XGBSHN5023 Personalised Care Social Prescribing Literature Review Assignment

Introduction Of XGBSHN5023 Personalised Care Social Prescribing Assignment

Social prescribing has recently been described as a form of practice that entails linking people to other things outside the ordinary medical care system in search of better health. It is planned to provide further support for patients by offering various community connections, including exercise, arts, and support groups. Social prescribing has come into focus more recently as a way of reducing demand for conventional healthcare services with increased interest in whole person, whole system practice (Ahluwalia, Spicer & Storey, 2020).

In this literature review, the efficacy and suitability of the social prescribing interventions are assessed. This work examines ways in which these interventions affect health and wellness, especially for people living with chronic diseases, mental disorders, and social exclusion. It equally evaluates the methods of determining outcomes based on the qualitative and quantitative approaches; and also, the issues of assessing the success.

As a result of employing an array of methodological approaches, this review also discusses the methodological strengths and weaknesses of a variety of studies identified in the literature, as well as key areas reinforced or that remain unanswered. As such, it aims to establish whether social prescribing can be a long-term solution for enhancing health outcomes and closing healthcare gaps.

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Main Body – Critique

Effectiveness and appropriateness of social prescribing interventions

Social prescribing has become one of the most important strategies since it attempts to connect people to social resources. It understands that the quality of people’s health depends on social, economic, and environmental factors, and it assists the clients in increasing their well-being through appreciation of arts, exercising, volunteering, and joining a gang. However, there is some emerging controversy about the utility of social prescribing in improving the health status of clients, and employees of healthcare organizations. Moreover, Self-Determination Theory (SDT) is used to demonstrate the motivational processes that pertain to social prescribing and the individual capacity for sustainable behavioural change.

Effectiveness of Social Prescribing Interventions

Several studies have shown that social prescribing can lead to benefits in the physical and mental well-being of patients. Numerous published articles demonstrate increased perceived self-fulfilment, decreased symptoms of depression and anxiety, as well as increased levels of social inclusion among the participants. For instance, a systematic review conducted by Bickerdike et al. (2017) established that social prescribing interventions help to increase pro-social activities, as well as lessen feelings of loneliness among the elderly and people with mental illnesses. They have also been associated with fewer GP consultations and hospitalisation indicating they can ease the burden on the health care facilities. However, the evaluations based on quantitative approaches are less conclusive; in fact, they are conflicting on the social prescribing benefits that are self-reported. A controlled clinical trial by Mercer et al. (2019) compared the effects of social prescription for patients with multimorbidity and revealed that there are only slight changes in the mental health scores when compared to the control group. Some of the issues that were cited in the study involving the impact of social prescribing were issues to do with the attribution of causality because the results observed may be influenced by factors that are outside the scope of social prescribing. In addition, the interventions may not receive an active participation from the participants at some given point thus, the variability of the results.

Appropriateness of Social Prescribing Interventions

Social prescribing determinacy involves the following factors including; patient eligibility for social prescribing approaches, the availability of community services to refer the patient, status of integration of social prescribing into a country’s healthcare structure. This is one of the significant strengths of social prescribing as more focus is placed on the patients and transmitted through their preferences. For instance, in a study carried out by Husk et al. (2020), there are positive findings revealed that the cognate matches with preference outcome in participants result from a well-matched intervention. Nevertheless, there are several disadvantages concerning the use of social prescription: Community services may however be scarce or of substandard quality, which may reach a negative condition where individuals in disadvantaged regions may not access the services. Moreover, there remains a conflict between the continuation of health disparities, the case that those most in need of social prescribing, such as people in the lower social classes, may be unable to engage because of financial limitations, lack of transportation, or lack of access to technology. Still, there are risks to social prescribing for several reasons, including limited funding that is often obtained from short-term grant funding and the voluntary sector (Hopkins et al., 2023).

Social and Cultural Considerations

According to the cultural differences and the societal structure, people have their considerations and acceptance towards the scheme. Thus, one might recognize that standardized interventions will often not apply to ethnic minorities or the elderly as well as those with physical handicaps. South et al. (2018) found out that, culturally appropriate social prescription activities such as homering systems having doctrinal exercise characteristics that are customized to their community’s cultural and religious beliefs can increase their partnership and efficacy. For instance, group work could be recommended for people from a collectivist type while others could require personal attention only. However, there are further considerations when it comes to the different genders of the parties involved in the interventions. Thus, some of the activities may be more attractive or easy to do for males rather than for females because of the existing cultural expectations. That is why it is necessary to pay attention to the gender perspective in the choice of social prescriber, for example, male-oriented groups for men’s mental health issues or female-oriented groups based on women’s social communities (Wakefield et al., 2022).

Integration with Healthcare Services

This means that the effectiveness of social prescribing also depends on the extent to which social prescribing fits into the current system of healthcare. The coordination of care provided by family physicians and other community organizations ensures that patients are well-attended. However, the coordination of the healthcare professionals and the social prescribing services is not well coordinated hence it leads to the fragmentation of care. Drinkwater et al. (2019) reported that primary care staff lacks clarity in practicing social prescribing, and hence, practice it irregularly. Hence, it is recommended that there should be consistent training for healthcare professionals on the importance of social prescribing and a good referral system to make it more appropriate and effective.

Long-Term Sustainability and Follow-Up

Despite the goal of social prescribing to enhance self-management, its long-term effectiveness is contingent on long-term support and follow-up activities. Yet, people are often reached for a short-term intervention only, after which they fail to stick to the agreed practice. The recent enhancement of structured follow-up plans that involve the periodic visiting of the participants boosts the retention aspect by reminding the participants of what was taught and the need to practice those behaviours. Moreover, participation in other people's support groups with peers and encouraging established mentorship relations may help lower the chances of the targeted individual's disengagement after the end of the initial time-limited program.

Effectiveness of social prescribing intervention methods of assessing, planning, and evaluating outcomes

Methods of Assessing Social Prescribing Outcomes

Qualitative Approaches

Interviews and Focus Groups

The present work is focused on identifying how qualitative research helps elaborate personal stories of people involved in social prescribing. Interviews and focus groups enable the researcher to elicit the detailed ways in which these interventions affect well-being. For instance, research by Husk et al. (2020) interviewed 20 participants involved in social prescribing; using semi-structured interviews, research has found increased self-efficacy, personal empowerment, and social connectedness. Nonetheless, qualitative method research is relative, and therefore cannot yield generalizable results across larger populations. Participants could recall participants by their recall bias or socially desirable bias where they only report satisfactory outcomes because that is still expected.

• Quantitative Approaches
• Wellbeing Scales and Surveys
• Quantitative research makes use of questionnaires to evaluate the impact of social prescribing initiatives. Common tools include:
• Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) – This is used to assess variation in wellbeing.
• General Health Questionnaire (GHQ-12) – Assesses mental health status.
• Patient Activation Measure (PAM) is one of the tools that were used in the study since it assesses a person’s capacity to manage his/her health.

For instance, Mercer et al. (2019) implemented an RCT having WEMWBS to assess the efficacy of social prescribing for patients with multimorbidity. The study revealed that there existed a slight improvement in the wellbeing with these results however they only showed minor changes and therefore not being statistically significant. It is for this reason that such findings offer a research direction of social prescribing but it is noisy since it exhibits variability depending on the levels of engagement of the patient or recipient as well as the quality of interventions.

Randomized Controlled Trials (RCTs)

RCTs are the best approach for measuring the effectiveness of a specific healthcare intervention since it is possible to take two groups of people where one can receive the intervention while the other does not. However, when it comes to social prescribing, issues of ethics that are ethically and practically sensitive arise. It can be considered unethical to assign participants to the control group, excluding the support services, especially if the study uses a range of types of social prescribing interventions. However, some authors call for methodological improvements to advance research and increase the stringency of the design of interventions (Rempel et al., 2021).

Mixed-Methods Approaches

Due to the shortcomings of qualitative and quantitative research, combining both approaches is common and involves using self-reports questionnaires in addition to analysing rates of healthcare use. For instance, Drinkwater et al., (2019) examined a study that involved using WEMWBS scores alongside the track records of patients’ health care visits and self-reported wellbeing and revealed a decline in the number of appointments made with GPs. This approach is advantageous as it does not only offer respondents’ perceptions on social prescribing but behavioural alteration as well.

Planning Social Prescribing Interventions

It is also noteworthy that, like with any form of planning, the most crucial step is the needs assessment for social prescribing. This situation ensures that the learners in his target population have their needs met by utilizing the appropriate approach. For instance, the elderly need a basic activity such as a social club to fill the gap created by the loss of their friends while the young man who has anxiety disorder may need mindfulness or creative arts. Personalization is key to engagement. Thomson et al., (2020) observed that participants who were engaged in the choice of their social prescribing activities, their engagement and satisfaction levels higher. This is consistent with the Self-Determination Theory (Deci & Ryan, 1985); emphasizing autonomy as well as intrinsic motivation towards self-change.

Training for Link Workers

In the context of social prescribing, link workers are very essential in how and where they are positioned to help in the general planning of social prescribing. When equipped with the necessary training mainly in motivational interviewing, mental health, and community assets mapping, then they would be better placed to support the patients. Fixsen et al. (2021) have mentioned that proper training is vital when it comes to link workers since it affects patient satisfaction and the overall success of delivered interventions.

Evaluating the Effectiveness of Social Prescribing

Challenges in Evaluation

Usually, evaluating social prescribing interventions poses some difficulties. First, where the type of interventions is diverse, it becomes difficult to agree on the measures that ought to be taken as the outcomes. Secondly, social prescribing takes time to be effective, meaning that the changes that are accrued are obtained after follow-up periods. To tackle these challenges, researchers recommend the adoption of realist evaluation approaches that focus on realist evaluation; that is, examining how, for what reasons, and in which contexts social prescribing is effective. Pawson and Tilley in their critique stated that knowledge concerning the processes of an intervention is as pertinent as assessing the effects of the program.

Longitudinal Studies and Sustainability

Consequently, longitudinal examinations of people’s progress over long years offer an idea of the long-term effectiveness of social prescribing. For example, Tierney et al. (2021) surveyed community participants of social prescribing for five years and found out that those who remained active in the participation of community activities continued to have better well-being than those who had dropped out.

The available literature on the topic reveals that social prescribing interventions could help enhance psychological well-being, lower isolation levels, and even reduce healthcare use. However, several methodological weaknesses including the use of self-reported data and the conduct of RCTs disabled the conclusion’s strength. As for the evaluation of social prescribing, an array of research methods should be identified, such as interviews, questionnaires, and mixed ones. There is a need to focus on clinical precision, link worker education and development, and good liaison with other primary care services. About the research that still needs to be done on social prescribing, there is a need to conduct longitudinal evaluations and incorporate standard measures to build credible effectiveness evidence for social prescribing.

Conclusion

Social prescribing has recently been recognized as an effective model of health intervention, where people are provided with access to non-clinical, community-based services. Social prescribing has been defined in this paper as a model used by healthcare practitioners to refer patients with non-medical needs to community support agencies to access different support services. It has been observed various studies that analysing the effectiveness of social prescribing, have brought about a positive shift in many of the targeted problems, such as improvement of mental health, reduction in loneliness, and lower utilization of the general practice services. Promoting positive experiences is a strongly highlighted concept of qualitative studies: people experience an enhanced sense of self-efficacy, connection, and power. However, regarding the measure of such changes, the quantitative results are inconclusive and range from small changes only in the scores of wellbeing. These findings are understandable as the variety of the interventions applied as well as the level of participation of the participants differ. To evaluate the effectiveness of social prescribing, one needs to use qualitative and quantitative research. A large number of studies have used self-reported well-being scales, medical service data, and RCTs, but each departs from the conceptual and methodological perfection. Enduring qualitative and quantitative data collection and analysis prove to be more accurate in assessing social prescribing’s efficiency. The factors making up an optimal service model require careful consideration and planning to ensure they reflect the uniqueness of the patients served; and the integration of social prescribing interventions with existing healthcare systems. The link workers’ task involves ensuring engagement and thus it becomes important to train the link workers to improve on the same.

References

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