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Ostojic K, Karem I, Dee-Price BJ, Paget SP, Berg A, Burnett H, Scott TR, Strnadová I, Woolfenden SR. Development of a new social prescribing intervention for families of children with cerebral palsy. Dev Med Child Neurol 2024. [PMID: 39031596 DOI: 10.1111/dmcn.16039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 07/22/2024]
Abstract
AIM To co-design a social prescribing intervention (the EPIC-CP programme: Equitable Pathways and Integrated Care in Cerebral Palsy) with children with cerebral palsy (CP), their families, and clinicians to address unmet social needs. METHOD The study was conducted (August 2021 to March 2023) at the paediatric rehabilitation departments of the three tertiary paediatric hospitals in New South Wales, Australia. Eligible participants attended or worked at one of the departments, including children with CP, parents/caregivers, and clinicians. Mixed-methods co-design was used in intervention co-production and prototyping. The project was overseen by research advisors with lived experience of CP. RESULTS More than 200 participants contributed to the co-design research. Families experienced a substantial burden of unmet social needs. Co-designed interventions involved systematic identification of unmet social needs with (1) targeted community resources and (2) engagement with a 'community linker' who supported children/young people and their families to access health, education, and social services that matched their identified needs and preferences. Research participants co-developed the programme logic model and prototype. This was piloted in research action cycles and iteratively refined until consensus was achieved. INTERPRETATION We co-designed a social prescribing programme responsive to the needs of its end-users and purposefully developed to be embedded in the Australian health setting. A pilot randomized controlled trial will further evaluate this intervention.
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Affiliation(s)
- Katarina Ostojic
- Community Paediatrics Research Group, Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Population Child Health Research Group, Discipline of Paediatrics & Child Health, Faculty of Medicine & Health, University of New South Wales, Sydney, Australia
| | - Isra Karem
- Community Paediatrics Research Group, Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Population Child Health Research Group, Discipline of Paediatrics & Child Health, Faculty of Medicine & Health, University of New South Wales, Sydney, Australia
| | | | - Simon P Paget
- Kids Rehab, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alison Berg
- Kids Rehab, the Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, Australia
| | - Heather Burnett
- HNEkidsRehab, John Hunter Children's Hospital, Newcastle, Australia
| | - Timothy R Scott
- Rehab2Kids, Sydney Children's Hospital, Sydney Children's Hospitals Network, Sydney, Australia
- Faculty of Medicine and Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Iva Strnadová
- School of Education, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
- Disability Innovation Institute, University of New South Wales, Sydney, Australia
| | - Susan R Woolfenden
- Community Paediatrics Research Group, Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Population Child Health Research Group, Discipline of Paediatrics & Child Health, Faculty of Medicine & Health, University of New South Wales, Sydney, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
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Jensen A, Holt N, Honda S, Bungay H. The impact of arts on prescription on individual health and wellbeing: a systematic review with meta-analysis. Front Public Health 2024; 12:1412306. [PMID: 39045154 PMCID: PMC11264378 DOI: 10.3389/fpubh.2024.1412306] [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: 04/04/2024] [Accepted: 06/26/2024] [Indexed: 07/25/2024] Open
Abstract
Introduction The evidence-base for the impact of participating in the arts for different aspects of health and wellbeing is growing. Arts on Prescription has gained increasing recognition as a method for fostering connections among individuals and communities, however, to date no systematic review of the impact on individual health and wellbeing has been conducted. This review aims to provide an understanding of individual health and wellbeing outcomes from participation in Arts on Prescription programmes. Methods Major electronic databases were systematically searched, including Cochrane Library; Web of Science; ProQuest; CINAHL; Arts & Humanities; Ebsocohost; Pubmed; PsycINFO. Other databases were also used: Google Scholar and websites of specific organizations, e.g., NHS Evidence, Kings Fund, Health foundation, Nuffield Trust and NESTA and University of Florida Arts-in Medicine Repository. The review used PRISMA reporting structures. Critical Appraisal Skills Programme (CASP) templates were used for qualitative and quantitative studies, and the Mixed Methods Appraisal Tool (MMAT) for studies with a mixed methods protocol to assess quality and risk of bias. A narrative review of the qualitative data was conducted. For quantitative outcomes, a meta-analysis for studies that met inclusion criteria was conducted, and a narrative review made of secondary and heterogeneous outcomes and approaches. Results 7,805 records were identified but only 25 records were included as studies with a focus on the impact on individual health and wellbeing. Studies were conducted in Australia, Denmark, Sweden, United Kingdom, and the United States. Programmes were held in community settings, arts venues, GP surgeries, primary healthcare settings, and one school. Most interventions varied from 8 to 10 weeks and included a wide range of different arts activities. Qualitative themes included social benefits, psychological benefits and progression opportunities. The meta-analysis showed a statistically significant improvement in wellbeing, and the narrative review identified promising outcomes that require further evidential support (e.g., reductions in anxiety and depression). Discussion Arts on Prescription programmes are an appropriate intervention for improving psychosocial wellbeing, providing both social and psychological benefits as well as progression opportunities. We discuss the various qualitative and quantitative outcomes, along with potential 'active ingredients' and barriers to participation (physical, psychological and social). Systematic review registration PROSPERO, identifier CRD42023408974, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023408974.
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Affiliation(s)
- Anita Jensen
- Clinical Research Center, Social Medicine and Health Policy, Department of Clinical Science and Centre for Primary Health Care, Lund University and Region Skåne, Malmö, Sweden
- National Competence Center for Culture, Health and Care, Nord Universitet, Levanger, Norway
| | - Nicola Holt
- Department of Health and Social Sciences, University of the West of England, Bristol, United Kingdom
| | - Sayaka Honda
- General Internal Medicine, St Luke’s International Hospital, Tokyo, Japan
| | - Hilary Bungay
- Faculty of Health, Education, Medicine, Social Care, and Education, School of Allied and Public Health, Anglia Ruskin University, Chelmsford, United Kingdom
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Cailhol J, Bihan H, Bourovali-Zade C, Boloko A, Duclos C. Quality Improvement Intervention Using Social Prescribing at Discharge in a University Hospital in France: Quasi-Experimental Study. JMIR Form Res 2024; 8:e51728. [PMID: 38739912 PMCID: PMC11130777 DOI: 10.2196/51728] [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: 08/09/2023] [Revised: 10/24/2023] [Accepted: 02/01/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Social prescription is seen as a public health intervention tool with the potential to mitigate social determinants of health. On one side, social prescription is not yet well developed in France, where social workers usually attend to social needs, and historically, there is a deep divide between the health and social sectors. On the other side, discharge coordination is gaining attention in France as a critical tool to improve the quality of care, assessed indirectly using unplanned rehospitalization rates. OBJECTIVE This study aims to combine social prescription and discharge coordination to assess the need for social prescription and its effect on unplanned rehospitalization rates. METHODS We conducted a quasi-experimental study in two departments of medicine in a French university hospital in a disadvantaged suburb of Paris over 2 years (October 2019-October 2021). A discharge coordinator screened patients for social prescribing needs and provided services on the spot or referred the patient to the appropriate service when needed. The primary outcome was the description of the services delivered by the discharge coordinator and of its process, as well as the characteristics of the patients in terms of social needs. The secondary outcome was the comparison of unplanned rehospitalization rates after data chaining. RESULTS A total of 223 patients were included in the intervention arm, with recruitment being disrupted by the COVID-19 pandemic. More than two-thirds of patients (n=154, 69.1%) needed help understanding discharge information. Slightly less than half of the patients (n=98, 43.9%) seen by the discharge coordinator needed social prescribing, encompassing language, housing, health literacy, and financial issues. The social prescribing covered a large range of services, categorized into finding a general practitioner or private sector nurse, including language-matching; referral to a social worker; referral to nongovernmental organization or group activities; support for transportation issues; support for health-related administrative procedures; and support for additional appointments with nonmedical clinicians. All supports were delivered in a highly personalized way. Ethnic data collection was not legally permitted, but for 81% (n=182) of the patients, French was not the mother tongue. After data chaining, rehospitalization rates were compared between 203 patients who received the intervention (n=5, 3.1%) versus 2095 patients who did not (n=51, 2.6%), and there was no statistical difference. CONCLUSIONS First, our study revealed the breadth of patient's unmet social needs in our university hospital, which caters to an area where the immigrant population is high. The study also revealed the complexity of the discharge coordinator's work, who provided highly personalized support and managed to gain trust. Hospital discharge could be used in France as an opportunity in disadvantaged settings. Eventually, indicators other than the rehospitalization rate should be devised to evaluate the effect of social prescribing and discharge coordination.
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Affiliation(s)
- Johann Cailhol
- Laboratoire Educations et Promotion de la Santé, University Sorbonne Paris Nord, Bobigny, France
- Infectious Diseases Unit, Groupe Hospitalo-Universitaire Paris Seine Saint Denis, Assistance Publique des Hopitaux de Paris, Bobigny, France
| | - Hélène Bihan
- Laboratoire Educations et Promotion de la Santé, University Sorbonne Paris Nord, Bobigny, France
- Diabetology Unit, Groupe Hospitalo-Universitaire Paris Seine Saint Denis, Assistance Publique des Hopitaux de Paris, Bobigny, France
| | - Chloé Bourovali-Zade
- Infectious Diseases Unit, Groupe Hospitalo-Universitaire Paris Seine Saint Denis, Assistance Publique des Hopitaux de Paris, Bobigny, France
| | - Annie Boloko
- Infectious Diseases Unit, Groupe Hospitalo-Universitaire Paris Seine Saint Denis, Assistance Publique des Hopitaux de Paris, Bobigny, France
| | - Catherine Duclos
- Laboratoire de recherche en informatique pour la santé, University Sorbonne Paris Nord, Bobigny, France
- Public Health Department, Groupe Hospitalo-Universitaire Paris Seine Saint Denis, Assistance Publique des Hopitaux de Paris, Bobigny, France
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Connolly H, Delimata N, Galway K, Kiely B, Lawler M, Mulholland J, O’Grady M, Connolly D. Exploration of Evaluation Practices in Social Prescribing Services in Ireland: A Cross-Sectional Observational Study. Healthcare (Basel) 2024; 12:219. [PMID: 38255106 PMCID: PMC10815325 DOI: 10.3390/healthcare12020219] [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: 11/30/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
National health services in Ireland and the UK fund the majority of social prescribing services and have issued recommendations for evaluation. However, it is not known what outcomes are prioritised for evaluation within individual services and what evaluation methods are used to capture recommended outcomes. A survey was carried out to examine evaluation practices of social prescribing services on the island of Ireland. This study used a cross-sectional observational design. The sample was all the staff involved in delivering and/or managing SP services on the island of Ireland. Questionnaires were distributed at a national SP conference and online. Closed-response questions were analysed using descriptive statistics. Content analysis was used for open-ended questions. Eighty-four usable surveys were returned (50% from the Republic of Ireland and 50% from Northern Ireland). All respondents (100%) agreed on the importance of measuring SP outcomes. The most frequently measured outcomes were health and well-being (89.2%) and loneliness (84%). The least frequently measured outcome was the satisfaction of healthcare professionals referring to SP: 78.4% of respondents never measured this outcome. The most frequently used measurement tool was the Short Warwick Edinburgh Mental Well-Being Scale, with 38/76 (50%) respondents using this measure. There was a lack of standardised measures identified for some outcomes. For example, 70% of respondents reported always measuring physical activity (PA), but only four respondents identified a specific PA measure. In open-ended questions, respondents recommended flexibility in evaluation methods to reflect the complexity and individualised focus of SP. They also identified the need for protected time to complete evaluations and recommended a national strategy to inform priorities in evaluations. This study demonstrates a wide variation on the island of Ireland on how SP services are measuring outcomes, with many outcomes rarely or never measured using standardised measures. Agreement is needed on a core outcome set for social prescribing in order to guide service delivery and evaluations.
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Affiliation(s)
- Hayley Connolly
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, F91 YW50 Sligo, Ireland; (H.C.); (M.L.)
| | - Natalie Delimata
- Department of Social Sciences, Atlantic Technological University, F91 YW50 Sligo, Ireland;
| | - Karen Galway
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (K.G.); (J.M.)
| | - Bridget Kiely
- Department of General Practice, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland;
| | - Margaret Lawler
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, F91 YW50 Sligo, Ireland; (H.C.); (M.L.)
| | - Jill Mulholland
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (K.G.); (J.M.)
| | - Megan O’Grady
- Discipline of Physiotherapy, Trinity Centre for Health Sciences, St. James’ Hospital, D08 W9RT Dublin, Ireland;
| | - Deirdre Connolly
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, F91 YW50 Sligo, Ireland; (H.C.); (M.L.)
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