社会处方的哪些方法有效、适用于谁以及在何种情况下有效？一项现实主义综述方案。
What approaches to social prescribing work, for whom, and in what circumstances? A protocol for a realist review.
作者信息
Husk Kerryn, Blockley Kelly, Lovell Rebecca, Bethel Alison, Bloomfield Dan, Warber Sara, Pearson Mark, Lang Iain, Byng Richard, Garside Ruth
机构信息
NIHR CLAHRC South West Peninsula (PenCLAHRC), Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, England.
European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, England.
出版信息
Syst Rev. 2016 Jun 3;5:93. doi: 10.1186/s13643-016-0269-6.
BACKGROUND
The use of non-drug, non-health-service interventions has been proposed as a cost-effective alternative to help those with long-term conditions manage their illness and improve their health and well-being. Interventions typically involve accessing activities run by the third sector or community agencies and may also be described as non-medical referral, community referral or social prescribing. To be effective, patients need to be "transferred" from the primary care setting into the community and to maintain their participation in activities. However, it is not currently known how and why these approaches enable which people under what circumstances to reach community services that may benefit their health and well-being.
METHODS
Database searches and extensive searching of grey sources will be carried out in an attempt to find evidence associated with referral and retention in social prescribing. After initial scoping searches, two main phases of searching will be conducted: (a) will focus on the identification of programme theories to illustrate how approaches to social prescribing work for different people and in different contexts and (b) will consist of targeted searches to locate evidence to refine these candidate theories into configurations of the contexts in which populations and the main mechanisms outcomes are achieved. Inclusion criteria will initially be broad in order to develop a clear picture of the ways in which social prescriptions might operate but may iteratively become more focused in response to initially identified evidence, for example, in terms of the population group. An expert advisory group consisting of professionals working in a range of organisations involved in social prescribing will be convened to check the approaches in the review and provide real-life experience of social prescribing. Findings from the review will be disseminated to commissioners, published in a peer-reviewed journal and used to help refine an intervention model for an outdoor nature-based group intervention.
DISCUSSION
This realist review will explore why mechanisms of social prescribing work, for what groups of people and their impact on enrolment, attendance and adherence to programmes. The use of realist approaches to detail the social prescribing process is novel and will offer insights into effective transfer of patients.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016039491.
背景
已有人提出采用非药物、非医疗服务干预措施，作为一种具有成本效益的替代方案，以帮助患有长期疾病的人管理自身疾病，改善健康状况和幸福感。这些干预措施通常涉及参与由第三部门或社区机构开展的活动，也可能被描述为非医疗转诊、社区转诊或社会处方。为了确保有效性，患者需要从初级保健机构“转诊”到社区，并持续参与相关活动。然而，目前尚不清楚这些方法如何以及为何能让哪些人在何种情况下获得可能有益于其健康和幸福感的社区服务。
方法
将进行数据库检索并广泛搜索灰色文献来源，试图找到与社会处方中的转诊和留存相关的证据。在初步的范围检索之后，将进行两个主要的检索阶段：（a）将专注于识别项目理论，以说明社会处方方法如何在不同人群和不同背景下起作用；（b）将包括针对性检索，以找到证据，将这些候选理论细化为实现人群目标以及主要机制结果的背景配置。纳入标准最初将较为宽泛，以便清晰了解社会处方可能的运作方式，但可能会根据最初识别出的证据反复调整，使其更具针对性，例如在人群组方面。将召集一个由在一系列参与社会处方的组织中工作的专业人员组成的专家咨询小组，以检查综述中的方法，并提供社会处方的实际经验。综述结果将传播给决策者，发表在同行评审期刊上，并用于帮助完善基于户外自然环境的团体干预的干预模型。
讨论
这项现实主义综述将探讨社会处方机制为何起作用、对哪些人群起作用以及其对项目注册、参与率和依从性的影响。采用现实主义方法详细描述社会处方过程具有创新性，将为患者的有效转诊提供见解。
系统综述注册
PROSPERO CRD42016039491
Zotero 插件