Establishing Internationally Accepted Conceptual and Operational Definitions of Social Prescribing Through Expert Consensus: A Delphi Study

Abstract

IntroductionWith the social prescribing movement gaining traction globally, there is a need for an agreed definition of social prescribing. There are two types of definitions — conceptual and operational, meaning agreement on both types of definitions is needed.ObjectiveThe aim of this study was to establish internationally accepted conceptual and operational definitions of social prescribing.DesignA three-round Delphi study was conducted.MethodsConsensus was defineda priorias ≥80% agreement. In Round 1, participants were asked to list key elements that are essential to the conceptual definition of social prescribing and to provide corresponding statements that operationalize each of the key elements. In Round 2, participants were asked to rate their agreement with items from the first round for inclusion in the conceptual and/or operational definitions of social prescribing. Based on the findings from this round, the conceptual and operational definitions of social prescribing were developed, including long and short versions of the conceptual definition. In Round 3, participants were asked to rate their agreement with the conceptual and operational definitions of social prescribing.ParticipantsThis study involved an international, multidisciplinary panel of experts. The expert panel (n=48) represented 26 different countries across five continents, numerous expert groups, and a variety of years of experience with social prescribing, with the average being 5 years (range = 1-20 years).ResultsAfter three rounds, internationally accepted conceptual and operational definitions of social prescribing were established. The definitions were transformed into the Common Understanding of Social Prescribing (CUSP) conceptual framework.ConclusionThis foundational work offers a common thread — a shared sense of what social prescribing is, which may be woven into social prescribing research, policy, and practice to foster common understanding of this concept.

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“…Social prescribing is a person-centred approach involving referral to non-clinical services including those within the third sector (Public Health England, 2019 ), which describes groups or organisations operating independently to government, where social justice is the primary goal (Salamon & Sokolowski, 2016 ). It is an intervention that directs patients with non-medical health needs away from healthcare and towards social means of addressing their needs (Muhl et al, 2022 ), such as support with the social determinants of health including finance and housing, activities around art and creativity, and exercise (Thomson et al, 2015 ). Social prescribing can also involve referring clients to engage in volunteering (Thomson et al, 2015 ; Tierney et al, 2022 ), defined as unpaid work or activity to benefit others outside of the family or household, in which the individual freely chooses to participate (Salamon & Sokolowski, 2016 ).…”