ObjectivesThis study aimed to assess the degree to which the ‘social cure’ model of psychosocial health captures the understandings and experiences of healthcare staff and patients in a social prescribing (SP) pathway and the degree to which these psychosocial processes predict the effect of the pathway on healthcare usage.DesignMixed-methods: Study 1: semistructured interviews; study 2: longitudinal survey.SettingAn English SP pathway delivered between 2017 and 2019.ParticipantsStudy 1: general practitioners (GPs) (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a 4-month follow-up after initial referral assessment.InterventionChronically ill patients experiencing loneliness referred onto SP pathway and meeting with a health coach and/or link worker, with possible further referral to existing or newly created relevant third-sector groups.Main outcome measureStudy 1: health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: patients’ primary care usage.ResultsHealthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging and reduced loneliness.ConclusionsMethodological triangulation offers robust conclusions that ‘social cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating social cure processes into SP initiatives are discussed.

Resilient, cohesive communities are important contributors to the health and well-being of their residents (Ehsan, Klaas, Bastianen, & Spini, 2019). Advances in social psychology suggest a multitude of physical and mental health outcomes derive from meaningful belonging in social groups within a range of contexts (Haslam,

We examined whether the Social Cure (SC) perspective explains the efficacy of a Social Prescribing (SP) pathway which addresses healthcare needs through enhancing social connections. Data were collected at pathway entry from patients with long-term health conditions, or who felt isolated/lonely/anxious ( N = 630), then again 4 months later ( N = 178), and 6-9 months later ( N = 63). Being on the pathway was associated with increased group memberships between T0 and T1. The relationship between increased group memberships and quality-of-life was serially mediated by belonging, support and loneliness. This study is the first to show SP enhances health/well-being via SC mechanisms.

Levels of loneliness across the world have reached epidemic proportions, and their impact upon population health is increasingly apparent. In response, policies and initiatives have attempted to reduce loneliness by targeting social isolation among residents of local communities. Yet, little is known about the social psychological processes underpinning the relationships between community belonging, loneliness, and well-being. We report three studies which apply the Social Identity Approach to Health to examine the mechanisms underpinning the relationships between community identity, health, and loneliness. Hypotheses were tested through secondary analyses of the 2014-2015 UK Community Life Survey (N = 4,314) as well as bespoke household surveys in a more (N = 408) and less (N = 143) affluent community at high risk of loneliness. Studies 1 and 2a demonstrated that the relationship between community identification and well-being was mediated by increased social support and reduced loneliness. In Study 2b, community identification predicted well-being through reduced loneliness, but not through social support. Our results are the first to evidence these relationships and suggest that community-level interventions that enhance community identification and peer support can promote a potential Social Cure for loneliness.International surveys of population health have shown that loneliness poses a threat to health as severe as that of smoking and obesity (Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015;Holt-Lunstad, Smith, & Layton, 2010). This has prompted the creation of public health initiatives to understand and tackle loneliness within the context of local communities. These typically identify poor community cohesion and integration as contributing factors to loneliness and increased social integration as part of the solution.However, such policies are rarely grounded in an in-depth understanding of the complex relationships between community belonging, loneliness, and health. SocialThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

White water (WW) activities such as paddling (canoeing and kayaking) and rafting are popular sports for recreational and professional participants. An increase in participation has been seen worldwide. However, these activities come with a risk of injury and even death if not conducted safely. A review was conducted to identify the types of injuries and ill-health that occur as a result of these activities. Injury and fatality rates were assessed to establish the risk attributed to these activities. Web of Science, PubMed, Ergonomics Abstracts and PsycINFO databases were searched and a total of 16 published articles were identified and reviewed. The shoulders and back were the most vulnerable sites for injury in WW paddling. Injuries to the face and lower limbs were most common in WW rafters. However, injury rates are low and estimates are discussed. Due to different methods used across the studies, the reported injury rates are not comparable. This review identified three illnesses incurred through WW activities. There may be more but these are not currently reported in the literature. A relative paucity of studies regarding injuries and fatalities in WW activities was identified. Directions for future research are suggested and discussed.