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Social prescribing for people with complex needs: a realist evaluation.

Emily Wood1, Sally Ohlsen2, Sarah-Jane Fenton3

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Summary

Social Prescribing interventions are complex and vary widely. This study refined a programme theory to better understand and target Social Prescribing for maximum client benefit and effectiveness.

Keywords:
Co-morbidityDepressionMulti-morbidityRealist evaluationSalutogenesisSocial Prescribing

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Area of Science:

  • Public Health
  • Health Services Research
  • Social Determinants of Health

Background:

  • Social Prescribing is an increasingly popular intervention with reported positive outcomes.
  • It functions as an umbrella term for diverse interventions, necessitating a clearer understanding of mechanisms.
  • Existing evaluations highlight positive results but lack detailed mechanistic insights.

Purpose of the Study:

  • To test, develop, and refine a programme theory for Social Prescribing.
  • To elucidate the underlying mechanisms of Social Prescribing interventions.
  • To enhance the effectiveness of Social Prescribing by enabling targeted application.

Main Methods:

  • A realist evaluation was conducted with a large Social Prescribing organisation.
  • Thirty-five stakeholder interviews (clients, staff) were performed.
  • Programme theory was iteratively developed, refined, and retested with stakeholders.

Main Results:

  • Social Prescribing demonstrated a complex web of contexts, mechanisms, and outcomes.
  • Key factors influencing outcomes included social isolation, wider health determinants, and interagency communication.
  • Effective Social Prescribing requires a non-stigmatizing, person-centred environment, aligning with Salutogenesis.

Conclusions:

  • The studied Social Prescribing model is holistic and person-centred.
  • It empowers individuals to strengthen their sense of coherence and access resources.
  • The model facilitates a move towards health promotion and a salutogenic direction.