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      Social prescribing for older people and the role of the cultural sector during the COVID‐19 pandemic: What are link workers' views and experiences?

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          Abstract

          Older people's well‐being can be bolstered by engaging with cultural activities and venues. They may be encouraged to try cultural offers by a link worker as part of social prescribing. However, the cultural sector, like all parts of life, was affected by the COVID‐19 pandemic; this has had implications for cultural offers available to link workers. A study was conducted to explore the views and experiences of link workers in using the cultural sector within social prescribing, particularly for older people (aged 60+) during the pandemic. An online questionnaire was distributed to and completed by link workers in the UK. Data were analysed mainly using descriptive statistics. Open text responses were clustered into similar ideas to create key concepts. Useable responses were received from 148 link workers. They highlighted a general lack of interaction between link workers and the cultural sector about how the latter could support social prescribing. Results suggested that personal familiarity with cultural offers might prompt link workers to refer to them. Some respondents proposed that cultural offers were regarded as elitist, which deterred them from referring there. However, there was a general acknowledgement that the cultural sector could contribute to social prescribing. Link workers need to regard the cultural sector as accessible, appropriate, adequate, affordable and available before referring older people to cultural offers as part of social prescribing. Link workers may benefit from becoming more familiar with cultural sector staff and offers, including online resources, so they can then propose them to patients with confidence.

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          Supporting social prescribing in primary care by linking people to local assets: a realist review

          Background Social prescribing is a way of addressing the ‘non-medical’ needs (e.g. loneliness, debt, housing problems) that can affect people’s health and well-being. Connector schemes (e.g. delivered by care navigators or link workers) have become a key component to social prescribing’s delivery. Those in this role support patients by either (a) signposting them to relevant local assets (e.g. groups, organisations, charities, activities, events) or (b) taking time to assist them in identifying and prioritising their ‘non-medical’ needs and connecting them to relevant local assets. To understand how such connector schemes work, for whom, why and in what circumstances, we conducted a realist review. Method A search of electronic databases was supplemented with Google alerts and reference checking to locate grey literature. In addition, we sent a Freedom of Information request to all Clinical Commissioning Groups in England to identify any further evaluations of social prescribing connector schemes. Included studies were from the UK and focused on connector schemes for adult patients (18+ years) related to primary care. Results Our searches resulted in 118 included documents, from which data were extracted to produce context-mechanism-outcome configurations (CMOCs). These CMOCs underpinned our emerging programme theory that centred on the essential role of ‘buy-in’ and connections. This was refined further by turning to existing theories on (a) social capital and (b) patient activation. Conclusion Our realist review highlights how connector roles, especially link workers, represent a vehicle for accruing social capital (e.g. trust, sense of belonging, practical support). We propose that this then gives patients the confidence, motivation, connections, knowledge and skills to manage their own well-being, thereby reducing their reliance on GPs. We also emphasise within the programme theory situations that could result in unintended consequences (e.g. increased demand on GPs).
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            A realist evaluation of social prescribing: an exploration into the context and mechanisms underpinning a pathway linking primary care with the voluntary sector

            This article adopts a realist approach to evaluate a social prescribing pilot in the areas of Hackney and City in London (United Kingdom). It unpacks the contextual factors and mechanisms that influenced the development of this pilot for the benefits of GPs, commissioners and practitioners, and reflects on the realist approach to evaluation as a tool for the evaluation of health interventions. Primary care faces considerable challenges including the increase in long-term conditions, GP consultation rates, and widening health inequalities. With its emphasis on linking primary care to non-clinical community services via a social prescribing coordinator (SPC), some models of social prescribing could contribute to reduce the burden on primary care, tackle health inequalities and encourage people to make greater use of non-clinical forms of support. This realist analysis was based on qualitative interviews with users, commissioners, a GP survey, focus groups and learning events to explore stakeholders’ experience. To enable a detailed analysis, we adapted the realist approach by subdividing the social prescribing pathway into stages, each with contextual factors, mechanisms and outcomes. SPCs were pivotal to the effective functioning of the social prescribing service and responsible for the activation and initial beneficial impact on users. Although social prescribing shows significant potential for the benefit of patients and primary care, several challenges need to be considered and overcome, including ‘buy in’ from some GPs, branding, and funding for the third sector in a context where social care cuts are severely affecting the delivery of health care. With its emphasis on context and mechanisms, the realist evaluation approach is useful in understanding how to identify and improve health interventions, and analyse in greater detail the contribution of different stakeholders. As the SPC is central to social prescribing, more needs to be done to understand their role conceptually and practically.
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              Effects of a museum-based social prescription intervention on quantitative measures of psychological wellbeing in older adults

              To assess psychological wellbeing in a novel social prescription intervention for older adults called Museums on Prescription and to explore the extent of change over time in six self-rated emotions ('absorbed', 'active', 'cheerful', 'encouraged', 'enlightened' and 'inspired').
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                Author and article information

                Contributors
                stephanie.tierney@phc.ox.ac.uk
                kamal.mahtani@phc.ox.ac.uk
                Journal
                Health Soc Care Community
                Health Soc Care Community
                10.1111/(ISSN)1365-2524
                HSC
                Health & Social Care in the Community
                John Wiley and Sons Inc. (Hoboken )
                0966-0410
                1365-2524
                23 July 2022
                23 July 2022
                : 10.1111/hsc.13949
                Affiliations
                [ 1 ] Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK
                [ 2 ] Nuffield Department of Population Health University of Oxford Oxford UK
                [ 3 ] Oxford Internet Institute University of Oxford Oxford UK
                [ 4 ] Peninsula Medical School University of Plymouth Plymouth UK
                [ 5 ] Division of Biosciences University College London London UK
                [ 6 ] Gardens, Libraries and Museums University of Oxford Oxford UK
                Author notes
                [*] [* ] Correspondence

                Stephanie Tierney and Kamal R. Mahtani, Centre for Evidence Based Medicine, University of Oxford, Oxford, UK.

                Email: stephanie.tierney@ 123456phc.ox.ac.uk and kamal.mahtani@ 123456phc.ox.ac.uk

                Author information
                https://orcid.org/0000-0002-2155-2440
                https://orcid.org/0000-0001-5674-8673
                Article
                HSC13949 HSCC-OA-21-1272.R2
                10.1111/hsc.13949
                9349870
                35869795
                021ace08-e04c-4059-bcf8-df6df7444f8b
                © 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 June 2022
                : 03 November 2021
                : 16 July 2022
                Page count
                Figures: 4, Tables: 3, Pages: 9, Words: 5891
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:04.08.2022

                Health & Social care
                covid‐19,cultural sector,link workers,older people,questionnaire,social prescribing

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