Using self-determination theory to understand the social prescribing process: a qualitative study

Abstract

BackgroundSocial prescribing assists patients to engage insocial activities and connect to community supports as part of a holistic approach to primary care. Rx: Community was a social prescribing project, implemented within 11 community health centres situated across Ontario, Canada.AimsTo explore how social prescribing as a process facilitates positive outcomes for patients.Design and settingWe used qualitative methods, conducting 18 focus groups involving 88 patients and 8 additional in-depth interviews.MethodsInterviews and focus groups were transcribed verbatim and analyzed thematically using a theoretical framework based onself-determination theory.ResultsParticipants who had received social prescriptions described social prescribing as an empathetic process that respects their needs and interests. Social prescribing facilitated the patient’s voice in their care, helped patient’s develop skills in addressing needs important to them, and fostered trusting relationships with staff and other participants. Patients reported their social support networks were expanded, and they had improved mental health and ability in self-management of chronic conditions. Patients who became involved in social prescribing as voluntary “health champions” reported this was a positive experience and they gained a sense of purpose by giving back to their communities in ways that felt meaningful for them.ConclusionSocial prescribing produced positive outcomes for patients, and fit well within the community health centre model of primarycare. Future research should examine the impact on health outcomes and examine the return on investment of developing and implementing social prescribing programs.

Health and wellbeing outcomes and social prescribing pathways in community‐based support for autistic adults: A systematic mapping review of reviews

“…Furthermore, suppression of autistic traits may be damaging to emotional wellbeing (Cassidy et al., 2018; Hull et al., 2017) and sense of identity (Hull et al., 2017; Wilkenfield & McCarthy, 2020), which highlights the importance of measuring emotional wellbeing concurrently where interventions target autism presentation due to the potential for stigma (Scott et al., 2019) and promoting strengths‐based interventions (Huntley et al., 2019). In contrast, social prescribing has been shown to lead to improvements across a range of outcomes and can promote social connections and community participation by facilitating integration within a diverse group of people (Bhatti et al., 2021). This, along with the person‐centred and tailored nature of social prescribing, aligns with a more strengths‐focused approach, which may help us to alleviate the stigma associated with deficits‐focused models (Huntley et al., 2019).…”

“…Self‐determination and self‐efficacy were considered in some reviews but none of the identified service studies. Social prescribing has been found to facilitate many domains of self‐determination (Bhatti et al., 2021), so could be an appropriate route to promoting this outcome in autistic adults but this requires evidence.…”

Implementing High-Quality Primary Care Through a Health Equity Lens

“…Social prescribing acknowledges social determinants of health and is based on meaningful engagement of patient "health champions" (patients who promote healthy lifestyles by inspiring others to take a more active role in their health), primary care clinicians, and allied health professionals in a team-based model of care focusing on health equity. 64 Direct evidence on the importance of having an equityfocused approach to primary care quality improvement is also reflected in a recent comparative study of adult mortality rates in Ontario and England. 65 The study showed a significant improvement of 10% in the relative gap in mortality by income in England compared to Ontario, because England had prioritized an explicit primary care policy targeting health inequity reduction.…”

Impact of COVID‐19 on social prescribing across an Integrated Care System: A Researcher in Residence study

“…There is a financial commitment for every General Practice to have access to a social prescribing ‘link‐worker’ by 2023 (NHSE, 2019b ). Denmark, Sweden and Canada are among other countries currently implementing social prescribing (Bhatti et al., 2021 ; Vidovic et al., 2021 ).…”