NIHR Applied Research Collaboration (ARC) South West Peninsula, University of Plymouth, Plymouth, UK.
Public Health, Cornwall Council and European Centre for Environment and Human Health, University of Exeter Medical School, Royal Cornwall Hospital, Truro, UK.
Health Soc Care Community. 2022 May;30(3):e621-e635. doi: 10.1111/hsc.13635. Epub 2021 Nov 5.
Adults on the autism spectrum are affected by health disparities which significantly reduce life expectancy and experience barriers to accessing healthcare. Social prescribing is a holistic approach that diverts patients from primary care to health-enhancing activities in communities. However, there has been a lack of research attention to how autistic people navigate the social prescribing pathway and the ability of these approaches to address existing disparities. This mapping review aimed to synthesise features of non-medical, community-based interventions for autistic adults to assess their suitability for a social prescribing approach. A systematic search and screening process was used to identify literature reviews from medical databases (Embase, Medline, PsycINFO, CINAHL and Cochrane reviews) and grey literature. We extracted data from 24 reviews and 19 studies including types of services, participants, outcomes, settings and procedures. A narrative and visual synthesis is used to map the variety of services and interventions identified, the outcome measures used, and the barriers and facilitators to progression through services in relation to a realist social prescribing framework. The review found that there has been minimal evaluation of holistic, low intensity services for autistic adults, such as those offered in social prescribing approaches. Outcome measures remain focused on features of autism and reveal less about the effects of interventions on health and wellbeing. Aspects of the social prescribing model were identified in the features of service pathways, but findings also suggested how social prescribing could be adapted to improve accessibility for autistic people.
自闭症谱系成人受到健康差距的影响，这大大降低了他们的预期寿命，并使他们在获得医疗保健方面面临障碍。社会处方是一种整体方法，将患者从初级保健转移到社区中的健康促进活动中。然而，对于自闭症患者如何在社会处方途径中进行导航以及这些方法是否能够解决现有的差距，研究关注较少。本映射综述旨在综合非医疗、社区为基础的自闭症成人干预措施的特点，评估其在社会处方方法中的适用性。我们使用系统搜索和筛选过程，从医学数据库（Embase、Medline、PsycINFO、CINAHL 和 Cochrane 综述）和灰色文献中确定文献综述。我们从 24 篇综述和 19 项研究中提取了数据，包括服务类型、参与者、结果、设置和程序。我们使用叙述和可视化综合方法来绘制所确定的各种服务和干预措施的图谱，使用的结果衡量标准，以及与现实的社会处方框架相关的服务进展的障碍和促进因素。该综述发现，对于自闭症成人的整体、低强度服务，如社会处方方法中提供的服务，评估很少。结果衡量标准仍然侧重于自闭症的特征，而对干预对健康和幸福感的影响的了解较少。服务途径的特点中确定了社会处方模型的各个方面，但研究结果也表明了如何调整社会处方以提高自闭症患者的可及性。
