scholarly journals Can Social Prescribing Foster Individual and Community Well-Being? A Systematic Review of the Evidence

2021 ◽  
Vol 18 (10) ◽  
pp. 5276
Author(s):  
Dragana Vidovic ◽  
Gina Yannitell Reinhardt ◽  
Clare Hammerton
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Well Being ◽  
Social Prescribing ◽  
Health And Social Care ◽  
Core Concepts ◽  
Community Outcomes ◽  
The Individual ◽  
Randomised Controlled ◽  
The Impact

Social prescribing programmes (SP) are person-centred coaching schemes meant to help participants improve individual circumstances, thereby to reduce demand on health and social care. SP could be an innovative means to improve preventive and public health in the pursuit of universal financially sustainable healthcare. Given its potential, our systematic review assesses type, content, and quality of evidence available regarding SP effectiveness at the individual, system, and community levels. We examine the impact of SP on addressing loneliness, social isolation, well-being, and connectedness, as well as related concepts, which are not yet considered jointly in one study. Following PRISMA, we search: EBSCOHost (CINAHL Complete; eBook Collection; E-Journals; MEDLINE Full Text; Open Dissertations; PsycARTICLES; PsycINFO); Web of Science Core Collection; and UK National Institute for Health and Care Excellence. Excluding systematic reviews and articles without impact evaluations, we review 51 studies. Several studies do not distinguish between core concepts and/or provide information on the measures used to assess outcomes; exactly one peer-reviewed study presents a randomised controlled trial. If we wish to know the potential of social prescribing to lead to universal financially sustainable healthcare, we urge researchers and practitioners to standardise definitions and metrics, and to explore conceptual linkages between social prescribing and system/community outcomes.

scholarly journals Protocol for a mixed methods process evaluation of the LinkMM randomised controlled trial “Use of link workers to provide social prescribing and health and social care coordination for people with complex multimorbidity in socially deprived areas”

2021 ◽  
Vol 4 ◽  
pp. 38
Author(s):  
Bridget Kiely ◽  
Patrick O'Donnell ◽  
Vivienne Byers ◽  
Emer Galvin ◽  
Fiona Boland ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomised Controlled Trial ◽  
Process Evaluation ◽  
Care Coordination ◽  
Social Care ◽  
Controlled Trial ◽  
Well Being ◽  
Social Prescribing ◽  
Health And Social Care ◽  
Randomised Controlled

Background Multimorbidity, defined as two or more chronic conditions is increasing in prevalence and is associated with increased health care use, fragmented care and poorer health outcomes. Link workers are non-health or social care professionals who support people to connect with resources in their community to improve their well-being, a process commonly referred to as social prescribing.  The use of link workers in primary care may be an effective intervention in helping those with long‐term conditions manage their illness and improve health and well‐being, but the evidence base in limited. The LinkMM study is a randomised controlled trial of the effectiveness of link workers based in primary care, providing social prescribing and health and social care coordination for people with multimorbidity. The aim of the LinkMM process evaluation is to investigate the implementation of the link worker intervention, mechanisms of impact and influence of the specific context on these, as per the Medical Research Council framework, using quantitative and qualitative methods. Methods Quantitative data will be gathered from a number of sources including researcher logbooks, participant baseline questionnaires, client management database, and will be analysed using descriptive statistics. Semi structured interviews with participants will investigate their experiences of the intervention. Interviews with link workers, practices and community stakeholders will explore how the intervention was implemented and barriers and facilitators to this. Thematic analysis of interview transcripts will be conducted. Discussion The process evaluation of the LinkMM trial will provide important information allowing a more in-depth understanding of how the intervention worked and lessons for future wider scale implementation.

scholarly journals A randomised controlled trial exploring the impact of a dedicated Health and Social Care Professionals team in the Emergency Department on the quality, safety, clinical and cost-effectiveness of care for older adults: Study Protocol

2019 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Íde O’Shaughnessy ◽  
Eimear Smalle ◽  
Stephen White ◽  
...  
Keyword(s):  
Older Adults ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Health And Social Care ◽  
Effectiveness Of Care ◽  
Randomised Controlled ◽  
The Impact

Abstract Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-index visit, often have increased ED length of stay and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, clinical and cost-effectiveness of care of older adults when compared to usual care. Methods : The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30-days, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to usual care; and perceptions on implementation by ED staff members. Discussion : This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation. Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515

scholarly journals A systematic review evaluating the impact of paid home carer training, supervision, and other interventions on the health and well-being of older home care clients

2017 ◽  
Vol 29 (4) ◽  
pp. 595-604 ◽  
Author(s):  
Claudia Cooper ◽  
Blerta Cenko ◽  
Briony Dow ◽  
Penny Rapaport
Keyword(s):  
Systematic Review ◽  
Home Care ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Life Quality ◽  
Well Being ◽  
Qualitative Synthesis ◽  
Model Learning ◽  
The Impact ◽  
Health And Well Being

ABSTRACTBackground:Interventions to support and skill paid home carers and managers could potentially improve health and well-being of older home care clients. This is the first systematic review of interventions to improve how home carers and home care agencies deliver care to older people, with regard to clients’ health and well-being and paid carers’ well-being, job satisfaction, and retention.Methods:We reviewed 10/731 papers found in the electronic search (to January 2016) fitting predetermined criteria, assessed quality using a checklist, and synthesized data using quantitative and qualitative techniques.Results:Ten papers described eight interventions. The six quantitative evaluations used diverse outcomes that precluded meta-analysis. In the only quantitative study (a cluster Randomized Controlled Trial), rated higher quality, setting meaningful goals, carer training, and supervision improved client health-related quality of life. The interventions that improved client outcomes comprised training with additional implementation, such as regular supervision and promoted care focused around clients’ needs and goals. In our qualitative synthesis of four studies, intervention elements carers valued were greater flexibility to work to a needs-based rather than a task-based model, learning more about clients, and improved communication with management and other workers.Conclusions:There is a dearth of evidence regarding effective strategies to improve how home care is delivered to older clients, particularly those with dementia. More research in this sector including feasibility testing of the first home care intervention trials to include health and life quality outcomes for clients with more severe dementia is now needed.

Effectiveness of an innovative and comprehensive eye care model for individuals in residential care facilities: results of the residential ocular care (ROC) multicentred randomised controlled trial

2020 ◽  
pp. bjophthalmol-2019-315620
Author(s):  
Ryan Eyn Kidd Man ◽  
Alfred Tau Liang Gan ◽  
Marios Constantinou ◽  
Eva K Fenwick ◽  
Edith Holloway ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Residential Care ◽  
Controlled Trial ◽  
Well Being ◽  
Vision Impairment ◽  
Residential Care Facilities ◽  
Care Facilities ◽  
Randomised Controlled ◽  
The Impact

BackgroundTo assess the clinical and patient-centred effectiveness of a novel residential ocular care (ROC) model in Australian individuals residing in residential care.MethodsIn this prospective, multicentred, randomised controlled trial conducted in 38 Australian aged-care facilities (2015–2017), 178 visually impaired individuals living in residential care facilities (mean age ±SD: 83.9±8.6 years; 65.7% women) were cluster randomised to ROC (n=95) or usual care (n=83) pathways. The ROC arm comprised a tailored and comprehensive within-site eye examination and care rehabilitation pathway, while usual care participants were given a referral to an external eyecare provider. Outcomes included presenting distance and near visual acuity (PNVA); Rasch-transformed Reading, Emotional and Mobility scores from the Impact of Vision Impairment questionnaire; quality of vision (QoV comprising Rasch-transformed Frequency, Severity and Bother domains) scores; Euroqol-5-Dimensions (raw scores); Cornell Scale for Depression (raw scores) and 6-month falls frequency, assessed at baseline and 6 months post intervention. Within-group and between-group comparisons were conducted using linear mixed models, adjusted for baseline differences in characteristics between the two arms.ResultsAt 6 months, intention-to-treat analyses showed significant between-group improvements in ROC residents compared with usual care for PNVA, Emotional and QoV scores (all p<0.05) These significant findings were retained in per-protocol analyses. No other between-group changes were observed.ConclusionOur ROC model was effective in improving near vision, emotional well-being and perceived burden of vision-related symptoms in residential care dwellers in Australia with vision impairment. Future studies to evaluate the cost effectiveness and implementation of ROC in Australia are warranted.

scholarly journals Effectiveness of link workers providing social prescribing on health outcomes and costs for adult patients in primary care and community settings. A protocol for a systematic review of the literature.

2020 ◽  
Vol 2 ◽  
pp. 21
Author(s):  
Bridget Kiely ◽  
Aisling Croke ◽  
Eamon O'Shea ◽  
Deirdre Connolly ◽  
Susan M. Smith
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Outcomes ◽  
Care Coordination ◽  
Randomised Controlled Trials ◽  
Social Care ◽  
Controlled Trials ◽  
Social Prescribing ◽  
Health And Social Care ◽  
Randomised Controlled

Introduction: The use of link workers for social prescribing and health and social care coordination is increasing, but there is insufficient data to demonstrate their effectiveness or for whom they work best. Multimorbidity is increasing in prevalence and affects those living in deprived areas ten years earlier than affluent areas. This systematic review aims to examine the evidence for the effectiveness and costs of link workers in improving health outcomes. We will also look for evidence for the use of link workers specifically for people living with multimorbidity and in deprived areas. Methods: Databases of published and grey literature will be searched for randomised and non-randomised controlled trials examining use of link workers based in primary care for community dwelling adults compared to usual care. Primary outcomes will be health related quality of life and mental health. Data on costs will be extracted. Studies will be selected for inclusion by title and abstract review by two reviewers. A Preferred Reporting Items for Systematic Reviews (PRISMA) flow diagram will document the selection process. A standardised form will be used to extract data. Data quality will be assessed using the Cochrane Risk of Bias tool for randomised controlled trials, a narrative synthesis will be completed and the GRADE assessment tool used to comment on evidence quality. A meta-analysis of effect size of primary outcomes and subgroup analysis for multimorbidity and social deprivation will be performed if there are sufficient comparable data. Conclusion: This systematic review will give an important overview of the evidence for the use of link workers providing social prescribing and health and social care coordination in primary care. This will help inform intervention development and guide policy makers on whether these interventions are cost effective and which groups stand to benefit most. Prospero registration: CRD42019134737 (04/07/2019)

scholarly journals Feasibility and acceptability of suicide prevention therapy on acute psychiatric wards: randomised controlled trial

BJPsych Open ◽  
2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Gillian Haddock ◽  
Daniel Pratt ◽  
Patricia A. Gooding ◽  
Sarah Peters ◽  
Richard Emsley ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Suicide Prevention ◽  
Suicidal Behaviour ◽  
Controlled Trial ◽  
Prevention Therapy ◽  
Health And Social Care ◽  
Acute Psychiatric Wards ◽  
Randomised Controlled ◽  
The Impact

BackgroundSuicidal behaviour is common in acute psychiatric wards resulting in distress, and burden for patients, carers and society. Although psychological therapies for suicidal behaviour are effective in out-patient settings, there is little research on their effectiveness for in-patients who are suicidal.AimsOur primary objective was to determine whether cognitive–behavioural suicide prevention therapy (CBSP) was feasible and acceptable, compared with treatment as usual (TAU) for in-patients who are suicidal. Secondary aims were to assess the impact of CBSP on suicidal thinking, behaviours, functioning, quality of life, service use, cost-effectiveness and psychological factors associated with suicide.MethodA single-blind pilot randomised controlled trial comparing TAU to TAU plus CBSP in in-patients in acute psychiatric wards who are suicidal (the Inpatient Suicide Intervention and Therapy Evaluation (INSITE) trial, trial registration: ISRCTN17890126). The intervention consisted of TAU plus up to 20 CBSP sessions, over 6 months continuing in the community following discharge. Participants were assessed at baseline and at 6 weeks and 6 months post-baseline.ResultsA total of 51 individuals were randomised (27 to TAU, 24 to TAU plus CBSP) of whom 37 were followed up at 6 months (19 in TAU, 18 in TAU plus CBSP). Engagement, attendance, safety and user feedback indicated that the addition of CBSP to TAU for in-patients who are acutely suicidal was feasible and acceptable while on in-patient wards and following discharge. Economic analysis suggests the intervention could be cost-effective.DiscussionPsychological therapy can be delivered safely to patients who are suicidal although modifications are required for this setting. Findings indicate a larger, definitive trial should be conducted.Declaration of interestThe trial was hosted by Greater Manchester Mental health NHS Trust (formerly, Manchester Mental Health and Social Care NHS Trust). The authors are affiliated to the University of Manchester, Greater Manchester Mental Health Foundation Trust, Lancashire Care NHS Foundation trust and the Manchester Academic Health Sciences Centre. Y.A. is a trustee for a North-West England branch of the charity Mind.

Brief digital interventions to support the psychological well-being of NHS staff during the COVID-19 pandemic: a three-arm pilot randomised controlled trial (Preprint)

2021 ◽  
Author(s):  
Johannes De Kock ◽  
Helen Ann Latham ◽  
Richard G. Cowden ◽  
Breda Cullen ◽  
Katia Narzisi ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Well Being ◽  
Rate Of Change ◽  
Mental Toughness ◽  
Psychological Interventions ◽  
Post Intervention ◽  
Pilot Randomised Controlled Trial ◽  
Health And Social Care ◽  
Randomised Controlled ◽  
Mental Well Being

BACKGROUND Health and social care staff are at high risk of experiencing adverse mental health outcomes during the COVID-19 pandemic. Hence, there is a need to prioritize and identify ways to effectively support their psychological wellbeing. Compared to traditional psychological interventions, digital psychological interventions are cost effective treatment options that allow for large-scale dissemination and transcend social distancing, overcome rurality, and minimize clinician time. OBJECTIVE This study reports outcomes of a CONSORT-compliant parallel-arm pilot randomised controlled trial (RCT) examining the potential usefulness of an existing and a novel digital psychological intervention aimed at supporting psychological health among NHS staff working through the COVID-19 pandemic. METHODS NHS Highland (NHSH) frontline staff volunteers (N = 169) were randomly assigned to the newly developed NHSH Staff Wellbeing Project (NHSWBP), an established digital intervention (My Possible Self; MPS), or to a waitlist (WL) condition for four weeks. Attempts were made to blind participants to which digital intervention they were allocated. The interventions were fully automated, without any human input or guidance. We measured five self-reported psychological outcomes over three time points: before (baseline), middle (after 2 weeks) and after treatment (4 weeks). The primary outcomes were anxiety (GAD-7), depression (PHQ-9) and mental well-being (Warwick-Edinburgh Mental Well-being Scale). The secondary outcomes included mental toughness (Mental Toughness Index) and gratitude (the Gratitude Questionnaire). RESULTS Retention rates at middle and post-intervention were 77% (n = 130) and 63.3% (n = 107), respectively. At post-intervention, small differences were noted between the WL condition and the two treatment conditions on anxiety (vs. MPS: d = .07, 95% CI: -.20, .33; vs. NHSWBP: d = .06, 95% CI: -.19, .31), depression (vs. MPS: d = .37, 95% CI: .07, .66; vs. NHSWBP: d = .18, 95% CI: -.11, .46), and mental well-being (vs. MPS: d = -.04, 95% CI: -.62, -.08; vs. NHSWBP: d = -.15, 95% CI: -.41, .10). A similar pattern of between-group differences was found for the secondary outcomes. The NHSWBP group generally had larger within group effects than the other groups and displayed a greater rate of change compared to the other conditions on all outcomes, except for gratitude, where the rate of change was greatest for the MPS group. CONCLUSIONS Conclusions: Our analyses provided encouraging results for the use of brief digital psychological interventions in improving psychological well-being among health and social care workers. Future multi-site RCTs, with power to reliably detect differences, are needed to determine the efficacy of contextualised interventions relative to existing digital treatments. CLINICALTRIAL Trial registration: ISRCTN18107122

scholarly journals Internet-assisted cognitive behavioural therapy with telephone coaching for anxious Finnish children aged 10–13 years: study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045474
Author(s):  
Terhi Luntamo ◽  
Tarja Korpilahti-Leino ◽  
Terja Ristkari ◽  
Sanna Hinkka-Yli-Salomäki ◽  
Marjo Kurki ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Well Being ◽  
Childhood Anxiety ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Telephone Coaching ◽  
The Impact

IntroductionChildhood anxiety is common, causes significant functional impairment and may lead to psychosocial problems by adulthood. Although cognitive behavioural therapy (CBT) is effective for treating anxiety, its availability is limited by the lack of trained CBT therapists and easily accessible local services. To address the challenges in both recognition and treatment, this study combines systematic anxiety screening in the general population with a randomised controlled trial (RCT) on internet-assisted CBT (ICBT) with telephone coaching. Child, family and intervention-related factors are studied as possible predictors or moderators, together with the COVID-19 pandemic.Methods and analysisThe study is an open two-parallel group RCT, stratified by sex, that compares ICBT with telephone coaching to an education control. Children aged 10–13 are screened at yearly school healthcare check-ups using five items from the Screen for Child Anxiety Related Disorders (SCARED) Questionnaire. The families of children who screen positive for anxiety are contacted to assess the family’s eligibility for the RCT. The inclusion criteria include scoring at least 22 points in the 41-item SCARED Questionnaire. The primary outcome is the SCARED child and parent reports. The secondary outcomes include the impact of anxiety, quality of life, comorbidity, peer relationships, perceptions of school, parental well-being and service use. Additional measures include demographics and life events, anxiety disorder diagnoses, as well as therapeutic partnerships, the use of the programme and general satisfaction among the intervention group.Ethics and disseminationThe study has been approved by the research ethics board of the Hospital District of South West Finland and local authorities. Participation is voluntary and based on informed consent. The anonymity of the participants will be protected and the results will be published in a scientific journal and disseminated to healthcare professionals and the general public.Trial registration numberClinicalTrials.gov NCT03310489, pre-results, initially released on 30 September 2017.

scholarly journals Does a social prescribing ‘holistic’ link-worker for older people with complex, multimorbidity improve well-being and frailty and reduce health and social care use and costs? A 12-month before-and-after evaluation

2019 ◽  
Vol 20 ◽  
Author(s):  
Julian Elston ◽  
Felix Gradinger ◽  
Sheena Asthana ◽  
Caroline Lilley-Woolnough ◽  
Sue Wroe ◽  
...  
Keyword(s):  
Older People ◽  
Service Use ◽  
Social Care ◽  
Patient Activation ◽  
Well Being ◽  
Long Term Conditions ◽  
Social Prescribing ◽  
Health And Social Care ◽  
Before And After ◽  
The Impact

Abstract Aim: To evaluate the impact of ‘holistic’ link-workers on service users’ well-being, activation and frailty, and their use of health and social care services and the associated costs. Background: UK policy is encouraging social prescribing (SP) as a means to improve well-being, self-care and reduce demand on the NHS and social services. However, the evidence to support this policy is generally weak and poorly conceptualised, particularly in relation to frail, older people and patient activation. Torbay and South Devon NHS Foundation Trust, an integrated care organisation, commissioned a Well-being Co-ordinator service to support older adults (≥50 years) with complex health needs (≥2 long-term conditions), as part of its service redesign. Methods: A before-and-after study measuring health and social well-being, activation and frailty at 12 weeks and primary, community and secondary care service use and cost at 12 months prior and after intervention. Findings: Most of the 86 participants achieved their goals (85%). On average health and well-being, patient activation and frailty showed a statistically significant improvement in mean score. Mean activity increased for all services (some changes were statistically significant). Forty-four per cent of participants saw a decrease in service use or no change. Thirteen high-cost users (>£5000 change in costs) accounted for 59% of the overall cost increase. This was largely due to significant, rapid escalation in morbidity and frailty. Co-ordinators played a valuable key-worker role, improving the continuity of care, reducing isolation and supporting carers. No entry-level participant characteristic was associated with change in well-being or service use. Larger, better conceptualised, controlled studies are needed to strengthen claims of causality and develop national policy in this area.

scholarly journals The Impact of Breast Density Information or Notification on Women's Cognitive, Psychological, and Behavioral Outcomes: A Systematic Review

2021 ◽  
Author(s):  
Brooke Nickel ◽  
Tessa Copp ◽  
Meagan Brennan ◽  
Rachel Farber ◽  
Kirsten McCaffery ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Breast Density ◽  
Controlled Trial ◽  
Behavioral Outcomes ◽  
The United States ◽  
Disadvantaged Communities ◽  
Study Team ◽  
Randomised Controlled ◽  
The Impact

Abstract Background Breast density (BD) is an independent risk factor for breast cancer and reduces the sensitivity of mammography. This systematic review aims to synthesize evidence from existing studies to understand the impact of BD information and/or notification on women's cognitive, psychological and behavioral outcomes. Methods Studies were identified via relevant database searches up to March 2020. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias. Results Of the 1134 titles identified, 29 studies were included. Twenty-three studies were quantitative, including only 1 randomised controlled trial of women receiving BD information, and 6 were qualitative. Twenty-seven studies were conducted in the United States, with 19 conducted post-BD legislation. The overall results in terms of BD awareness, knowledge, attitudes, perceptions and intentions were heterogeneous across included studies, with the strongest consistency demonstrated regarding the importance of communication with and involvement of healthcare professionals. Together the studies did however highlight that there is still limited awareness of BD in the community, especially in more socio-economic disadvantaged communities, and limited knowledge about what BD means and the implications for women. Importantly, BD information in the context of overall breast cancer risk has not yet been studied. Conclusions There are important gaps in the understanding of the impact of BD information or notification on women and how best to communicate BD information to women. More high-quality evidence to inform both current and future practice related to BD is still needed.

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