Introduction: Although social prescribing is a growing global health and social movement, no Delphi studies have determined which outcomes are critical to assess. Our aim was to identify a core outcome set based on feedback from diverse user groups of people who could be affected by (e.g. adults = 60 years) or who can affect (e.g. providers, researchers) social prescribing.
Methods: Following standard guidelines for Delphi studies, we developed a two-round online survey with a focus on Canadian perspectives. We asked participants to rate 21 outcomes as “critical” (7–9 on a 9-point scale), “important but not critical” (4–6 points) or “not important” (1–3 points). We provide a subgroup description of findings from older adult/family and friend perspectives.
Results: Round 1 was completed by 74 people from 10 user groups and Round 2 by 52 people from eight user groups (70% retention). Ratings between rounds were generally consistent. Seven outcomes met the “critical” threshold. No outcomes were excluded. Critical outcomes focused on mental health, physical and social functioning, and well-being. Participants commented on environmental (e.g. resources, care delivery) and equity factors.
Conclusion: This study identified seven critical outcomes to consider in evaluations of social prescribing research and interventions. Future investigations should investigate how contextual and personal factors might influence outcomes and identify specific instruments (e.g. questionnaires, performance-based tests) to assess each outcome. Identification of outcomes is a continuous process, requiring regular updates as results may change due the ongoing evolution of social prescribing and other factors.
Social prescribing is a health and social model of care, currently in place in the United Kingdom’s public health care system and in other global locations. Evidence to date for social prescribing is emerging, but previous syntheses highlight limitations with study designs. In addition, based on our review of the literature, there is variation in the types of outcomes used in social prescribing. Further, other outcomes should be considered when conducting trials in social prescribing beyond person-level outcomes, for example resource utilization and implementation factors.
Currently, there are two projects with similar features to our work: https://www.comet-initiative.org/Studies/Details/2010; and https://www.comet-initiative.org/Studies/Details/1572. These projects conducted (1) an umbrella review of reviews on integrated health and social care for people living with chronic conditions; and (2) development of core outcomes for people receiving social care.
However, in our project, Social Prescribing Outcomes for Trials (SPOT), the goal is to use a multi-stage process to identify core outcomes for social prescribing at the person, provider, program, and societal-level for future effectiveness-implementation trials.
Maureen C. Ashe, Anna M. Chudyk, Margaret Lin, Thomas Iverson, Gurkirat Singh Nijjar, W. Ben Mortenson, Theresa Pauly, Robert Petrella, Kathy L. Rush, Bobbi Symes, Sian Tsuei, Kate Mulligan,
Disease Category: Effective practice/health systems
Disease Name: N/A
Age Range: 19
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Researchers
- Service providers
- COS for clinical trials or clinical research
- Consensus meeting
- Delphi process
- Semi structured discussion
This is a multi-step project. Prior to starting this project, we completed a systematic review on social prescribing and older adults. Our next steps include: (1) identifying, grouping, and describing psychometric properties for outcomes used in previous social prescribing studies; (2) inviting the SPOT Team to provide feedback on the results from step 1; (3) conducting a modified Delphi study to generate the list of important outcomes within a group of patient partners, health and social providers, public and volunteer organizations and researchers; (4) finalizing the list of outcomes based on online group discussion with the SPOT Team; and (5) implementing our knowledge mobilization plan (e.g., webinar and publication).