of dementia research, which foregrounds diversity within minority ethnic populations. This study, conducted between July 2024 and August 2026, will explore the diverse care experiences of South Asian people living with dementia. Conducted across four sites (Newcastle, Nottingham, Birmingham and London), it aims to understand how inequalities related to ethnicity intersect with other factors (eg, gender, age and class) to shape the dementia care experiences of people living in South Asian communities and apply this learning to explore how public policy and care systems could be improved to reduce health and social inequalities. METHODS AND ANALYSIS In Newcastle, ethnographic research will be undertaken with up to 20 people living with dementia (or with memory concerns) in South Asian communities for a period of 12 months. The lengthy research period will enable a deep understanding about how experiences change as dementia progresses over time. In Nottingham and Birmingham, semi-structured interviews and/or focus groups will be conducted with up to 30 people living with dementia (or with memory concerns) in South Asian communities. This will enhance the data generated via the ethnographic research. Analysis will follow the principles of reflexive thematic analysis and will involve identifying themes and synthesising and theorising the data. Following this, findings will be reflected upon in 4-6 task groups convened in London, Nottingham and Newcastle with practitioners from health and social care, voluntary organisations or faith groups involved in dementia care. Task groups will focus on developing practical goals based on the research findings. ETHICS AND DISSEMINATION Ethical approval for this study has been granted by Newcastle University Faculty of Medical Sciences Ethics Committee (Reference: 2773/43721). Findings will be disseminated to academics, practitioners, policymakers and members of the public via a range of channels including conferences, peer-reviewed publications, lay reports, leaflets and non-written formats such as animated videos.
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Affiliation(s)
- Kate Gibson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Manpreet Bains
- Centre for Academic Primary Care, University of Nottingham, Nottingham, UK
| | - Kritika Samsi
- The Policy Institute, King's College London, London, UK
| | - Ana-Maria Cîrstea
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Katie Brittain
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Muhl C, Mulligan K, Giurca BC, Polley MJ, Bloch G, Nowak DA, Osborn-Forde C, Hsiung S, Lee KH, Herrmann WJ, Baker JR, Stokes-Lampard DHJ, Everington SS, Dixon M, Wachsmuth I, Figueiredo C, Skjerning HT, Rojatz D, Chen YD, Heijnders ML, Wallace C, Howarth M, Watanabe D, Bertotti M, Jansson AH, Althini S, Holzinger F, Dooler DG, Brand S, Anfilogoff TJ, Fancourt D, Nelson MLA, Tierney S, Leitch A, Nam HK, Card KG, Hayes D, Slade S, Essam MA, Palmer GA, Welch VA, Robinson D, Hilsgen L, Taylor N, Nielsen RØ, Vidovic D, McDaid EM, Hoffmeister LV, Bonehill J, Siegel A, Bártová A, Acurio-Páez D, Mendive JM, Husk K. Building common understanding: seeking consensus and defining social prescribing across contexts - a collective commentary on a Delphi study. BMC Health Serv Res 2024; 24:1280. [PMID: 39449029 PMCID: PMC11515304 DOI: 10.1186/s12913-024-11603-x] [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: 02/04/2024] [Accepted: 09/18/2024] [Indexed: 10/26/2024] Open
Abstract
Social prescribing has become a global phenomenon. A Delphi study was recently conducted with 48 social prescribing experts from 26 countries to establish global agreement on the definition of social prescribing. We reflect on the use and utility of the outputs of this work, and where we go from here.
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Affiliation(s)
- Caitlin Muhl
- Faculty of Health Sciences, Queen's University, 99 University Ave, Kingston, ON, Canada.
| | - Kate Mulligan
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Canadian Institute for Social Prescribing, Canadian Red Cross, Toronto, ON, Canada.
| | - Bogdan Chiva Giurca
- Arts and Sciences, University College London, London, UK
- National Academy for Social Prescribing, London, UK
| | | | - Gary Bloch
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Dominik Alex Nowak
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Sonia Hsiung
- Canadian Institute for Social Prescribing, Canadian Red Cross, Toronto, ON, Canada
| | - Kheng Hock Lee
- Office of Education and Community Partnerships, SingHealth Community Hospitals, Singapore, Singapore
- Family Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Wolfram J Herrmann
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - James Robert Baker
- Australian Social Prescribing Institute of Research and Education (ASPIRE), Surry Hills, NSW, Australia
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | | | | | | | - Isabelle Wachsmuth
- Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Cristiano Figueiredo
- Public Health Research Centre, Comprehensive Health Research Centre, NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal
- Unidade de Saúde Familiar da Baixa, Unidade Local de Saúde São José, Lisbon, Portugal
| | | | - Daniela Rojatz
- Competence Centre for Health Promotion and Healthcare, Austrian National Public Health Institute, Vienna, Austria
| | - Yu-Da Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Carolyn Wallace
- Wales School for Social Prescribing Research (WSSPR), University of South Wales, Pontypridd, Rhondda Cynon Taf, UK
| | - Michelle Howarth
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, Lancashire, UK
| | - Daisuke Watanabe
- Faculty of Humanities, Seikei University, Musashino, Tokyo, Japan
| | - Marcello Bertotti
- Institute for Connected Communities, University of East London, London, UK
| | | | - Susanna Althini
- General Practice, Visby, Gotland, Sweden
- Primary Care Management, Health and Medical Care Administration, Region of Gotland, Visby, Sweden
- Primary Care Management, Health and Medical Care Administration, Region of Kalmar, Högsby, Sweden
| | - Felix Holzinger
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Siân Brand
- Social Prescribing Network, London, UK
- Sport and Health, Writtle University College, Chelmsford, Essex, UK
| | - Tim James Anfilogoff
- Social Prescribing Network, London, UK
- Hertfordshire and West Essex Integrated Care Board, Hertfordshire and West Essex, Hertfordshire, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
| | - Michelle L A Nelson
- Science of Care, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | | | - Hae-Kweun Nam
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Gangwon State, Wonju, Republic of Korea
| | - Kiffer G Card
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Daniel Hayes
- Department of Behavioural Science and Health, University College London, London, UK
| | - Siân Slade
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Melbourne, VIC, Australia
| | | | | | - Vivian Andrea Welch
- Bruyere Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - David Robinson
- Medical Gerontology, Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Laurie Hilsgen
- Carers New Zealand - NZ Carers Alliance, Auckland, New Zealand
| | - Niall Taylor
- Scottish Government, Population Health Directorate, Edinburgh, UK
| | - Rasmus Østergaard Nielsen
- Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dragana Vidovic
- Department of Government, University of Essex, Colchester, Essex, UK
| | | | - Louíse Viecili Hoffmeister
- Public Health Research Centre, Comprehensive Health Research Centre, NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal
| | | | - Alan Siegel
- Social Prescribing USA, San Francisco, CA, USA
- Adult and Family Medicine, Kaiser Oakland, Oakland, CA, USA
| | - Alžběta Bártová
- Department of Psychosocial Sciences and Ethics, Hussite Theological Faculty, Charles University, Prague, Czech Republic
- Centre of Longevity and Long-Term Care (CELLO), Faculty of Humanities, Charles University, Prague, Czech Republic
| | - David Acurio-Páez
- Facultad Ciencias Médicas, Universidad de Cuenca, Cuenca, Azuay, Ecuador
| | - Juan Manuel Mendive
- La Mina Primary Health Care Academic Centre, Catalan Institute of Health, Sant Adrià de Besòs, Barcelona, Spain
| | - Kerryn Husk
- Faculty of Health, University of Plymouth, Plymouth, UK
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Turk A, Tierney S, Hogan B, Mahtani KR, Pope C. A meta-ethnography of the factors that shape link workers' experiences of social prescribing. BMC Med 2024; 22:280. [PMID: 38965525 PMCID: PMC11225255 DOI: 10.1186/s12916-024-03478-w] [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: 05/20/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Social prescribing is gaining traction internationally. It is an approach which seeks to address non-medical and health-related social needs through taking a holistic person-centred and community-based approach. This involves connecting people with and supporting them to access groups and organisations within their local communities. It is hoped that social prescribing might improve health inequities and reduce reliance on healthcare services. In the UK, social prescribing link workers have become core parts of primary care teams. Despite growing literature on the implementation of social prescribing, to date there has been no synthesis that develops a theoretical understanding of the factors that shape link workers' experiences of their role. METHODS We undertook a meta-ethnographic evidence synthesis of qualitative literature to develop a novel conceptual framework that explains how link workers experience their roles. We identified studies using a systematic search of key databases, Google alerts, and through scanning reference lists of included studies. We followed the eMERGe guidance when conducting and reporting this meta-ethnography. RESULTS Our synthesis included 21 studies and developed a "line of argument" or overarching conceptual framework which highlighted inherent and interacting tensions present at each of the levels that social prescribing operates. These tensions may arise from a mismatch between the policy logic of social prescribing and the material and structural reality, shaped by social, political, and economic forces, into which it is being implemented. CONCLUSIONS The tensions highlighted in our review shape link workers' experiences of their role. They may call into question the sustainability of social prescribing and the link worker role as currently implemented, as well as their ability to deliver desired outcomes such as reducing health inequities or healthcare service utilisation. Greater consideration should be given to how the link worker role is defined, deployed, and trained. Furthermore, thought should be given to ensuring that the infrastructure into which social prescribing is being implemented is sufficient to meet needs. Should social prescribing seek to improve outcomes for those experiencing social and economic disadvantage, it may be necessary for social prescribing models to allow for more intensive and longer-term modes of support.
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Affiliation(s)
- Amadea Turk
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Bernie Hogan
- Oxford Internet Institute, University of Oxford, Oxford, UK
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Ohta R, Yakabe T, Adachi H, Sano C. The Association Between Community Participation and Loneliness Among Patients in Rural Community Hospitals: A Cross-Sectional Study. Cureus 2024; 16:e56501. [PMID: 38638785 PMCID: PMC11026138 DOI: 10.7759/cureus.56501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction Loneliness among adults is a critical public health issue, particularly in rural areas where social isolation can be more pronounced. Understanding the factors that influence loneliness can guide the development of effective interventions. This study explores the impact of demographic, health-related, and social participation factors on loneliness among rural Japanese adults, focusing on the role of community participation. Method This cross-sectional study was conducted with rural Japanese adults who regularly visited rural community hospitals. Data were collected on participants' demographic characteristics, health status, and social participation and analyzed using a multivariate logistic regression model to identify factors associated with higher levels of loneliness. The covariates included age, sex, body mass index (BMI), chronic health conditions, and community participation. Results The study found that community participation had a significant negative association with loneliness, with an odds ratio (OR) of 0.46 (p < 0.01), indicating that individuals engaged in community activities were substantially less likely to experience higher levels of loneliness. Higher BMI was associated with lower odds of loneliness (OR = 0.93, p < 0.02), suggesting a protective effect against loneliness. Conclusion The findings highlight the paramount importance of community engagement in mitigating loneliness among rural Japanese adults. The inverse relationship between BMI and loneliness suggests that BMI and social participation influence loneliness. These insights underscore the need for comprehensive interventions that promote community participation and address the multifaceted nature of loneliness. Future research should further explore the mechanisms through which community engagement and BMI impact loneliness to develop targeted strategies for improving the well-being of rural adults.
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Affiliation(s)
| | | | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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Calderón-Larrañaga S, Greenhalgh T, Finer S, Clinch M. What does social prescribing look like in practice? A qualitative case study informed by practice theory. Soc Sci Med 2024; 343:116601. [PMID: 38280288 DOI: 10.1016/j.socscimed.2024.116601] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/11/2023] [Accepted: 01/11/2024] [Indexed: 01/29/2024]
Abstract
Social prescribing (SP) typically involves linking patients in primary care with a range of local, community-based, non-clinical services. While there is a growing body of literature investigating the effectiveness of SP in improving healthcare outcomes, questions remain about how such outcomes are achieved within the everyday complexity of community health systems. This qualitative case study, informed by practice theory, aimed to investigate how SP practices relevant to people at high risk of type 2 diabetes (T2D) were enacted in a primary care and community setting serving a multi-ethnic, socioeconomically deprived population. We collected different types of qualitative data, including 35 semi-structured interviews with primary care clinicians, link workers and SP organisations; 30 hours of ethnographic observations of community-based SP activities and meetings; and relevant documents. Data analysis drew on theories of social practice, including Feldman's (2000) notion of the organisational routine, which emphasises the creative and emergent nature of routines in practice. We identified different, overlapping ways of practising SP: from highly creative, reflective and adaptive ('I do what it takes'), to more constrained ('I do what I can') or compliant ('I do as I'm told') approaches. Different types of practices were in tension and showed varying degrees of potential to support patients at high risk of T2D. Opportunities to adapt, try, negotiate, and ultimately reinvent SP to suit patients' own needs facilitated successful SP adoption and implementation, but required specific individual, relational, organisational, and institutional resources and conditions. Feldman, M.S., 2000. Organizational Routines as a Source of Continuous Change. Organ. Sci. 11, 611-629.
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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
| | - 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
| | - 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
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