Stephanie Tierney1, Geoff Wong2, Nia Roberts3, Anne-Marie Boylan2, Sophie Park4, Ruth Abrams4, Joanne Reeve5, Veronika Williams6, Kamal R Mahtani2. 1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. stephanie.tierney@phc.ox.ac.uk. 2. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. 3. Bodleian Health Care Libraries, University of Oxford, Oxford, UK. 4. Department of Primary Care and Population Health, University College London, London, UK. 5. Hull York Medical School, University of Hull, Hull, UK. 6. School of Nursing, Nipissing University, North Bay, Canada.
Abstract
BACKGROUND: Social prescribing is a way of addressing the 'non-medical' needs (e.g. loneliness, debt, housing problems) that can affect people's health and well-being. Connector schemes (e.g. delivered by care navigators or link workers) have become a key component to social prescribing's delivery. Those in this role support patients by either (a) signposting them to relevant local assets (e.g. groups, organisations, charities, activities, events) or (b) taking time to assist them in identifying and prioritising their 'non-medical' needs and connecting them to relevant local assets. To understand how such connector schemes work, for whom, why and in what circumstances, we conducted a realist review. METHOD: A search of electronic databases was supplemented with Google alerts and reference checking to locate grey literature. In addition, we sent a Freedom of Information request to all Clinical Commissioning Groups in England to identify any further evaluations of social prescribing connector schemes. Included studies were from the UK and focused on connector schemes for adult patients (18+ years) related to primary care. RESULTS: Our searches resulted in 118 included documents, from which data were extracted to produce context-mechanism-outcome configurations (CMOCs). These CMOCs underpinned our emerging programme theory that centred on the essential role of 'buy-in' and connections. This was refined further by turning to existing theories on (a) social capital and (b) patient activation. CONCLUSION: Our realist review highlights how connector roles, especially link workers, represent a vehicle for accruing social capital (e.g. trust, sense of belonging, practical support). We propose that this then gives patients the confidence, motivation, connections, knowledge and skills to manage their own well-being, thereby reducing their reliance on GPs. We also emphasise within the programme theory situations that could result in unintended consequences (e.g. increased demand on GPs).
BACKGROUND: Social prescribing is a way of addressing the 'non-medical' needs (e.g. loneliness, debt, housing problems) that can affect people's health and well-being. Connector schemes (e.g. delivered by care navigators or link workers) have become a key component to social prescribing's delivery. Those in this role support patients by either (a) signposting them to relevant local assets (e.g. groups, organisations, charities, activities, events) or (b) taking time to assist them in identifying and prioritising their 'non-medical' needs and connecting them to relevant local assets. To understand how such connector schemes work, for whom, why and in what circumstances, we conducted a realist review. METHOD: A search of electronic databases was supplemented with Google alerts and reference checking to locate grey literature. In addition, we sent a Freedom of Information request to all Clinical Commissioning Groups in England to identify any further evaluations of social prescribing connector schemes. Included studies were from the UK and focused on connector schemes for adult patients (18+ years) related to primary care. RESULTS: Our searches resulted in 118 included documents, from which data were extracted to produce context-mechanism-outcome configurations (CMOCs). These CMOCs underpinned our emerging programme theory that centred on the essential role of 'buy-in' and connections. This was refined further by turning to existing theories on (a) social capital and (b) patient activation. CONCLUSION: Our realist review highlights how connector roles, especially link workers, represent a vehicle for accruing social capital (e.g. trust, sense of belonging, practical support). We propose that this then gives patients the confidence, motivation, connections, knowledge and skills to manage their own well-being, thereby reducing their reliance on GPs. We also emphasise within the programme theory situations that could result in unintended consequences (e.g. increased demand on GPs).
Entities:
Keywords:
Care navigators; Evidence synthesis; Link workers; Realist review; Social capital; Social prescribing
Authors: Dipesh P Gopal; Sarah Beardon; Martin Caraher; Charlotte Woodhead; Stephanie Jc Taylor Journal: Br J Gen Pract Date: 2021-09-30 Impact factor: 6.302
Authors: Holly Q Bennett; Andrew Kingston; Ilianna Lourida; Louise Robinson; Lynne Corner; Carol Eg Brayne; Fiona E Matthews; Carol Jagger Journal: EClinicalMedicine Date: 2021-07-31
Authors: Jasneet Parmar; Sharon Anderson; Marjan Abbasi; Saeed Ahmadinejad; Karenn Chan; Lesley Charles; Bonnie Dobbs; Amandeep Sheny Khera; Jennifer Stickney-Lee; Peter George J Tian; Suvidha Jain Journal: Int J Environ Res Public Health Date: 2021-03-23 Impact factor: 3.390