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Costa A, Henriques J, Alarcão V, Madeira T, Virgolino A, Polley MJ, Henriques A, Feteira-Santos R, Arriaga M, Nogueira P. "You get out of the house, you talk to each other, you laugh…And that's fantastic" - a qualitative study about older people's perceptions of social prescribing in mainland Portugal. BMC Health Serv Res 2024; 24:645. [PMID: 38769571 PMCID: PMC11106980 DOI: 10.1186/s12913-024-11086-w] [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: 10/18/2023] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Social prescribing (SP) is a non-clinical approach, most commonly based in healthcare units, that aims to address non-medical health-related social needs by connecting individuals with community-based services. This qualitative study explores the perception of Portuguese older adults regarding the benefits of SP and their willingness to participate in SP initiatives. METHODS Three face-to-face focus group sessions were conducted with 23 participants in different cities in Portugal. Open and semi-open questions were used to guide the discussions and thematic analysis was used to analyze the data. RESULTS The participants recognized the potential benefits of SP for older adults, including diversifying leisure activities, improving mental health, and complementing existing support systems. They highlighted the need for external support, usually in the form of link workers, to facilitate personalized referrals and consider individual characteristics and preferences. While some participants expressed reluctance to engage in SP due to their existing busy schedules and a perceived sense of imposition, others showed openness to having new experiences and recognized the potential value of SP in promoting activity. Barriers to participation, including resistance to change, mobility issues, and family responsibilities, were identified. CONCLUSIONS The study emphasizes the importance of a person-centered and co-designed approach to SP, involving older adults in the planning and implementation of interventions. The findings provide valuable insights for the development of SP programs tailored to the unique needs and aspirations of older adults in Portugal, ultimately promoting active and healthy aging. Future research should consider the perspectives of family doctors and include a broader representation of older adults from diverse geographic areas.
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Affiliation(s)
- Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisbon, Lisboa, 1600 - 190, Portugal.
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal.
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal.
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisboa, 1649-023, Portugal.
| | - Joana Henriques
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa, 1600-560, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), Lisboa, 1649-026, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
| | - Marie J Polley
- Research and Development, Meaningful Measures Ltd, Bristol, UK
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisbon, Lisboa, 1600 - 190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
| | - Miguel Arriaga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisboa, 1649-023, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisbon, Lisboa, 1600 - 190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas - TERRA, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa, 1649-028, Portugal
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa, 1600-560, Portugal
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Costa A, Henriques J, Alarcão V, Madeira T, Virgolino A, Henriques A, Feteira-Santos R, Polley M, Arriaga M, Nogueira P. Social prescribing for older adults in mainland Portugal: Perceptions and future prospects. Prev Med Rep 2024; 39:102652. [PMID: 38384966 PMCID: PMC10879768 DOI: 10.1016/j.pmedr.2024.102652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
Background In order to address health inequalities, which have been exacerbated by the COVID-19 pandemic, and promote older adults' quality of life, it is necessary to explore non-medical approaches such as social prescribing. Social prescribing is a person-centered approach that allows health professionals to refer patients to services provided by the social and community sectors. This study aimed to explore older adults' perceptions of social prescribing in mainland Portugal and to identify factors associated with these perceptions, providing insights for future implementation strategies. Methods A cross-sectional study was conducted with 613 older adults aged 65 to 93. Participants' sociodemographic, economic, and health characteristics were assessed, along with their perceptions of social prescribing's benefits and activity interest. Results Over 75% of respondents agreed that social prescribing would benefit the health system and their community. Most participants (87.7% and 89.7%, respectively) thought that activities like personal protection and development activities and cultural enrichment would be particularly relevant to them. Factors such as marital status, education, health status, and pain/discomfort levels influenced the perceived relevance of these activities. Conclusion This study reveals that older adults in mainland Portugal are open to social prescribing and suggests that tailored interventions considering individual preferences and characteristics can lead to more effective implementation and equal access to social prescribing. Further research and policy efforts should focus on integrating social prescribing into the healthcare system to support healthy aging in Portugal.
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Affiliation(s)
- Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Joana Henriques
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), Lisboa 1649-026, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
| | - Marie Polley
- University of Westminster, School of Social Sciences (Psychology), 115 New Cavendish Street, London W1W 6UW, United Kingdom
- Consultancy Ltd., Hitchin SG4 0AP, United Kingdom
| | - Miguel Arriaga
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Católica Research Centre for Psychological-Family and Social Wellbeing (CRC-W), Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon 1649-023, Portugal
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Avenida Prof Egas Moniz, Lisboa, Lisbon 1600-190, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, Lisboa 1649-028, Portugal
- Laboratório para a Sustentabilidade do Uso da Terra e dos Serviços dos Ecossistemas – TERRA, Lisboa, Portugal
- Escola Nacional de Saúde Pública, ENSP, Centro de Investigação em Saúde Pública, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Avenida Padre Cruz, Lisboa 1600-560, Portugal
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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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Lee H, Koh SB, Jo HS, Lee TH, Nam HK, Zhao B, Lim S, Lim JA, Lee HH, Hwang YS, Kim DH, Nam EW. Global Trends in Social Prescribing: Web-Based Crawling Approach. J Med Internet Res 2023; 25:e46537. [PMID: 37086427 PMCID: PMC10242464 DOI: 10.2196/46537] [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: 02/15/2023] [Revised: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Social loneliness is a prevalent issue in industrialized countries that can lead to adverse health outcomes, including a 26% increased risk of premature mortality, coronary heart disease, stroke, depression, cognitive impairment, and Alzheimer disease. The United Kingdom has implemented a strategy to address loneliness, including social prescribing-a health care model where physicians prescribe nonpharmacological interventions to tackle social loneliness. However, there is a need for evidence-based plans for global social prescribing dissemination. OBJECTIVE This study aims to identify global trends in social prescribing from 2018. To this end, we intend to collect and analyze words related to social prescribing worldwide and evaluate various trends of related words by classifying the core areas of social prescribing. METHODS Google's searchable data were collected to analyze web-based data related to social prescribing. With the help of web crawling, 3796 news items were collected for the 5-year period from 2018 to 2022. Key topics were selected to identify keywords for each major topic related to social prescribing. The topics were grouped into 4 categories, namely Healthy, Program, Governance, and Target, and keywords for each topic were selected thereafter. Text mining was used to determine the importance of words collected from new data. RESULTS Word clouds were generated for words related to social prescribing, which collected 3796 words from Google News databases, including 128 in 2018, 432 in 2019, 566 in 2020, 748 in 2021, and 1922 in 2022, increasing nearly 15-fold between 2018 and 2022 (5 years). Words such as health, prescribing, and GPs (general practitioners) were the highest in terms of frequency in the list for all the years. Between 2020 and 2021, COVID, gardening, and UK were found to be highly related words. In 2022, NHS (National Health Service) and UK ranked high. This dissertation examines social prescribing-related term frequency and classification (2018-2022) in Healthy, Program, Governance, and Target categories. Key findings include increased "Healthy" terms from 2020, "gardening" prominence in "Program," "community" growth across categories, and "Target" term spikes in 2021. CONCLUSIONS This study's discussion highlights four key aspects: (1) the "Healthy" category trends emphasize mental health, cancer, and sleep; (2) the "Program" category prioritizes gardening, community, home-schooling, and digital initiatives; (3) "Governance" underscores the significance of community resources in social prescribing implementation; and (4) "Target" focuses on 4 main groups: individuals with long-term conditions, low-level mental health issues, social isolation, or complex social needs impacting well-being. Social prescribing is gaining global acceptance and is becoming a global national policy, as the world is witnessing a sharp rise in the aging population, noncontagious diseases, and mental health problems. A successful and sustainable model of social prescribing can be achieved by introducing social prescribing schemes based on the understanding of roles and the impact of multisectoral partnerships.
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Affiliation(s)
- Hocheol Lee
- Department of Health Administration, Software Digital Healthcare Convergence College, Yonsei University, Wonju, Republic of Korea
- Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea
| | - Sang Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Tae Ho Lee
- Korea Industry Development Institute, Gangneung, Republic of Korea
| | - Hae Kweun Nam
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Bo Zhao
- Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea
| | - Subeen Lim
- Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea
| | - Joo Aeh Lim
- Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea
| | - Ho Hee Lee
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Yu Seong Hwang
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Dong Hyun Kim
- Department of Information Statistics, Yonsei University, Wonju, Republic of Korea
| | - Eun Woo Nam
- Department of Health Administration, Software Digital Healthcare Convergence College, Yonsei University, Wonju, Republic of Korea
- Yonsei Global Health Center, Yonsei University, Wonju, Republic of Korea
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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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Abstract
Social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are the non-medical factors that influence health outcomes. Evidence indicates that health behaviours, comorbidities and disease-modifying therapies all contribute to multiple sclerosis (MS) outcomes; however, our knowledge of the effects of social determinants — that is, the ‘risks of risks’ — on health has not yet changed our approach to MS. Assessing and addressing social determinants of health could fundamentally improve health and health care in MS; this approach has already been successful in improving outcomes in other chronic diseases. In this narrative Review, we identify and discuss the body of evidence supporting an effect of many social determinants of health, including racial background, employment and social support, on MS outcomes. It must be noted that many of the published studies were subject to bias, and screening tools and/or practical interventions that address these social determinants are, for the most part, lacking. The existing work does not fully explore the potential bidirectional and complex relationships between social determinants of health and MS, and the interpretation of findings is complicated by the interactions and intersections among many of the identified determinants. On the basis of the reviewed literature, we consider that, if effective interventions targeting social determinants of health were available, they could have substantial effects on MS outcomes. Therefore, funding for and focused design of studies to evaluate and address social determinants of health are urgently needed. Here, the authors discuss the potential effects of social determinants of health on multiple sclerosis risk and outcomes. They suggest that addressing these determinants of health could substantially improve the lives of individuals with multiple sclerosis and call for more research. Addressing an individual’s social determinants of health — that is, the conditions under which they are born, grow, live, work and age — could provide opportunities to reduce the burden of living with multiple sclerosis (MS). Individual factors that may influence MS-related outcomes include sex, gender and sexuality, race and ethnicity, education and employment, socioeconomic status, and domestic abuse. Societal infrastructures, including access to food, health care and social support, can also affect MS-related outcomes. Awareness of the specific circumstances of a patient with MS might help neurologists deliver better care. Social determinants of health are not static and can change according to wider sociopolitical contexts, as highlighted by the COVID-19 pandemic. Rigorous studies of interventions to ameliorate the effects of poor social determinants on people with MS are urgently needed.
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Morse DF, Sandhu S, Mulligan K, Tierney S, Polley M, Chiva Giurca B, Slade S, Dias S, Mahtani KR, Wells L, Wang H, Zhao B, De Figueiredo CEM, Meijs JJ, Nam HK, Lee KH, Wallace C, Elliott M, Mendive JM, Robinson D, Palo M, Herrmann W, Østergaard Nielsen R, Husk K. Global developments in social prescribing. BMJ Glob Health 2022; 7:e008524. [PMID: 35577392 PMCID: PMC9115027 DOI: 10.1136/bmjgh-2022-008524] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/02/2022] [Indexed: 11/09/2022] Open
Abstract
Social prescribing is an approach that aims to improve health and well-being. It connects individuals to non-clinical services and supports that address social needs, such as those related to loneliness, housing instability and mental health. At the person level, social prescribing can give individuals the knowledge, skills, motivation and confidence to manage their own health and well-being. At the society level, it can facilitate greater collaboration across health, social, and community sectors to promote integrated care and move beyond the traditional biomedical model of health. While the term social prescribing was first popularised in the UK, this practice has become more prevalent and widely publicised internationally over the last decade. This paper aims to illuminate the ways social prescribing has been conceptualised and implemented across 17 countries in Europe, Asia, Australia and North America. We draw from the 'Beyond the Building Blocks' framework to describe the essential inputs for adopting social prescribing into policy and practice, related to service delivery; social determinants and household production of health; workforce; leadership and governance; financing, community organisations and societal partnerships; health technology; and information, learning and accountability. Cross-cutting lessons can inform country and regional efforts to tailor social prescribing models to best support local needs.
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Affiliation(s)
| | - Sahil Sandhu
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Stephanie Tierney
- Department of Primary Care Health Sciences, University of Oxford Nuffield, Oxford, UK
| | | | | | - Siân Slade
- University of Melbourne, Melbourne, Victoria, Australia
| | - Sónia Dias
- Universidade Nova de Lisboa Escola Nacional de Saúde Pública, Lisbon, Portugal
| | - Kamal R Mahtani
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Leanne Wells
- Consumers Health Forum of Australia, Deakin, Victoria, Australia
| | - Huali Wang
- Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, Beijing, China
| | - Bo Zhao
- Health Administration, Yonsei University-Wonju Campus, Wonju, Gangwon-do, Republic of Korea
| | | | | | - Hae Kweun Nam
- Department of Preventive Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | | | | | | | | | - David Robinson
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Miia Palo
- Lapland Hospital District, Rovaniemi, Finland
| | | | - Rasmus Østergaard Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Research Unit for General Practice, Aarhus, Denmark
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Costa A, Lopes J, Sousa CJ, Santos O, Virgolino A, Nogueira P, Henriques A, Seabra P, Capitão C, Martins R, Arriaga M, Alarcão V. Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging. BMC Health Serv Res 2021; 21:1164. [PMID: 34706718 PMCID: PMC8548849 DOI: 10.1186/s12913-021-07186-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Social Prescribing (SP) is an innovative strategy to respond to the non-clinical health needs of the population. A Social Prescribing Local System (SPLS) can be defined as a set of joined community, health, and social organizations to foster SP-oriented activities. This study aimed to develop and assess the feasibility of an SPLS implemented in a Mediterranean country, to promote health and wellbeing and contribute to active and healthy aging. METHODS A mixed-methods approach was followed, including three sequential components: 1) Cross-sectional online survey targeting health professionals (HP) working in a primary health care cluster, Portugal's southern region; 2) Pilot study implementing an on-the-job training program for HP, designed to meet identified training needs in the survey; 3) Focus group (FG) with the HP who participated in the pilot study, two individual interviews, with an elderly patient and a community provider for assessing the satisfaction with the pilot test. RESULTS Sixty-five HP completed the survey; of these, 13 completed the theoretical part of the on-the-job training program; and six (out of these 13) completed the full program. Five HP participated in the FG, one patient and one community provider were interviewed. The surveyed HP perceived as facilitators to implement SP: an automatic system of notifications to prompt the use of SP, contribute to patient satisfaction, human and community resources' stability. The survey also highlighted barriers to SP implementation: length of appointments, shortage of human resources, data records confidentiality, low patient adherence rates, bureaucratic issues, time constraints, and financial costs. Participants were satisfied with the training. Identified SPLS implementation benefits were grouped into four dimensions (from the qualitative approach): gains for patients' health and wellbeing, support for the health services, sustainability of the community resources, and HP' professional satisfaction. CONCLUSIONS Our study took the first steps towards the implementation of an SPLS. Findings reinforce that training HP in SP and on-the-job training seems feasible. This approach was well received and appears to represent a suitable and sustainable strategy. It can promote professional satisfaction, support health services, contribute to the stability of community resources, improve health and promote active and healthy aging.
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Affiliation(s)
- A Costa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal.
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal.
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal.
| | - J Lopes
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - C J Sousa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - O Santos
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Unbreakable Idea Research, Lda, 2550-426, Painho, Portugal
| | - A Virgolino
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - P Nogueira
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Laboratório de Biomatemática, Instituto de Medicina Preventiva e Saúde pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Egas Moniz, 1649-028, Lisbon, Portugal
| | - A Henriques
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - P Seabra
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096, Lisbon, Portugal
| | - C Capitão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - R Martins
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - M Arriaga
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisbon, Portugal
- Directorate-General for Health, Health Literacy and Wellbeing Division, Alameda Dom Afonso Henriques, 1000-123, Lisbon, Portugal
| | - V Alarcão
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Centro de Investigação e Estudos de Sociologia, ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Avenida das Forças Armadas, 1649-026, Lisbon, Portugal
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