Impact of social prescribing to address loneliness: A mixed methods evaluation of a national social prescribing programme
Impact of social prescribing to address loneliness: A mixed methods evaluation of a national social prescribing programme
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DOI：
10.1111/hsc.13200
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发表时间：
2020-10-20
影响因子：
2.4
通讯作者：
Haywood, Annette
中科院分区：
文献类型：
--
作者：
Foster, Alexis;Thompson, Jill;Haywood, Annette
孤独被认为是一个全球性的公共卫生问题，因为它对身心健康的不利影响，但很少有人知道哪些干预措施可以减少孤独。一个潜在的干预措施是社会处方，其中一个链接工作者帮助服务用户获得适当的支持，如社群活动和社会团体。一些定性研究已经确定，社会处方可能有助于减少服务用户的孤独感。有鉴于此，英国红十字会（第三部门组织）在英国开发并提供了一项全国性的社会处方服务，以支持那些正在经历或面临孤独风险的人。服务用户可以从链接工作人员那里获得长达12周的支持。本研究采用混合方法研究支持对孤独感的影响，并找出服务提供的促进因素和障碍。该研究包括：（a）分析2017年5月至2019年12月期间定期收集的定量数据（n = 10，643），包括加州大学洛杉矶分校数据（n = 2，250）的前后分析和匹配的比较工作，以测量孤独感的变化;（B）与服务用户，链接工作人员和志愿者（n = 60）的半结构化访谈和（c）社会投资回报分析。大多数服务使用者（72.6%，n = 1634/2250）在接受支持后感到不那么孤独。UCLA评分的平均变化为-1.84（95% CI -1.91至-1.77），最大变化为6.00（降低表示改善）。其他好处包括改善福祉，增加信心和生活有更多的目的。基础案例分析估计，每投入1磅服务，社会投资回报率为3.42磅。拥有熟练的链接工人和针对个人需求的支持似乎是关键。然而，面临的挑战包括利用志愿者，满足一些服务用户的需要，有关路标和持续改善孤独。尽管如此，这项服务似乎成功地支持了服务用户的孤独感。
Loneliness is considered a global public health issue because of its detrimental impact on physical and mental health but little is known about which interventions can reduce loneliness. One potential intervention is social prescribing, where a link worker helps service-users to access appropriate support such as community activities and social groups. Some qualitative studies have identified that social prescribing may help to reduce service-users' loneliness. Given this, the British Red Cross (a third sector organisation) developed and delivered a national social prescribing service in the United Kingdom to support people who were experiencing, or at risk of, loneliness. Service-users could receive up to 12 weeks of support from a link worker. A mixed methods study was conducted to understand the impact of the support on loneliness, and to identify the facilitators and barriers to service delivery. The study included: (a) analysis of quantitative data collected routinely between May 2017 and December 2019 (n = 10,643) including pre-post analysis of UCLA data (n = 2,250) and matched comparator work to measure changes in loneliness; (b) semi-structured interviews with service-users, link workers and volunteers (n = 60) and (c) a Social Return on Investment Analysis. The majority of the service-users (72.6%, n = 1634/2250) felt less lonely after receiving support. The mean change in UCLA score was -1.84 (95% CI -1.91 to -1.77) of a maximum change of 6.00 (decrease indicates an improvement). Additional benefits included improved wellbeing, increased confidence and life having more purpose. The base case analysis estimated a social return on investment of 3.42 pound per 1 pound invested in the service. Having skilled link workers and support tailored to individual needs appeared key. However, challenges included utilising volunteers, meeting some service-users' needs in relation to signposting and sustaining improvements in loneliness. Nonetheless, the service appeared successful in supporting service-users experiencing loneliness.