Exploring how and why social prescribing evaluations work: a realist review

Abstract

ObjectiveThe evidence base for social prescribing is inconclusive, and evaluations have been criticised for lacking rigour. This realist review sought to understand how and why social prescribing evaluations work or do not work. Findings from this review will contribute to the development of an evidence-based evaluation framework and reporting standards for social prescribing.DesignA realist review.Data sourcesASSIA, CINAHL, Embase, Medline, PsycINFO, PubMed, Scopus Online, Social Care Online, Web of Science and grey literature.Eligibility criteriaDocuments reporting on social prescribing evaluations using any methods, published between 1998 and 2020 were included. Documents not reporting findings or lacking detail on methods for data collection and outcomes were excluded.AnalysisIncluded documents were segregated into subcases based on methodology. Data relating to context, mechanisms and outcomes and the programme theory were extracted and context-mechanism-outcome configurations were developed. Meta-inferences were drawn from all subcases to refine the programme theory.Results83 documents contributed to analysis. Generally, studies lacked in-depth descriptions of the methods and evaluation processes employed. A cyclical process of social prescribing evaluation was identified, involving preparation, conducting the study and interpretation. The analysis found that coproduction, alignment, research agency, sequential mixed-methods design and integration of findings all contributed to the development of an acceptable, high-quality social prescribing evaluation design. Context-mechanism-outcome configurations relating to these themes are reported.ConclusionsTo develop the social prescribing evidence base and address gaps in our knowledge about the impact of social prescribing and how it works, evaluations must be high quality and acceptable to stakeholders. Development of an evaluation framework and reporting standards drawing on the findings of this realist review will support this aim.PROSPERO registration numberCRD42020183065.

Effectiveness of social prescribing for chronic disease prevention in adults: a systematic review and meta-analysis of randomised controlled trials

“…Our study resonates with preceding SP reviews regarding the limitations in the available evidence and the need for further high-quality research 23 24 26 29 34 76–78. As we envisioned, there is limited development and evaluation of SP interventions to address the chronic disease risk factors in adults.…”

“…When this review was recently updated by Griffiths et al 24 to include the new evidence until July 2021, the limitations persisted. Similarly, many other reviews increasingly emphasised methodological deficits in the available studies that might undermine the efforts in judging clinical effectiveness 26 29–31 33 36 76–78. Most biases in our eligible studies stemmed from outcome assessment, missing data and poor reporting.…”

Developing a research agenda for social prescribing in the UK using lessons from the US

“…2 Many social prescribing evaluations have been of low methodological quality -with small numbers of participants, weak designs, no control groups, short durations, little consideration of confounding factors, and considerable loss to follow-up. 3 In response to the weak evidence base, researchers have called for a coordinated evaluation framework to help develop a common body of knowledge on social prescribing. 3 The National Academy of Social Prescribing in the UK launched an academic collaborative to define evidence gaps.…”

“…3 In response to the weak evidence base, researchers have called for a coordinated evaluation framework to help develop a common body of knowledge on social prescribing. 3 The National Academy of Social Prescribing in the UK launched an academic collaborative to define evidence gaps. The National Institute for Health and Care Research recently funded a multiregion evaluation of the national rollout in primary care.…”

“… 2 Many social prescribing evaluations have been of low methodological quality — with small numbers of participants, weak designs, no control groups, short durations, little consideration of confounding factors, and considerable loss to follow-up. 3 …”