Social Prescribing in populations at high risk of type 2 diabetes
Research type
Research Study
Full title
Evaluating the possible impact of social prescribing on populations at high risk of type 2 diabetes. A realist multi-level, mixed-methods study.
IRAS ID
279519
Contact name
Sara Calderón-Larrañaga
Contact email
Sponsor organisation
Joint Research Management Office, Queen Mary University of London
Duration of Study in the UK
3 years, 11 months, 24 days
Research summary
Research summary
Type 2 diabetes is heavily influenced by social risk factors, such as unemployment or lack of social support, but little is known about how these may be tackled by NHS prevention programmes. Social prescribing is a new initiative in the NHS and provides a mechanism where healthcare professionals in GP surgeries can offer ‘prescriptions’ not only for medical issues, but also for social issues. These prescriptions might include referrals to local community services offering employment, housing or financial advice, as well as a range of ‘healthy lifestyle’ activities, such as cooking classes, weight management or exercise programmes.Despite widespread national support, evidence for the effectiveness of social prescribing is both insufficient and contested. In this study, we will investigate whether social prescribing can contribute to type 2 diabetes prevention and, if so, when, how and in what circumstances it might best be introduced.
We will use structured literature review to highlight what is known already about the subject; work with patients and health/social care professionals delivering social prescribing to investigate if and how it might work; and finally, develop a framework to guide further research on the effects of social prescribing on type 2 diabetes prevention efforts on a larger scale. The results of this study will also help improve care delivered by existing prevention and social prescribing programmes. The work will be undertaken in east London, an ethnically-diverse and socioeconomically-deprived population, living at high risk of type 2 diabetes.
Summary of results
Social Prescribing (SP) typically involves linking patients in primary care with services provided by the voluntary and community sector. Preliminary evidence suggests that SP may offer a means of delivering community-based health promotion activities, potentially contributing to the prevention of long-term conditions, such as type 2 diabetes (T2D). This thesis aimed to investigate the role of SP in T2D prevention and inform the design, implementation and evaluation of SP initiatives relevant to communities at high risk.The study was informed by complexity science and combined literature reviews with empirical research in a multi-ethnic, socioeconomically deprived community at high risk of T2D. The methods included the analysis electronic health records data, interviews with key stakeholders and observation of primary care and community-based SP activities.
The study revealed that SP offered an opportunity to adopt a health promotion approach to T2D prevention in communities at high risk, by emphasising a positive and holistic view of health, focusing on the whole population (while paying special attention to those in greatest need) and encouraging community action and involvement. SP contributed to more acceptable, culturally appropriate, and hence potentially effective ways to addressing the risks to health and T2D that communities face.
However, delivering these services proved highly intricate, requiring the careful weighing of situational judgement against larger organisational and institutional constraints. For example, practitioners engaged with ‘good practice’ in SP while it had meaning and purpose for them. This was facilitated by formal training, practical skills (acquired through relevant personal and professional background(s)) and ongoing opportunities for reflection and coordination among professionals. On an organisational level, it was important to collectively understand the role of SP in T2D prevention by creating a shared vision of what constitutes ‘good practice’. Frontline staff also required flexibility and authority to make adjustments, while organisations remained receptive to new ideas and ways of delivering SP. The study also confirmed the central role of stable and sufficient community and primary care commissioning arrangements, including spare capabilities to support innovation.
REC name
London - Bromley Research Ethics Committee
REC reference
20/LO/0713
Date of REC Opinion
29 Jul 2020
REC opinion
Further Information Favourable Opinion