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Evers S, Kenkre J, Kloppe T, Kurpas D, Mendive JM, Petrazzuoli F, Vidal-Alaball J. Survey of general practitioners' awareness, practice and perception of social prescribing across Europe. Eur J Gen Pract 2024; 30:2351806. [PMID: 38757217 PMCID: PMC11104702 DOI: 10.1080/13814788.2024.2351806] [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: 07/07/2023] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Social prescribing (SP) is a patient pathway by which healthcare professionals connect patients with other sources of support, groups, or activities within their community. The awareness, practice, and perception of SP among GPs across Europe remains unclear. OBJECTIVES To explore the awareness, practice, and perception of GPs on SP in the WONCA Europe region. METHODS An anonymous, cross-sectional online survey was distributed through a snowballing system, mailing lists, and at three international conferences in 2022/2023 to explore GPs' awareness, practice, and perception of SP. The questionnaire in English contained 21 open and closed questions. RESULTS Of the 208 participating GPs from 33 countries, 116 (56%) previously heard of 'social prescribing' and 66 (32%) regularly referred patients to community activities through a formal system. These 66 GPs reported different funding sources and varied activities, with an average of four activities and physical exercise being the most prevalent. Among them, 25 (38%) knew about national or local SP awareness campaigns. Of these 25, 17 (68%) agreed that SP increases their job satisfaction and 21 (84%) agreed that it has a positive impact on their patients. Variations in SP awareness and referral practice were evident across and within countries. CONCLUSION Despite disparities in awareness and referral practice as well as a diversity of activities and funding sources, most GPs who actively referred patients and were informed about SP campaigns agreed that SP positively impacts them and their patients.
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Affiliation(s)
- Sinah Evers
- Department of Health Services Research, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
| | - Joyce Kenkre
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
- Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Thomas Kloppe
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Donata Kurpas
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
- Health Sciences Faculty, Wroclaw Medical University, Wroclaw, Poland
- European Rural and Isolated Practitioner Association (EURIPA), Paris, France
| | - Juan M. Mendive
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
- La Mina Primary Health Care Academic Centre, Catalan Health Institute (ICS), University of Barcelona, Barcelona, Spain
- Institute for Primary Health Care Research IDIAP Jordi Gol, Barcelona, Spain
| | - Ferdinando Petrazzuoli
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
- European Rural and Isolated Practitioner Association (EURIPA), Paris, France
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Josep Vidal-Alaball
- WONCA Europe Social Prescribing and Community Orientation Special Interest Group, Brussels, Belgium
- Health Promotion in Rural Areas Research Group, Institut Català de la Salut, Barcelona, Spain
- Central Catalonia Research Support Unit, Jordi Gol i Gurina University Institute for Research in Primary Health Care Foundation, Sant Fruitós de Bages, Barcelona, Spain
- Faculty of Medicine, Vic-Central University of Catalonia, Vic, Spain
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Doyle DM, Link BG. On social health: history, conceptualization, and population patterning. Health Psychol Rev 2024; 18:619-648. [PMID: 38349646 PMCID: PMC11332409 DOI: 10.1080/17437199.2024.2314506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/31/2024] [Indexed: 08/20/2024]
Abstract
We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.
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Affiliation(s)
- David Matthew Doyle
- Department of Medical Psychology, Amsterdam University Medical Centers, Location VUmc, Amsterdam, the Netherlands
| | - Bruce G. Link
- School of Public Policy and Department of Sociology, University of California, Riverside, CA, US
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Hayes S, Sharman L, McNamara N, Dingle G. Link workers' and clients' perspectives on how social prescribing offers a social cure for loneliness. J Health Psychol 2024:13591053241274090. [PMID: 39175155 DOI: 10.1177/13591053241274090] [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: 08/24/2024] Open
Abstract
Social prescribing is a healthcare model designed to reduce loneliness and improve individuals' health by addressing unmet social needs. The present study adopted the Social Cure framework to provide an understanding of the psychosocial processes involved in helping participants to engage with social activities, from both the link workers' and clients' perspectives. Semi-structured interviews were conducted with 15 link workers (Mage = 40.12; 87% female) and 15 clients (Mage = 55.33; 73% female, 7% non-binary) of social prescribing programmes across Australia and the transcripts were analysed using reflexive thematic analysis. Three overarching themes were identified: (1) Breaking Down Barriers, (2) Finding Fit with Others, and (3) Rebuilding a Sense of Self. These findings communicate how social prescribing addressed the psychosocial barriers of clients, and how joining groups that fostered positive shared social identities resulted in meaningful improvements to clients' well-being.
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Kaneko M, Shinoda S, Nakayama I, Xu J, Yagome S, Goto A. Usual source and better quality of primary care are associated with lower loneliness scores: a cross-sectional study. Fam Pract 2024; 41:312-320. [PMID: 37116200 PMCID: PMC11167986 DOI: 10.1093/fampra/cmad049] [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] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Loneliness is a global issue, and primary care physicians play an important role in assessing and intervening with loneliness. This study aimed to examine the association between having a usual source of care (USC) or a good quality of primary care, and loneliness. METHODS This cross-sectional study was conducted in Japan in 2022. A total of 6,000 residents were randomly sampled from the general population, aged 20-74 years. The outcome was the total score of the University of California, Los Angeles (UCLA) 3-item loneliness scale. The exposure included USC and the Person-Centered Primary Care Measure (PCPCM), which assesses the quality of primary care. We conducted a linear regression analysis to adjust for age, sex, educational status, annual household income, self-rated health, living status (whether alone or not), and the existence of physical health problems. RESULTS Of the 6,000 residents, 1,277 responded to the survey. The median score of the UCLA 3-item loneliness scale was 6.0 and the mean total score of the PCPCM was 2.62. Of the 1,277 individuals, 713 (55.8%) had USC. Having USC was significantly associated with lower scores on the UCLA 3-item loneliness scale; the coefficient was -0.34 (95% confidence interval (CI): -0.57 to -0.12). Also, the total PCPCM score was significantly associated with lower loneliness scores; the coefficient was -0.56 (P < 0.001, 95% CI: -0.78 to -0.35). CONCLUSIONS Having USC and a better quality primary care were associated with a lower loneliness score. The quality of primary care could be a factor to mitigate patient loneliness.
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Affiliation(s)
- Makoto Kaneko
- Department of Health Data Science, Yokohama City University, Yokohama, Japan
| | - Satoru Shinoda
- Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Izumi Nakayama
- Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama, Japan
| | - Juan Xu
- Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | | | - Atsushi Goto
- Department of Health Data Science, Yokohama City University, Yokohama, Japan
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Zhao J, Zhu H, Zhu D, Chang F, Liu C, Yang Y, Han T. Effectiveness of identity-building interventions on recovery identity and patient-reported health outcomes in chronic diseases: A meta-analysis. J Health Psychol 2024:13591053241249636. [PMID: 38819962 DOI: 10.1177/13591053241249636] [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: 06/02/2024] Open
Abstract
This meta-analysis aimed to assess the impact of identity-building interventions on recovery identity and patient-reported health outcomes in chronic disease patients. We identified 15 relevant empirical studies (comprising 2261 patients) from 989 records through extensive keyword searches and manual screening conducted between March 2nd and March 13th, 2023. Utilizing the Cochrane tool, meta-regression, and the GRADE approach, we evaluated these studies for their characteristics, findings, and quality. The analysis revealed that identity-building interventions, encompassing recovery-oriented group, interest group, and linguistic approaches, positively influenced identity synthesis and had varying effects on health outcomes. Notably, multiple regression analysis demonstrated that identity synthesis significantly predicted health outcomes. However, the study identified mild heterogeneity, a high attrition bias risk, and insufficient data on selection and detection bias as limitations. Overall, identity-building interventions proved influential in enhancing recovery identity, a vital predictor of patient-reported health outcomes in chronic disease patients.
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Affiliation(s)
| | | | - Dian Zhu
- Shanghai Jiao Tong University, China
| | | | | | - Yan Yang
- Shanghai Jiao Tong University, China
| | - Ting Han
- Shanghai Jiao Tong University, China
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Dingle GA, Sharman LS, Hayes S, Haslam C, Cruwys T, Jetten J, Haslam SA, McNamara N, Chua D, Baker JR, Johnson T. A controlled evaluation of social prescribing on loneliness for adults in Queensland: 8-week outcomes. Front Psychol 2024; 15:1359855. [PMID: 38680281 PMCID: PMC11049426 DOI: 10.3389/fpsyg.2024.1359855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction There have been few controlled evaluations of Social Prescribing (SP), in which link workers support lonely individuals to engage with community-based social activities. This study reports early outcomes of a trial comparing General Practitioner treatment-as-usual (TAU) with TAU combined with Social Prescribing (SP) in adults experiencing loneliness in Queensland. Methods Participants were 114 individuals who were non-randomly assigned to one of two conditions (SP, n = 63; TAU, n = 51) and assessed at baseline and 8 weeks, on primary outcomes (loneliness, well-being, health service use in past 2 months) and secondary outcomes (social anxiety, psychological distress, social trust). Results Retention was high (79.4%) in the SP condition. Time × condition interaction effects were found for loneliness and social trust, with improvement observed only in SP participants over the 8-week period. SP participants reported significant improvement on all other outcomes with small-to-moderate effect sizes (ULS-8 loneliness, wellbeing, psychological distress, social anxiety). However, interaction effects did not reach significance. Discussion Social prescribing effects were small to moderate at the 8-week follow up. Group-based activities are available in communities across Australia, however, further research using well-matched control samples and longer-term follow ups are required to provide robust evidence to support a wider roll out.
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Affiliation(s)
- Genevieve A. Dingle
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Leah S. Sharman
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Shaun Hayes
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Catherine Haslam
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Tegan Cruwys
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - Jolanda Jetten
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - S. Alexander Haslam
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Niamh McNamara
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - David Chua
- Inala Primary Care, Brisbane, QLD, Australia
- Centre for Community Health and Wellbeing, The University of Queensland, Brisbane, QLD, Australia
| | - James R. Baker
- Primary and Community Care Services, Gold Coast, QLD, Australia
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
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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.
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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
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Aughterson H, Fancourt D, Chatterjee H, Burton A. Social prescribing for individuals with mental health problems: An ethnographic study exploring the mechanisms of action through which community groups support psychosocial well-being. Wellcome Open Res 2024; 9:149. [PMID: 38952567 PMCID: PMC11216282 DOI: 10.12688/wellcomeopenres.20981.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 07/03/2024] Open
Abstract
Background Social prescribing involves connecting individuals to community groups and activities, often to support their mental health and well-being. It has received increasing support in recent years across the NHS. There is a strong evidence base for the benefits of different types of community activities, including exercise groups, arts groups and nature interventions, on mental health outcomes, however, less is known about how these groups impact mental health and well-being. This study explores through what individual-level mechanisms (the 'how') these groups support psychosocial well-being. Methods An ethnographic study was conducted over 12-months to explore key shared, individual-level mechanisms across 4 social prescribing community groups: football, singing, gardening and reading. This study focused mostly on those with severe mental illness, whereas previously most social prescribing studies have focused on mild to moderate mental health problems. To frame the findings, a 'multi-level theoretical framework of mechanisms of action' of leisure activities was used. Results Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine. Conclusions It is hoped that the findings of this study can help referring professionals increase their understanding of exactly how such groups support individuals' mental health, thus enhancing referring practices.
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Affiliation(s)
- Henry Aughterson
- Behavioral Science and Health, University College London, London, England, UK
| | - Daisy Fancourt
- Behavioral Science and Health, University College London, London, England, UK
| | - Helen Chatterjee
- Behavioral Science and Health, University College London, London, England, UK
| | - Alexandra Burton
- Behavioral Science and Health, University College London, London, England, UK
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Yadav UN, Paudel G, Ghimire S, Khatiwada B, Gurung A, Parsekar SS, Mistry SK. A rapid review of opportunities and challenges in the implementation of social prescription interventions for addressing the unmet needs of individuals living with long-term chronic conditions. BMC Public Health 2024; 24:306. [PMID: 38279079 PMCID: PMC10821289 DOI: 10.1186/s12889-024-17736-2] [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: 09/15/2023] [Accepted: 01/10/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND People with long-term chronic conditions often struggle to access and navigate complex health and social services. Social prescription (SP) interventions, a patient-centred approach, help individuals identify their holistic needs and increase access to non-clinical resources, thus leading to improved health and well-being. This review explores existing SP interventions for people with long-term chronic conditions and identifies the opportunities and challenges of implementing them in primary healthcare settings. METHODS This rapid review followed the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and searched relevant articles in three databases (PubMed/MEDLINE, EMBASE, and Web of Science) by using subject headings and keywords combined with Boolean operators. The search encompassed articles published between January 2010 and June 2023. Two authors independently conducted study screening and data abstraction using predefined criteria. A descriptive synthesis process using content analysis was performed to summarise the literature. RESULTS Fifteen studies were included, with all but one conducted in the United Kingdom, and revealed that social prescribers help guide patients with long-term chronic conditions to various local initiatives related to health and social needs. Effective implementation of SP interventions relies on building strong relationships between social prescribers and patients, characterised by trust, empathy, and effective communication. A holistic approach to addressing the unmet needs of people with long-term chronic conditions, digital technology utilisation, competent social prescribers, collaborative healthcare partnerships, clinical leadership, and access to local resources are all vital components of successful SP intervention. However, the implementation of SP interventions faces numerous challenges, including accessibility and utilisation barriers, communication gaps, staffing issues, an unsupportive work environment, inadequate training, lack of awareness, time management struggles, coordination and collaboration difficulties, and resource constraints. CONCLUSION The present review emphasises the importance of addressing the holistic needs of people with long-term chronic conditions through collaboration and coordination, training of social prescribers, community connections, availability of local resources, and primary care leadership to ensure successful interventions, ultimately leading to improved patient health and well-being outcomes. This study calls for the need to develop or utilise appropriate tools that can capture people's holistic needs, as well as an implementation framework to guide future contextual SP interventions.
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Affiliation(s)
- Uday Narayan Yadav
- National Centre for Aboriginal and Torres Strait Islander Well-Being Research, The Australian National University, Canberra, ACT, Australia.
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
| | - Grish Paudel
- School of Health Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Saruna Ghimire
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | | | - Ashmita Gurung
- Department of Public Health, Torres University, Sydney, Australia
| | - Shradha S Parsekar
- Independent Freelance Consultant, Goa, India
- Public Health Evidence South Asia, Prasanna School of Public Health, Manipal, Karnataka, India
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
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Evers S, Husk K, Napierala H, Wendt L, Gerhardus A. Theories used to develop or evaluate social prescribing in studies: a scoping review. BMC Health Serv Res 2024; 24:140. [PMID: 38279096 PMCID: PMC10821232 DOI: 10.1186/s12913-024-10563-6] [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: 09/13/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024] Open
Abstract
OBJECTIVE This scoping review aims to provide an overview of how theories were used in the development or evaluation of social prescribing (SP) intervention studies. BACKGROUND SP describes a patient pathway where general practitioners (GPs) connect patients with community activities through referrals to link workers. This review seeks to understand the explanations provided for the outcomes and implementation process of SP. INCLUSION CRITERIA Studies using a defined theory to develop or evaluate a specific SP intervention in primary care and the community sector. METHODS This scoping review was conducted in accordance with JBI methodology. The following databases were searched on 8th of July 2022: PubMed, ASSIA, Cochrane, Cinahl, PsycINFO, Social Care Online, Sociological Abstracts, Scopus, and Web of Science. The search only considered English language texts. Additional literature was identified by searching relevant web pages and by contacting experts. The selection of sources and the data extraction was done by two reviewers independently. RESULTS The search resulted in 4240 reports, of which 18 were included in the scoping review. Of these, 16 were conducted in the UK, one in Canada and one in Australia. The majority of reports employed a qualitative approach (11/18). Three were study protocols. 11 distinct theories were applied to explain outcomes (4 theories), differences in outcomes (3 theories), and the implementation of the intervention (4 theories). In terms of practical application, the identified theories were predominantly used to explain and understand qualitative findings. Only one theory was used to define variables for hypothesis testing. All theories were used for the evaluation and none for the development of SP. CONCLUSION The theories influenced which outcomes the evaluation assessed, which causal pathway was expected to generate these outcomes, and which methodological approaches were used. All three groups of theories that were identified focus on relevant aspects of SP: fostering positive patient/community outcomes, addressing inequalities by considering the context of someone's individual circumstances, and successfully implementing SP by collaboratively working across professions and institutional boundaries. Additional insight is required regarding the optimal use of theories in practical applications.
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Affiliation(s)
- Sinah Evers
- Department of Health Services Research, Institute of Public Health and Nursing Research, University of Bremen, Grazer Straße 4, Bremen, 28359, Germany.
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | - Kerryn Husk
- NIHR ARC South West Peninsula (PenARC), Faculty of Health, University of Plymouth, Plymouth, UK
| | - Hendrik Napierala
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Institute of General Practice and Family Medicine, Berlin, Germany
| | - Lydia Wendt
- Department of Health Services Research, Institute of Public Health and Nursing Research, University of Bremen, Grazer Straße 4, Bremen, 28359, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- School of Social Sciences, City University of Applied Sciences, Bremen, Germany
- Research Cluster 'Healthy City Bremen', Bremen, Germany
| | - Ansgar Gerhardus
- Department of Health Services Research, Institute of Public Health and Nursing Research, University of Bremen, Grazer Straße 4, Bremen, 28359, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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Sonke J, Manhas N, Belden C, Morgan-Daniel J, Akram S, Marjani S, Oduntan O, Hammond G, Martinez G, Davidson Carroll G, Rodriguez AK, Burch S, Colverson AJ, Pesata V, Fancourt D. Social prescribing outcomes: a mapping review of the evidence from 13 countries to identify key common outcomes. Front Med (Lausanne) 2023; 10:1266429. [PMID: 38020134 PMCID: PMC10660286 DOI: 10.3389/fmed.2023.1266429] [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: 07/24/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction As a means for supporting a range of health and wellbeing goals, social prescribing programs have been implemented around the world. Reflecting a range of contexts, needs, innovation, and programing, a broad array of outcomes has been studied in relation to these programs. As interest in social prescribing grows, more targeted study of key outcomes and in turn evidence synthesis that can inform evidence-based practice, policy, and investment is needed. Methods and Results This mapping review identified, described, and synthesized the broad array of social prescribing outcomes that have been studied in 13 countries and maps the outcomes that have been most commonly studied. From 87 articles included in this review, a total of 347 unique outcomes were identified, including 278 unique patient outcomes and 69 unique system outcomes. The most commonly studied categories of patient outcomes were found to be mental health, lifestyle and behavior, and patient/service user experience. The most commonly studied system outcomes were healthcare/service utilization and financial/economic outcomes. Discussion This review highlights the value of heterogeneity and mixed methods approaches in outcomes studies for capturing nuanced experiences and outcomes in this nascent area of practice, while contributing to the advancement of evidence synthesis for social prescribing globally by quantifying and offering insight into the outcomes that have been studied to date. It also lays a foundation for the development of key common outcomes and a Core Outcomes Set for social prescribing. Additionally, it identified key outcomes that, given their relationship to critical health and social issues, warrant both broader and deeper study.
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Affiliation(s)
- Jill Sonke
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Nico Manhas
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Cassandra Belden
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Jane Morgan-Daniel
- Health Science Center Libraries, University of Florida, Gainesville, FL, United States
| | - Seher Akram
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Stefany Marjani
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Oluwasanmi Oduntan
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - Gabrielle Hammond
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Gabriella Martinez
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Gray Davidson Carroll
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Alexandra K. Rodriguez
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Shanaé Burch
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Aaron J. Colverson
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
- School of Music, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Virginia Pesata
- Center for Arts in Medicine, College of the Arts, University of Florida, Gainesville, FL, United States
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Menhas R, Yang L, Danish Nisar R. Community-based social healthcare practices in China for healthy aging: a social prescription perspective analysis. Front Public Health 2023; 11:1252157. [PMID: 37849719 PMCID: PMC10578489 DOI: 10.3389/fpubh.2023.1252157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/29/2023] [Indexed: 10/19/2023] Open
Abstract
Background The global population is aging, and the number of people suffering from chronic diseases is increasing. In response to these trends, community-enhanced social healthcare practices are a novel paradigm of social prescribing that aims to improve both the community's and the individual's level of health by combining community involvement, organizational change, and individual-level practice. Objective The study examined the state of community-based social healthcare practices using the lens of social prescription in China with an eye on promoting healthy aging there. Method Thematic analysis approach was used in this investigation. A social prescription lens was used to conduct an open-ended theme study of China's community-based social healthcare practices for healthy aging. The research was conducted in Yiwu in Zhejiang Province, P. R. China. A sample of 24 "comprehensive evaluation team members (CETM)" was chosen using a purposive selection strategy. Results In the context of the social prescription, we analyzed social healthcare practices for healthy aging at the community level. All the comprehensive evaluation team members described community social healthcare practices under the paradigm of social prescription. After analyzing the community social healthcare practices under the paradigm of social prescription, six main themes (E-Social Prescription, Nature-based Social Prescription, Healthy Living Social Prescription, Culture-based Social Prescription, Health Screening Social Prescription, and Health Education Social Prescription) emerged for healthy aging at the community level. Conclusion Social prescribing links individuals to non-clinical services and activities, typically provided by the nonprofit and community sectors. Community-based social healthcare practices under social prescription can be an efficient and cost-effective way to assist patients with chronic diseases in managing their illnesses and enhancing their overall health and wellbeing.
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Affiliation(s)
- Rashid Menhas
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Lili Yang
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Rana Danish Nisar
- Department of Politics and International Relations (DPIR), University of Sargodha, Sargodha, Pakistan
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13
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Gonnord T, Clarys D, Boucard G, Esnard C. Positive impact of social relationships fostered by physical and/or cognitive group activity on older people's quality of life: PRISMA systematic review. Front Psychol 2023; 14:1166072. [PMID: 37767210 PMCID: PMC10520714 DOI: 10.3389/fpsyg.2023.1166072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction This review identified and examined the research literature on the effect of participating in physical and/or cognitive activities on older people's quality of life, to establish whether the social relationships fostered by these activities can be a vector of better physical, mental and social quality of life. Method A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched four databases (MEDLINE, APA PsycArticles/PsycInfo, PubMed, and Web of Science) for articles published between 1975 and 2022 using search terms related to psychosocial, population, and intervention topics. Studies were eligible if they involved older adults, participation in at least one activity (physical or cognitive), and at least one quality of life related outcome measure. Results We selected 20 articles published between 1990 and 2021, the majority concerning studies conducted in English-speaking countries. Ten studies were interventional (introduction of program of activities), and 10 studies were observational (60% quantitative, 40% qualitative). Overall, results revealed a positive impact of the activities on every aspect of quality of life (i.e., cognitive, physical, social, psychological, and quality of life in general). Conclusion The present review confirmed the beneficial impact of practicing physical and/or cognitive group activities on older people's quality of life, but the contribution of social factors and social relationships remains underestimated and not well defined in researches.
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Affiliation(s)
- Tiphanie Gonnord
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
| | - David Clarys
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
| | - Geoffroy Boucard
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
- Laboratoire Mobilité Vieillissement Exercice (EA6314), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France
| | - Catherine Esnard
- Centre de Recherches sur la Cognition et l’Apprentissage, Département de Psychologie, Université de Poitiers, Université François Rabelais de Tours, CNRS, Poitiers, France
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Thompson C, Halcomb E, Masso M. The contribution of primary care practitioners to interventions reducing loneliness and social isolation in older people-An integrative review. Scand J Caring Sci 2023; 37:611-627. [PMID: 36732897 DOI: 10.1111/scs.13151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/22/2022] [Accepted: 01/14/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Social connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well-being. Given their regular contact and trusted relationships with older people, practitioners delivering community-based primary care are well-positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear. AIM This integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community-dwelling older people. METHOD Using an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis. RESULTS Included studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi-component, with ten studies including a group-based activity and three providing primarily individual-level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people. CONCLUSION There is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation.
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Affiliation(s)
- Cristina Thompson
- Australian Health Services Research Institute, University of Wollongong, New South Wales, Wollongong, Australia
- School of Nursing, University of Wollongong, New South Wales, Wollongong, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, New South Wales, Wollongong, Australia
| | - Malcolm Masso
- Australian Health Services Research Institute, University of Wollongong, New South Wales, Wollongong, Australia
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15
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Buechner H, Toparlak SM, Ostinelli EG, Shokraneh F, Nicholls-Mindlin J, Cipriani A, Geddes JR, Syed Sheriff R. Community interventions for anxiety and depression in adults and young people: A systematic review. Aust N Z J Psychiatry 2023; 57:1223-1242. [PMID: 36722407 PMCID: PMC10466972 DOI: 10.1177/00048674221150362] [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] [Indexed: 02/02/2023]
Abstract
BACKGROUND Growing evidence suggests that community-based interventions may be effective for anxiety and depression. This study aimed to describe studies of community interventions delivered to adults and/or young people, either in person or online, evaluated in randomised controlled trials and provide an indication as to their effectiveness, acceptability, quality of data and where possible, mechanisms of action. We included interventions delivered at and/or by museums, art galleries, libraries, gardens, music groups/choirs and sports clubs. METHOD We developed and followed a preregistered protocol: PROSPERO CRD42020204471. Randomised controlled trials in adults and young people were identified in an extensive search with no date/time, language, document type and publication status limitations. Studies were selected according to predetermined eligibility criteria and data independently extracted and then assessed using Risk of Bias 1. The studies were deemed too heterogeneous for meta-analysis and were therefore reported using a narrative synthesis. RESULTS Our analysis included 31 studies, with 2898 participants. Community interventions most studied in randomised controlled trials were community music (12 studies, 1432 participants), community exercise (14 studies, 955 participants) and community gardens/gardening (6 studies, 335 participants). The majority of studies were from high-income countries - many were in specific populations (such as those with physical health problems) and were generally of low quality. Dropout rates across the included studies were low (1 participant on average per 100 participants). The inadequate description of interventions limited identification of potential mechanisms of action. DISCUSSION The uncertainty of the evidence allows only a weak recommendation in support of community interventions for anxiety and depression. The results suggest community engagement is a promising area for wide-reaching interventions to be implemented and evaluated, but more high-quality trials are needed, especially in young people and under-represented communities.
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Affiliation(s)
| | - Sureyya M Toparlak
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Edoardo G Ostinelli
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Farhad Shokraneh
- Institute of Health Informatics, University College London, London, UK
| | | | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rebecca Syed Sheriff
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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16
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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.
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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
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17
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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.
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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
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18
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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 DOI: 10.1186/s12913-023-09650-x] [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: 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.
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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
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Teggart K, Neil-Sztramko SE, Nadarajah A, Wang A, Moore C, Carter N, Adams J, Jain K, Petrie P, Alshaikhahmed A, Yugendranag S, Ganann R. Effectiveness of system navigation programs linking primary care with community-based health and social services: a systematic review. BMC Health Serv Res 2023; 23:450. [PMID: 37158878 PMCID: PMC10165767 DOI: 10.1186/s12913-023-09424-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/19/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Fragmented delivery of health and social services can impact access to high-quality, person-centred care. The goal of system navigation is to reduce barriers to healthcare access and improve the quality of care. However, the effectiveness of system navigation remains largely unknown. This systematic review aims to identify the effectiveness of system navigation programs linking primary care with community-based health and social services to improve patient, caregiver, and health system outcomes. METHODS Building on a previous scoping review, PsychInfo, EMBASE, CINAHL, MEDLINE, and Cochrane Clinical Trials Registry were searched for intervention studies published between January 2013 and August 2020. Eligible studies included system navigation or social prescription programs for adults, based in primary care settings. Two independent reviewers completed study selection, critical appraisal, and data extraction. RESULTS Twenty-one studies were included; studies had generally low to moderate risk of bias. System navigation models were lay person-led (n = 10), health professional-led (n = 4), team-based (n = 6), or self-navigation with lay support as needed (n = 1). Evidence from three studies (low risk of bias) suggests that team-based system navigation may result in slightly more appropriate health service utilization compared to baseline or usual care. Evidence from four studies (moderate risk of bias) suggests that either lay person-led or health professional-led system navigation models may improve patient experiences with quality of care compared to usual care. It is unclear whether system navigation models may improve patient-related outcomes (e.g., health-related quality of life, health behaviours). The evidence is very uncertain about the effect of system navigation programs on caregiver, cost-related, or social care outcomes. CONCLUSIONS There is variation in findings across system navigation models linking primary care with community-based health and social services. Team-based system navigation may result in slight improvements in health service utilization. Further research is needed to determine the effects on caregiver and cost-related outcomes.
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Affiliation(s)
- Kylie Teggart
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Abbira Nadarajah
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Amy Wang
- Department of Family Medicine, University of Alberta, 5-16 University Terrace, Edmonton, AB, T6G 2T4, Canada
| | - Caroline Moore
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Nancy Carter
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Janet Adams
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Kamal Jain
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Penelope Petrie
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Aref Alshaikhahmed
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Shreya Yugendranag
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada
| | - Rebecca Ganann
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, HSC 3N25L8S 4K1, Canada.
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Grover S, Sandhu P, Nijjar GS, Percival A, Chudyk AM, Liang J, McArthur C, Miller WC, Mortenson WB, Mulligan K, Newton C, Park G, Pitman B, Rush KL, Sakakibara BM, Petrella RJ, Ashe MC. Older adults and social prescribing experience, outcomes, and processes: a meta-aggregation systematic review. Public Health 2023; 218:197-207. [PMID: 37060740 DOI: 10.1016/j.puhe.2023.02.016] [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: 11/02/2022] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVE Social prescribing is a complex care model, which aims to address unmet non-medical needs and connect people to community resources. The purpose of this systematic review was to synthesize available evidence from qualitative methods (e.g. interviews or focus groups) on experience, outcomes, and processes for social prescribing and older adults (from the person or provider level). STUDY DESIGN This was a systematic review using the Joanna Brigg's meta-aggregative approach. METHODS We searched multiple online databases for peer-reviewed studies, which included older adults aged ≥60 years (group mean age) and social prescribing experience, outcomes, or processes. We included all qualitative or mixed methods designs from all years and languages. Date of the last primary search was March 24, 2022. Two authors used online software to conduct the screening independently and then decided on the final list of included studies via notes and online discussion. RESULTS We screened 376 citations (after duplicates) and included eight publications. There were 197 older adult participants (59% women), and many people were living with chronic health conditions. Few details were provided for participants' ethnicity, education, and related factors. We created five synthesized findings related to (1) the approach of social prescribing; implementation factors such as (2) relationships, (3) behavior change strategies, and (4) the environment; and (5) older adults' perceived health and psychosocial outcomes. CONCLUSIONS Despite the limited number of available studies, data provide an overview of people and processes involved with social prescribing, identified research and practice gaps, and possible next steps for implementing and evaluating social prescribing for older adults in primary care.
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Affiliation(s)
- Sanya Grover
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Prabhleen Sandhu
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Gurkirat Singh Nijjar
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Amanda Percival
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Anna M Chudyk
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jessica Liang
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - William C Miller
- UBC Department of Occupational Science and Occupational Therapy, Vancouver, BC, Canada; GF Strong Rehabilitation Research Program, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - W Ben Mortenson
- UBC Department of Occupational Science and Occupational Therapy, Vancouver, BC, Canada; GF Strong Rehabilitation Research Program, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Kate Mulligan
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Christie Newton
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
| | - Grace Park
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada; Fraser Health Authority, Surrey, BC, Canada
| | | | - Kathy L Rush
- School of Nursing, UBC-Okanagan, Kelowna, BC, Canada
| | - Brodie M Sakakibara
- UBC Department of Occupational Science and Occupational Therapy, Vancouver, BC, Canada; Centre for Chronic Disease Prevention and Management, Southern Medical Program, UBC-Okanagan, Kelowna, BC, Canada
| | - Robert J Petrella
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada; Department of Family Medicine, Western University, London, Ontario, Canada; School of Kinesiology, Western University, London, Ontario, Canada; Western Centre for Public Health & Family Medicine, Western University, London, Ontario, Canada
| | - Maureen C Ashe
- Department of Family Practice, The University of British Columbia (UBC), Vancouver, BC, Canada
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21
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Marquez J, Goodfellow C, Hardoon D, Inchley J, Leyland AH, Qualter P, Simpson SA, Long E. Loneliness in young people: a multilevel exploration of social ecological influences and geographic variation. J Public Health (Oxf) 2023; 45:109-117. [PMID: 34999845 PMCID: PMC10017088 DOI: 10.1093/pubmed/fdab402] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness is a growing public health concern, yet little is known about loneliness in young people. The current study aimed to identify social ecological factors related to loneliness and examine the extent to which geographic region may account for differences in loneliness. METHODS The data come from a cross-sectional sample of 6503 young people living in the UK. Loneliness was measured using the UCLA 3-item scale. Bivariate analyses were used to test associations between each predictor and loneliness. Multilevel models were used to identify key social ecological factors related to loneliness, and the extent to which loneliness may vary across geographic regions (local authority districts). RESULTS Sociodemographic, social, health and well-being, and community factors were found to be associated with loneliness. Geographic region was associated with 5-8% of the variation in loneliness. The effect of gender, sexual orientation and minority ethnic background on loneliness differed across regions. CONCLUSIONS This is the first study to highlight modifiable social and community factors related to youth loneliness, and individual vulnerabilities, such as poor mental well-being. Results related to geographic differences suggest that local-level initiatives may be most appropriate in tackling loneliness, rather than wider, less contextualized national efforts.
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Affiliation(s)
- J Marquez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - C Goodfellow
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - D Hardoon
- What Works Centre for Wellbeing, London SW1H 9EA, UK
| | - J Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - A H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - P Qualter
- University of Manchester, Manchester Institute of Education, Manchester M13 9PL, UK
| | - S A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - E Long
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
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22
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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.
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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
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23
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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.
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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.
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24
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Yin M, Lee EJ. Exposure to loneliness cues reduces prosocial behavior: Evidence from N400 and P300. Front Psychol 2023; 14:1094652. [PMID: 37138978 PMCID: PMC10150042 DOI: 10.3389/fpsyg.2023.1094652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
Loneliness is a major risk factor for morbidity and mortality. However, the effect of loneliness on subsequent prosocial behavior is not well known. Understanding the neurobiological mechanisms underlying loneliness is necessary to address this research gap. We investigate the mechanism using a modified public goods game (PGG) wherein participants can choose to act for a collective or selfish interest after being exposed to loneliness cues. Both behavioral (Study 1) and event-related potential (ERP) (Study 2) measures were used to explore this relationship. In Study 1 (N = 131), we found that participants exhibited decreased prosocial actions under the loneliness priming condition as opposed to the control condition. In Study 2 (N = 17), frontal N400 and posterior P300 components were identified under the loneliness priming condition as opposed to the control condition. Increased (decreased) frontal N400 and posterior P300 lead to selfish (prosocial) choices. These results indicate that humans instinctively perceive loneliness as inconsistency with their desired social-relational life, which in turn stimulates coping strategies for self-preservation. This study contributes to our understanding of the neurobiological basis of loneliness associated with prosocial behavior.
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Affiliation(s)
- Meiling Yin
- Business School, Sungkyunkwan University, Seoul, Republic of Korea
| | - Eun-Ju Lee
- Business School, Sungkyunkwan University, Seoul, Republic of Korea
- Neuro Intelligence Center, Sungkyunkwan University, Seoul, Republic of Korea
- *Correspondence: Eun-Ju Lee,
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25
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Green H, Fernandez R, Moxham L, MacPhail C. Social capital and wellbeing among Australian adults' during the COVID-19 pandemic: a qualitative study. BMC Public Health 2022; 22:2406. [PMID: 36550458 PMCID: PMC9772589 DOI: 10.1186/s12889-022-14896-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19 has created global disruption, with governments across the world taking rapid action to limit the spread of the virus. Physical distancing and lockdowns abruptly changed living conditions for many, posing specific challenges of social isolation and lack of connectedness due to being physically and socially isolated from family and friends. Social capital is the bonding of individuals within a society that facilitates and shapes social interactions. The aim of this study was to qualitatively explore the impact that existing social capital has on Australians' experience of lockdowns during the COVID-19 pandemic and the effect this has had on their wellbeing and quality of life. METHODS Participants from various socioeconomic areas within Australia were purposively selected to participate in semi-structured interviews conducted via videoconferencing or telephone. Inductive thematic analysis of the data was undertaken. RESULTS A total of 20 participants were interviewed ranging in age from 21 to 65 years, including 50% (n = 10) females, 40% (n = 8) males, 5% (n = 1) non-binary and 5% (n = 1) transgender. Three main themes emerged from the analysis of the data: No person is an island; Social engagement; and Loneliness and isolation. Individuals who resided in low socioeconomic areas, those who lived alone and had reduced social support expressed feelings of poorer wellbeing. CONCLUSIONS This study describes the lived-experiences of the influence of the COVID-19 pandemic on Australians' social capital and wellbeing. The findings highlight the need for interventions to increase social support, social cohesion, and social connectedness, especially among Australians from low socioeconomic areas, to enhance their overall wellbeing.
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Affiliation(s)
- Heidi Green
- grid.416398.10000 0004 0417 5393Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW Australia ,grid.1007.60000 0004 0486 528XCentre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XSchool of Health and Society, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XIllawarra Health and Medical Research, University of Wollongong, Wollongong, NSW Australia
| | - Ritin Fernandez
- grid.416398.10000 0004 0417 5393Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW Australia ,grid.1007.60000 0004 0486 528XCentre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XIllawarra Health and Medical Research, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XSchool of Nursing, University of Wollongong, Wollongong, NSW Australia
| | - Lorna Moxham
- grid.1007.60000 0004 0486 528XCentre for Evidence Based Initiatives in Health Care: A JBI Centre of Excellence, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XIllawarra Health and Medical Research, University of Wollongong, Wollongong, NSW Australia ,grid.1007.60000 0004 0486 528XSchool of Nursing, University of Wollongong, Wollongong, NSW Australia
| | - Catherine MacPhail
- grid.1007.60000 0004 0486 528XSchool of Health and Society, University of Wollongong, Wollongong, NSW Australia
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26
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Killam K. Invited discussant comments during the UCL-Penn Global COVID Study webinar 'Alone Together: Loneliness Research and Social Health Innovation in Lockdown and Beyond'. UCL OPEN ENVIRONMENT 2022; 4:e004. [PMID: 37228469 PMCID: PMC10208344 DOI: 10.14324/111.444/ucloe.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The coronavirus (Covid-19) pandemic has influenced people's social relationships around the world in surprising ways. It has also underscored the importance of and accelerated innovation in solutions for social isolation and loneliness. This commentary offers takeaways from emerging research findings and a wide lens on the societal movement underway to create more socially connected communities.
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Affiliation(s)
- Kasley Killam
- Founder and Executive Director, Social Health Labs, www.socialhealthlabs.com
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27
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Moore C, Unwin P, Evans N, Howie F. Social prescribing: Exploring general practitioners' and healthcare professionals' perceptions of, and engagement with, the NHS model. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5176-e5185. [PMID: 35869824 PMCID: PMC10084047 DOI: 10.1111/hsc.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/25/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Social prescribing (SP) has rapidly expanded over recent years. Previously a bottom-up, community-led phenomenon, SP is now a formal part of structured NHS policy and practice. This study was designed to ascertain how general practitioners and other primary healthcare professionals (HCPs) within one clinical commissioning group (CCG) perceive and engage with this new NHS model. The research comprised an online survey distributed to HCPs within a predominately rural, English CCG between June and August 2021. Qualitative data were gathered and analysed using reflexive thematic analysis. Positive portrayals of SP were found, although definitions and perceptions varied greatly. Many HCPs reported high levels of engagement with SP services; yet referral rates appeared to remain significantly lower than the previously estimated 20% of primary care attendees referred for social reasons. Moreover, 96% of HCPs reported signposting patients directly to community or external services, rather than referring them to SP. This signposting, which has been positioned as a model of SP, reflects engagement with SP in practice, which is likely to have pre-dated the introduction of the fuller NHS model. HCPs may be unaware that this could be classed as a social prescription, and this type of SP remains uncaptured within NHS statistics. These results indicate an underuse of the national system set up to deliver one particular model of SP, rather than that SP does not occur. Additionally, despite national guidance issued to accompany the NHS model, practices such as referral and feedback processes, and link worker presence within practices, were not uniform even within this single CCG. Nevertheless, understanding is increasing as SP becomes embedded within primary care. The lack of consistency in referrals between practices warrants further examination in terms of equity of service choices to patients, as does the very low self-reported referral rate to SP.
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Affiliation(s)
- Coco Moore
- School of Allied Health and CommunityThe University of WorcesterWorcesterUK
| | - Peter Unwin
- School of Allied Health and CommunityThe University of WorcesterWorcesterUK
| | - Nick Evans
- School of Science and the EnvironmentThe University of WorcesterWorcesterUK
| | - Frances Howie
- Three Counties School of Nursing and MidwiferyThe University of WorcesterWorcesterUK
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28
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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.
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Affiliation(s)
- Leah S. Sharman
- School of PsychologyUniversity of QueenslandSt LuciaAustralia
| | | | - Shaun Hayes
- School of PsychologyUniversity of QueenslandSt LuciaAustralia
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29
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Liebmann M, Pitman A, Hsueh YC, Bertotti M, Pearce E. Do people perceive benefits in the use of social prescribing to address loneliness and/or social isolation? A qualitative meta-synthesis of the literature. BMC Health Serv Res 2022; 22:1264. [PMID: 36261835 PMCID: PMC9580419 DOI: 10.1186/s12913-022-08656-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
Social prescribing is a means by which clinical services can link individuals who have psychological, social and/or practical needs with non-clinical services within their local community. There is a lack of empirical evidence investigating whether social prescribing helps such individuals and which interventions are the most effective and accepted by them to address their loneliness. This meta-synthesis aimed to synthesise findings from qualitative studies exploring experiences of people (of any age) who participated in any social prescribing intervention aimed at loneliness and/or social isolation to ascertain whether they felt it helped address loneliness/isolation and the potential mechanisms by which this might occur. We conducted a systematic search of 5 electronic databases and 4 other databases that would yield grey literature in April 2021 to identify qualitative articles on this topic written in English or French. We assessed the quality of the included studies using recognised tools, and synthesised findings using the approach of thematic analysis. We identified 19 records analysed (e.g. journal articles) from 18 studies meeting inclusion criteria. Our analysis identified three themes: (1) increased sense of wellbeing (with six subthemes), (2) factors that engendered an ongoing desire to connect with others, and (3) perceived drawbacks of social prescribing. These themes illustrate the benefits and difficulties people perceive in social prescribing programmes addressing loneliness and social isolation, with an overall balance of more benefits than drawbacks in social prescribing participation. However, given the unhelpful aspects of social prescribing identified by some participants, greater thought should be given to potential harms. Moreover, further qualitative and quantitative research is needed to better understand mechanisms and effectiveness, and how different components of social prescribing might be best matched to individual participants.
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Affiliation(s)
- M Liebmann
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK
| | - A Pitman
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK.
| | - Yung-Chia Hsueh
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK
| | - M Bertotti
- Institute for Connected Communities, University of East London, Water Lane, London, E15 4LZ, UK
| | - E Pearce
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK
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30
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Kiely B, Croke A, O'Shea M, Boland F, O'Shea E, Connolly D, Smith SM. Effect of social prescribing link workers on health outcomes and costs for adults in primary care and community settings: a systematic review. BMJ Open 2022; 12:e062951. [PMID: 36253037 PMCID: PMC9644316 DOI: 10.1136/bmjopen-2022-062951] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To establish the evidence base for the effects on health outcomes and costs of social prescribing link workers (non-health or social care professionals who connect people to community resources) for people in community settings focusing on people experiencing multimorbidity and social deprivation. DESIGN Systematic review and narrative synthesis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. DATA SOURCES Cochrane Database, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, EU Clinical Trials Register, CINAHL, Embase, Global Health, PubMed/MEDLINE, PsycInfo, LILACS, Web of Science and grey literature were searched up to 31 July 2021. A forward citation search was completed on 9 June 2022. ELIGIBILITY CRITERIA Controlled trials meeting the Cochrane Effectiveness of Practice and Organisation of Care (EPOC) guidance on eligible study designs assessing the effect of social prescribing link workers for adults in community settings on any outcomes. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data, evaluated study quality using the Cochrane EPOC risk of bias tool and judged certainty of the evidence. Results were synthesised narratively. RESULTS Eight studies (n=6500 participants), with five randomised controlled trials at low risk of bias and three controlled before-after studies at high risk of bias, were included. Four included participants experiencing multimorbidity and social deprivation. Four (n=2186) reported no impact on health-related quality of life (HRQoL). Four (n=1924) reported mental health outcomes with three reporting no impact. Two US studies found improved ratings of high-quality care and reduced hospitalisations for people with multimorbidity experiencing deprivation. No cost-effectiveness analyses were identified. The certainty of the evidence was low or very low. CONCLUSIONS There is an absence of evidence for social prescribing link workers. Policymakers should note this and support evaluation of current programmes before mainstreaming. PROSPERO REGISTRATION NUMBER CRD42019134737.
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Affiliation(s)
- Bridget Kiely
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Aisling Croke
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Muireann O'Shea
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Eamon O'Shea
- School of Business and Economics, National University of Ireland Galway, Galway, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College, Dublin, Ireland
| | - Susan M Smith
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Discipline of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
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31
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Cooper M, Avery L, Scott J, Ashley K, Jordan C, Errington L, Flynn D. Effectiveness and active ingredients of social prescribing interventions targeting mental health: a systematic review. BMJ Open 2022; 12:e060214. [PMID: 35879011 PMCID: PMC9328101 DOI: 10.1136/bmjopen-2021-060214] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE This study aims to establish the effectiveness and active ingredients of UK-based social prescribing interventions targeting mental health and well-being outcomes. DESIGN Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysies guidelines and a published protocol. DATA SOURCES Nine databases were systematically searched up to March 2022. ELIGIBILITY CRITERIA Social prescribing interventions in the UK involving adults aged ≥18 years, which reported on mental health outcomes. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted data on study characteristics; outcomes; referral pathways; treatment fidelity strategies; person-centredness; intervention development processes and theory-linked behaviour change techniques (BCTs). Data were narratively synthesised. RESULTS 52 074 records were retrieved by the search, 13 interventions reported across 17 studies were included in this review (N=5036 participants at post-intervention). Fifteen studies were uncontrolled before-and-after designs, one a randomised controlled trial and one a matched groups design. The most frequently reported referral pathway was the link worker model (n=12), followed by direct referrals from community services (n=3). Participants were predominantly working age adults, and were referred for anxiety, depression, social isolation and loneliness. 16 out of 17 studies reported statistically significant improvements in outcomes (mental health, mental well-being, general health, or quality of life). Strategies to enhance treatment fidelity were suboptimal across studies. Only two studies used a specific theoretical framework. A few studies reported engaging service users in codesign (n=2) or usability and/or feasibility testing (n=4). Overall, 22 BCTs were coded across 13 interventions. The most frequently coded BCTs were social support-unspecified (n=11), credible source (n=7) and social support-practical (n=6). CONCLUSIONS Robust conclusions on the effectiveness of social prescribing for mental health-related outcomes cannot be made. Future research would benefit from comprehensive intervention developmental processes, with reference to appropriate theory, alongside long-term follow-up outcome assessment, using treatment fidelity strategies and a focus on principle of person-centred care. PROSPERO REGISTRATION NUMBER CRD42020167887.
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Affiliation(s)
- Matthew Cooper
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Leah Avery
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Jason Scott
- Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Kirsten Ashley
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Cara Jordan
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Linda Errington
- School of Biomedical, Nutritional, and Sport Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Darren Flynn
- Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Dingle GA, Sharman LS, Hayes S, Chua D, Baker JR, Haslam C, Jetten J, Haslam SA, Cruwys T, McNamara N. A controlled evaluation of the effect of social prescribing programs on loneliness for adults in Queensland, Australia (protocol). BMC Public Health 2022; 22:1384. [PMID: 35854258 PMCID: PMC9295098 DOI: 10.1186/s12889-022-13743-3] [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: 06/17/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In social prescribing, link workers support individuals whose persistent health problems are exacerbated by loneliness by connecting them to community-based social activities. This approach is well established in the UK and is gaining attention in Australia. However, a major limitation of research to date has been a lack of theoretically informed and rigorous evaluations of social prescribing. We will address these points in this study, applying a social identity framework to examine the effects of group-based social prescribing (SP) activity compared to primary care treatment as usual (TAU). METHODS Ninety participants experiencing loneliness recruited from primary care services and community centres across five sites in Southeast Queensland will be assigned to one of two conditions (SP, TAU) and assessed at two timepoints (baseline, + 8 weeks). Individuals will be aged 18 years and over, have sufficient English language skills to provide consent, and at the time of recruitment they will not be experiencing acute symptoms or social issues that require urgent intervention. Primary outcomes are loneliness, mental well-being, and health service use (total number of GP, hospital, and allied health visits in the past 3 months). Secondary outcomes will assess social group processes, including number of important social groups, new group identification, multiple identity compatibility, and group-based support and emotion regulation. DISCUSSION This study will provide comprehensive data about the extent to which, and how, social prescribing to community-based group activities may help people to feel less lonely, more socially integrated, and healthy over the first 8 weeks. If effective, this social identity-informed model of social prescribing can be disseminated in communities across Australia. TRIAL REGISTRATION ANZCTR, Registered 8 June 2022 - Retrospectively registered, https://www.anzctr.org.au/ACTRN12622000801718.aspx.
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Affiliation(s)
- G A Dingle
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia.
| | - L S Sharman
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia
| | - S Hayes
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia
| | - D Chua
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia.,Inala Primary Care, Brisbane, Australia
| | - J R Baker
- Primary & Community Care Services, Gold Coast, Australia
| | - C Haslam
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia
| | - J Jetten
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia
| | - S A Haslam
- School of Psychology, The University of Queensland, St Lucia QLD, Brisbane, 4072, Australia
| | - T Cruwys
- Australian National University, Canberra, Australia
| | - N McNamara
- Nottingham Trent University, Nottingham, UK
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Fernandes‐Jesus M, Rochira A, Mannarini T. Opposition to immigration: How people who identify with far‐right discourses legitimize the social exclusion of immigrants. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022. [DOI: 10.1002/casp.2634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Maria Fernandes‐Jesus
- School of Education, Language and Psychology York St John University York UK
- Centro de Investigação e Intervenção Social, Instituto Universitário de Lisboa (ISCTE‐IUL) Lisbon Portugal
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Goodfellow C, Hardoon D, Inchley J, Leyland AH, Qualter P, Simpson SA, Long E. Loneliness and personal well-being in young people: Moderating effects of individual, interpersonal, and community factors. J Adolesc 2022; 94:554-568. [PMID: 35403218 PMCID: PMC9320932 DOI: 10.1002/jad.12046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Loneliness is prevalent among young people. But, there is little work exploring the association between loneliness with well-being among this age group. Framed by social-ecological theory, we examined demographic, interpersonal, and community factors associated with personal wellbeing and, critically, identified malleable moderators of the relationship between loneliness and well-being that could be targeted in intervention efforts. METHODS We used cross-sectional, secondary data from 965 young people (aged 16-24) from the Community Life Survey in England. Loneliness was measured using a single-item direct measure; personal wellbeing was measured through a composite measure containing items assessing happiness, life satisfaction, and a sense that life is worthwhile (α = 0.88). Regression techniques were used to assess associations between individual, interpersonal, and community factors and well-being, and to identify moderators of the relationship between loneliness and well-being. RESULTS Loneliness was negatively associated with well-being. Chatting with neighbors and having people to provide help moderated the relationship between loneliness and well-being. Full-time students and those with good physical health had higher well-being while being a carer was predictive of lower well-being. All community variables were strongly associated with increased well-being. Of all interpersonal variables investigated, only having people to count on was associated with increased well-being. CONCLUSIONS Our results demonstrate that supportive relationships and close community ties are important for reducing the negative impact of loneliness on youth well-being. Interventions to improve well-being could benefit from targeting these aspects of young people's social and community lives, while acknowledging individual vulnerabilities, such as poor physical health.
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Affiliation(s)
- Claire Goodfellow
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | | | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Pamela Qualter
- Manchester Institute of EducationUniversity of ManchesterManchesterUK
| | - Sharon A. Simpson
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Emily Long
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
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Milicev J, Qualter P, Goodfellow C, Inchley J, Simpson SA, Leyland AH, Kharicha K, Long E. The prospective relationship between loneliness, life satisfaction and psychological distress before and during the COVID-19 pandemic in the UK. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-15. [PMID: 35668719 PMCID: PMC9136554 DOI: 10.1007/s10389-022-01719-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022]
Abstract
Aim Mental wellbeing in the UK seems to have deteriorated significantly during the COVID-19 pandemic, with the rates of loneliness, life satisfaction and psychological distress taking longer to return to the pre-pandemic levels than elsewhere. Nevertheless, there is little knowledge about the interactions between these outcomes, or the factors that played a role in the rates of change. The current study aims to address this gap by simultaneously investigating changes in loneliness, life satisfaction and psychological distress in the UK from pre-pandemic levels to those between April and November 2020, while critically assessing the role of a range of social ecological influencing factors. Subject and Methods Longitudinal data from Understanding Society (N=3475) were used to explore the changes in loneliness, life satisfaction and psychological distress from pre-pandemic levels (2017-2019) through November 2020, the interactions between these outcomes, and the role of individual, social, community and geographic factors in the rates of change, using multivariate latent growth curve model. Results Loneliness, life satisfaction and psychological distress deteriorated minimally between April and November 2020, compared to the pre-pandemic levels (2017-2019), while the rate of change in each outcome influenced the rates of change in the other two. Key individual (age, gender, physical health), social (number of friends and similarity to them), and environmental (neighbourhood quality) variables influenced baseline scores and the rates of change. Conclusion Considering significant dynamic associations between loneliness, life satisfaction and psychological distress, we argue that interventions to tackle any one of the outcomes may have beneficial effects on others, while highlighting malleable factors and individual and community-level interventions to tackle loneliness.
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Affiliation(s)
- Jelena Milicev
- MRC / CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G3 7HR UK
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL UK
| | - Claire Goodfellow
- MRC / CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G3 7HR UK
| | - Joanna Inchley
- MRC / CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G3 7HR UK
| | - Sharon Anne Simpson
- MRC / CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G3 7HR UK
| | - Alastair H. Leyland
- MRC / CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G3 7HR UK
| | - Kalpa Kharicha
- Campaign to End Loneliness part of What Works Centre for Wellbeing, London, SW1H 9EA UK
| | - Emily Long
- MRC / CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, G3 7HR UK
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Bowe M, Wakefield JRH, Kellezi B, Stevenson C, McNamara N, Jones BA, Sumich A, Heym N. The mental health benefits of community helping during crisis: Coordinated helping, community identification and sense of unity during the COVID-19 pandemic. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022; 32:521-535. [PMID: 34230792 PMCID: PMC8250747 DOI: 10.1002/casp.2520] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 12/18/2022]
Abstract
Communities are vital sources of support during crisis, providing collective contexts for shared identity and solidarity that predict supportive, prosocial responses. The COVID-19 pandemic has presented a global health crisis capable of exerting a heavy toll on the mental health of community members while inducing unwelcome levels of social disconnection. Simultaneously, lockdown restrictions have forced vulnerable community members to depend upon the support of fellow residents. Fortunately, voluntary helping can be beneficial to the well-being of the helper as well as the recipient, offering beneficial collective solutions. Using insights from social identity approaches to volunteering and disaster responses, this study explored whether the opportunity to engage in helping fellow community members may be both unifying and beneficial for those engaging in coordinated community helping. Survey data collected in the UK during June 2020 showed that coordinated community helping predicted the psychological bonding of community members by building a sense of community identification and unity during the pandemic, which predicted increased well-being and reduced depression and anxiety. Implications for the promotion and support of voluntary helping initiatives in the context of longer-term responses to the COVID-19 pandemic are provided. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
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Affiliation(s)
- Mhairi Bowe
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | | | - Blerina Kellezi
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | | | - Niamh McNamara
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | | | - Alex Sumich
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | - Nadja Heym
- Department of PsychologyNottingham Trent UniversityNottinghamUK
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Stuart A, Katz D, Stevenson C, Gooch D, Harkin L, Bennasar M, Sanderson L, Liddle J, Bennaceur A, Levine M, Mehta V, Wijesundara A, Talbot C, Bandara A, Price B, Nuseibeh B. Loneliness in older people and COVID-19: Applying the social identity approach to digital intervention design. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022; 6:100179. [PMID: 35233473 PMCID: PMC8872705 DOI: 10.1016/j.chbr.2022.100179] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 01/25/2023] Open
Abstract
The COVID-19 pandemic is worsening loneliness for many older people through the challenges it poses in engaging with their social worlds. Digital technology has been offered as a potential aid, however, many popular digital tools have not been designed to address the needs of older adults during times of limited contact. We propose that the Social Identity Model of Identity Change (SIMIC) could be a foundation for digital loneliness interventions. While SIMIC is a well-established approach for maintaining wellbeing during life transitions, it has not been rigorously applied to digital interventions. There are known challenges to integrating psychological theory in the design of digital technology to enable efficacy, technology acceptance, and continued use. The interdisciplinary field of Human Computer Interaction has a history of drawing on models originating from psychology to improve the design of digital technology and to design technologies in an appropriate manner. Drawing on key lessons from this literature, we consolidate research and design guidelines for multidisciplinary research applying psychological theory such as SIMIC to digital social interventions for loneliness.
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Affiliation(s)
- Avelie Stuart
- University of Exeter, Exeter, United Kingdom,Corresponding author. Washington Singer Labs, University of Exeter, Perry Road, Exeter, EX4 4QG, UK
| | - Dmitri Katz
- The Open University, Milton Keynes, United Kingdom
| | | | - Daniel Gooch
- The Open University, Milton Keynes, United Kingdom
| | - Lydia Harkin
- Nottingham Trent University, Nottingham, United Kingdom
| | | | | | - Jacki Liddle
- The University of Queensland, Queensland, Australia
| | | | - Mark Levine
- Lancaster University, Lancaster, United Kingdom
| | - Vikram Mehta
- The Open University, Milton Keynes, United Kingdom
| | | | | | | | - Blaine Price
- The Open University, Milton Keynes, United Kingdom
| | - Bashar Nuseibeh
- The Open University, Milton Keynes, United Kingdom,Lero - the Irish Software Research Centre, University of Limerick, Limerick, Ireland
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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] [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.
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Affiliation(s)
- Kazuo Araki
- Department of Health Informatics, School of Public Health Kyoto University Graduate School of Medicine Kyoto Prefecture Kyoto Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, School of Public Health Kyoto University Graduate School of Medicine Kyoto Prefecture Kyoto Japan
| | - Hiroshi Okada
- Department of Health Informatics, School of Public Health Kyoto University Graduate School of Medicine Kyoto Prefecture Kyoto Japan
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health Kyoto University Graduate School of Medicine Kyoto Prefecture Kyoto Japan
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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.
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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
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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.
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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
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Baxter L, Burton A, Fancourt D. Community and cultural engagement for people with lived experience of mental health conditions: what are the barriers and enablers? BMC Psychol 2022; 10:71. [PMID: 35296361 PMCID: PMC8928686 DOI: 10.1186/s40359-022-00775-y] [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: 12/04/2021] [Accepted: 03/07/2022] [Indexed: 01/05/2023] Open
Abstract
Background Community and cultural engagement can support recovery, help symptom management and increase social connections for people with lived experience of mental health conditions. However, research suggests that people with mental health conditions experience significant barriers to participation. The aim of this study was to explore barriers and enablers of participation in community and cultural activities among people with mental health conditions. Methods A qualitative interview study with 23 people with mild-to-moderate mental health conditions was undertaken. Data were analysed thematically, and themes were mapped to domains of the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Results Eleven themes were identified from the analysis. Three themes involved participant Capability: physical skills, psychological traits and physical health limitations and three themes related to Opportunity: affordability and accessibility, structure and nature of the group, and support from others to attend. Five themes mapped to Motivation: creative identity, recovery and coping, enjoyment and fun, connecting with others, and information and planning. Participants were motivated to engage with community and cultural activities through “a creative identity”, belief that engagement would help recovery from mental illness, and a desire to connect with others and make friends. Motivation to participate was sustained by the enjoyable nature of activities. However, participants’ ability to engage was hampered by the expense, inaccessibility and sometimes unstructured nature of activities, and social anxiety associated with attending. Some participants had physical limitations such as fatigue or physical health problems to overcome. Interventions that could address these barriers include peer support, training for social prescribers to account for identity and previous experiences of participation, training for community organisations in providing a welcoming and structured environment, and provision of long-term sustainable funding to community organisations to subsidise attendance, transport or equipment costs. Conclusion People with mental health conditions may be at risk of experiencing barriers to community and cultural engagement due to existing social inequalities and social anxiety, however believing that involvement will support mental health was an enabler to participation. Future studies are needed to test the effectiveness of potential interventions to address the barriers and harness the facilitators identified here, to enable a more socially inclusive community and voluntary sector, and a potentially more responsive and effective social prescribing service in the UK for people experiencing mental health problems. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00775-y.
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Affiliation(s)
- Louise Baxter
- Department of Behavioural Science and Health, University College London, London, UK.,Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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Galvez-Hernandez P, González-de Paz L, Muntaner C. Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review. BMJ Open 2022; 12:e057729. [PMID: 35121608 PMCID: PMC8819903 DOI: 10.1136/bmjopen-2021-057729] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Primary care is well positioned to identify and address loneliness and social isolation in older adults, given its gatekeeper function in many healthcare systems. We aimed to identify and characterise loneliness and social isolation interventions and detect factors influencing implementation in primary care. DESIGN Scoping review using the five-step Arksey and O'Malley Framework. DATA SOURCES MEDLINE, CINAHL, EMBASE, COCHRANE databases and grey literature were searched from inception to June 2021. ELIGIBILITY CRITERIA Empirical studies in English and Spanish focusing on interventions addressing social isolation and loneliness in older adults involving primary care services or professionals. DATA EXTRACTION AND SYNTHESIS We extracted data on loneliness and social isolation identification strategies and the professionals involved, networks and characteristics of the interventions and barriers to and facilitators of implementation. We conducted a thematic content analysis to integrate the information extracted. RESULTS 32 documents were included in the review. Only seven articles (22%) reported primary care professionals screening of older adults' loneliness or social isolation, mainly through questionnaires. Several interventions showed networks between primary care, health and non-healthcare sectors, with a dominance of referral pathways (n=17). Two-thirds of reports did not provide clear theoretical frameworks, and one-third described lengths under 6 months. Workload, lack of interest and ageing-related barriers affected implementation outcomes. In contrast, well-defined pathways, collaborative designs, long-lasting and accessible interventions acted as facilitators. CONCLUSIONS There is an apparent lack of consistency in strategies to identify lonely and socially isolated older adults. This might lead to conflicts between intervention content and participant needs. We also identified a predominance of schemes linking primary care and non-healthcare sectors. However, although professionals and participants reported the need for long-lasting interventions to create meaningful social networks, durable interventions were scarce. Sustainability should be a core outcome when implementing loneliness and social isolation interventions in primary care.
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Affiliation(s)
- Pablo Galvez-Hernandez
- Lawrence S. Bloomberg Faculty of Nursing & Health Services and Policy Research Collaborative Specialization, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Luis González-de Paz
- Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS, Barcelona, Spain
- Escola Superior d'Infermeria del Mar (ESIMar), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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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.
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Dewa LH, Lawrance E, Roberts L, Brooks-Hall E, Ashrafian H, Fontana G, Aylin P. Quality Social Connection as an Active Ingredient in Digital Interventions for Young People With Depression and Anxiety: Systematic Scoping Review and Meta-analysis. J Med Internet Res 2021; 23:e26584. [PMID: 34927592 PMCID: PMC8726025 DOI: 10.2196/26584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/30/2021] [Accepted: 10/14/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Disrupted social connections may negatively affect youth mental health. In contrast, sustained quality social connections (QSCs) can improve mental health outcomes. However, few studies have examined how these quality connections affect depression and anxiety outcomes within digital interventions, and conceptualization is limited. OBJECTIVE The aim of this study is to conceptualize, appraise, and synthesize evidence on QSC within digital interventions (D-QSC) and the impact on depression and anxiety outcomes for young people aged 14-24 years. METHODS A systematic scoping review and meta-analysis was conducted using the Joanna Briggs Institute methodological frameworks and guided by experts with lived experience. Reporting was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The MEDLINE, Embase, PsycINFO, and CINAHL databases were searched against a comprehensive combination of key concepts on June 24, 2020. The search concepts included young people, digital intervention, depression, anxiety, and social connection. Google was also searched. A reviewer independently screened abstracts and titles and full text, and 9.99% (388/3882) of these were screened by a second reviewer. A narrative synthesis was used to structure the findings on indicators of D-QSC and mechanisms that facilitate the connection. Indicators of D-QSC from the included studies were synthesized to produce a conceptual framework. RESULTS Of the 5715 publications identified, 42 (0.73%) were included. Among the included studies, there were 23,319 participants. Indicators that D-QSC was present varied and included relatedness, having a sense of belonging, and connecting to similar people. However, despite the variation, most of the indicators were associated with improved outcomes for depression and anxiety. Negative interactions, loneliness, and feeling ignored indicated that D-QSC was not present. In 24% (10/42) of the applicable studies, a meta-analysis showed a significant decrease in depression (-25.6%, 95% CI -0.352 to -0.160; P<.001) and anxiety (-15.1%, 95% CI -0.251 to -0.051; P=.003) after a D-QSC. Digital mechanisms that helped create a quality connection included anonymity, confidentiality, and peer support. In contrast, mechanisms that hindered the connection included disconnection from the real world and inability to see body language. Data synthesis also identified a 5-component conceptual framework of D-QSC that included rapport, identity and commonality, valued interpersonal dynamic, engagement, and responded to and accepted. CONCLUSIONS D-QSC is an important and underconsidered component for youth depression and anxiety outcomes. Researchers and developers should consider targeting improved QSC between clinicians and young people within digital interventions for depression. Future research should build on our framework to further examine relationships among individual attributes of QSC, various digital interventions, and different populations.
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Affiliation(s)
- Lindsay H Dewa
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom.,School of Public Health, Imperial College London, London, United Kingdom
| | - Emma Lawrance
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom.,Mental Health Innovations, London, United Kingdom
| | - Lily Roberts
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | | | - Hutan Ashrafian
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Gianluca Fontana
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Paul Aylin
- School of Public Health, Imperial College London, London, United Kingdom
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Stevenson C, Wakefield JRH. Financial distress and suicidal behaviour during COVID-19: Family identification attenuates the negative relationship between COVID-related financial distress and mental Ill-health. J Health Psychol 2021; 26:2665-2675. [PMID: 34259082 PMCID: PMC8543569 DOI: 10.1177/13591053211014597] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
COVID-19 provides a 'perfect storm' of social and economic suicide risk-factors. Recent research has evidenced an initial impact of the pandemic upon suicide rates, but has yet to understand how elevated financial threat and social isolation may predict suicide ideation/behaviour, or which social factors promote resilience. This study addressed these shortcomings. An online longitudinal survey study (N = 370) which took place from May to September 2020 showed COVID-related financial distress predicts suicidal thoughts and behaviour via increased depression and loneliness. Family identification attenuates these relationships. Our findings reaffirm the importance of social factors in reducing mental ill-health outcomes of economic crises.
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Abstract
Loneliness is a growing public health concern that is associated with a range of negative health outcomes. The extent to which loneliness may also be associated with greater use of primary health care remains unclear. The present meta-analysis aimed to address this gap by quantifying research on the association of loneliness to primary health care use. The database searches yielded 23 eligible studies with 25 effects, total N = 113,639. A random effects meta-analysis revealed a small positive average effect size (ravg = .094; 95% CI [.07, .12])between loneliness and the use of primary care that increased in magnitude as the proportion of females in the samples increased. Studies that used objective measures of primary care use yielded effects that were significantly larger than those using self-report measures. The effects were robust to differences in age and type of health-care systems, and the type of loneliness scale (single versus multi-item). The findings from this first comprehensive meta-analysis of the association of loneliness with use of primary care indicate that people who experience loneliness make a greater number of visits to primary-care practitioners. This evidence highlights the practical impact of loneliness on health-care use when viewed at the population level.
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Affiliation(s)
- Fuschia M Sirois
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Janine Owens
- Mental Health Theme, NIHR Applied Research Collaborative, Greater Manchester (NIHR ARC GM), University of Manchester, Manchester, UK
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Kim JE, Lee YL, Chung MA, Yoon HJ, Shin DE, Choi JH, Lee S, Kim HK, Nam EW. Effects of social prescribing pilot project for the elderly in rural area of South Korea during COVID-19 pandemic. Health Sci Rep 2021; 4:e320. [PMID: 34250272 PMCID: PMC8247938 DOI: 10.1002/hsr2.320] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 05/12/2021] [Accepted: 05/20/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Older adults-classified as a high-risk group-are highly likely to experience increased loneliness due to the implementation of various policies designed to prevent the spread of COVID-19. Accordingly, this study aims to examine the effects of a pilot social prescribing project for elderly people in rural area of South Korea during the COVID-19 pandemic. METHODS Using the PRECEDE-PROCEED model, the effectiveness of the pilot project was verified through pre- and post-impact and outcome evaluation. RESULTS According to the results of the impact evaluation, loneliness reduced significantly, while the social participation attitude score increased. Although the average score of self-efficacy increased, it was not statistically significant. Moreover, it was found that self-esteem increased significantly. In the outcome evaluation, depression reduced considerably. CONCLUSION To conclude, the pilot social prescribing project was effective in reducing depression and loneliness for the elderly in rural areas of Korea. It was also confirmed that there is potential to develop a new health promotion project that can improve the self-esteem of the elderly, and expand their social activities. Second, the pilot project was carried out in an integrated manner by utilizing resources in communities with good accessibility. Therefore, it is expected to be used as a new "Integrated community care model" to improve the mental health of the elderly in rural areas. Third, during the COVID-19 pandemic, the elderly tend to experience increasing feelings of depression, isolation, and loneliness due to "social distancing." Therefore, it is expected that social prescribing programs for the elderly in rural areas would become a new alternative for relieve mental disorder of the seniors.
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Affiliation(s)
- Ji Eon Kim
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Yu Lim Lee
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Min Ah Chung
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Hye Jin Yoon
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Dong Eun Shin
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
| | - Jin Hee Choi
- Mirae Campus LINC+Yonsei UniversityWonjuSouth Korea
| | - Sangheon Lee
- Heungeop‐myeon Sub‐Health CenterWonjuSouth Korea
| | - Hae Kyung Kim
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Heungeop Community LibraryWonjuSouth Korea
| | - Eun Woo Nam
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
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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.
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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.
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Affiliation(s)
- G Y Reinhardt
- Department of Government, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, Essex, UK
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Dayson C, Harris C, Woodward A. Voluntary sector interventions to address loneliness and mental health in older people: taking account of emotional, psychological and social wellbeing. Perspect Public Health 2021; 141:237-243. [PMID: 34120519 DOI: 10.1177/17579139211017580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS (1) To explore the relationship between loneliness and mental health in older people accessing interventions delivered through the voluntary sector. (2) To understand how these interventions can take account of mental health, discussing the relative strengths of a number of different one-to-one and group-based interventions. METHODS Qualitative case study of Age Better in Sheffield (ABiS), an initiative to address loneliness and isolation among older people (aged above 50). 37 beneficiaries of voluntary sector interventions participated in the study: 17 had accessed a one-to-one intervention and 20 had accessed group-based activities. RESULTS One-to-one therapeutic interventions are beneficial when loneliness is associated with low psychological and emotional wellbeing stemming from trauma and other complex pre-existing issues that have left individuals unable to build social relationships and networks. One-to-one peer-to-peer interventions are beneficial for individuals whose loneliness is linked to low psychological and emotional wellbeing but for whom their issues are less complex. Group-based interventions are beneficial when loneliness is linked to social wellbeing and individuals want to build social networks and relationships and contribute to their community. Participants should be supported to access other forms of support if the benefits of the initial intervention are to be sustained. CONCLUSIONS There is an interconnected relationship between loneliness and the emotional, psychological and social components of mental health that should be taken into account in the design of interventions. A range of one-to-one and group-based interventions are necessary to meet the varying needs and circumstances of older people experiencing loneliness. Public health commissioners should invest in an ecosystem of voluntary organisations providing different types of loneliness intervention if the epidemic of loneliness is to be addressed.
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Affiliation(s)
- Chris Dayson
- Associate Professor, Centre for Regional Economic and Social Research, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Catherine Harris
- Centre for Regional Economic and Social Research, Sheffield Hallam University, Sheffield, UK
| | - Abigail Woodward
- Centre for Regional Economic and Social Research, Sheffield Hallam University, Sheffield, UK
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