Gordon Laura, Hastry Megan, Bate Angela, Gordon Katie, Greaves Emily, Dimitriadou Simoni, Rapley Tim, Basu Anna Purna
Population Health Sciences Institute, Newcastle University, Level 3, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
School of Psychology, Newcastle University, Newcastle upon Tyne, UK.
BMC Health Serv Res. 2025 Jan 30;25(1):176. doi: 10.1186/s12913-025-12329-0.
Social prescribing link workers support individuals to engage with community resources, co-creating achievable goals. Most schemes are community-based, targetting adults. Vulnerable populations including hospitalized children with neurodisability and their families, could also benefit from social prescribing.
To pilot a hospital-initiated social prescribing service for children with neurodisability and their families; to explore its feasibility, acceptability and undertake social return on investment (SROI) analysis.
Mixed-methods cohort study with SROI analysis. We recruited children aged < 16y with neurodisability, identified during inpatient stays, their parents/carers and siblings. Participants received link worker support for 6 months, extending beyond hospital discharge. Pre- and post-intervention pilot data covered profile of needs (Support Star), quality of life (EQ5D/CHU-9D), wellbeing (WEMWBS/CORS) and financial strain. We undertook 22 qualitative observations of family/link worker interactions and 39 in-depth interviews with families, link workers and healthcare professionals. Together these data were analysed within a SROI to establish the costs and social value generated.
Of 48 families supported by the service, 25 were recruited to the evaluation (26 children, aged 10 m-15y; 4 siblings; 36 parents). Baseline quality of life and wellbeing indices averaged below population norms. Link workers were highly effective at supporting families (only 6/151 goals unmet). Unmet need decreased by 6 months (Support Star, p < 0.001). Families reported having felt overwhelmed when trying to adjust to new ways of life post diagnosis/discharge before link worker intervention, with little support to navigate non-medical needs. Parents, link workers and health care professionals found link worker support invaluable for making community services accessible. Families then felt more connected to their communities, and less isolated, with increased belief in their self-efficacy. Families and healthcare professionals felt that the duration of support, and eligibility criteria, should be extended. Inputs to deliver the service for 1 year (49 families) were estimated at £74,736: outcomes for the 18 families studied were estimated at a value of £205,861.
Hospital in-reach social prescribing is feasible, acceptable, and addresses a range of otherwise unmet needs of children with neurodisability and their families, showing a positive SROI. Other vulnerable patient groups could also benefit from this approach.
ISRCTN23306751 (2.8.22).
社会处方联络工作人员帮助个人利用社区资源，共同制定可实现的目标。大多数计划以社区为基础，针对成年人。包括患有神经残疾的住院儿童及其家庭在内的弱势群体，也可以从社会处方中受益。
为患有神经残疾的儿童及其家庭试行一项由医院发起的社会处方服务；探讨其可行性、可接受性，并进行社会投资回报（SROI）分析。
采用混合方法队列研究并进行SROI分析。我们招募了住院期间确诊的16岁以下患有神经残疾的儿童、他们的父母/照顾者和兄弟姐妹。参与者接受了6个月的联络工作人员支持，出院后仍继续。干预前后的试点数据涵盖需求概况（支持之星）、生活质量（EQ5D/儿童健康问卷 - 9D）、幸福感（沃里克 - 爱丁堡心理健康量表/儿童幸福感量表）和经济压力。我们对家庭/联络工作人员的互动进行了22次定性观察，并对家庭、联络工作人员和医疗保健专业人员进行了39次深入访谈。这些数据一起在SROI框架内进行分析，以确定产生的成本和社会价值。
在该服务支持的48个家庭中，25个家庭被纳入评估（26名儿童，年龄在10个月至15岁之间；4名兄弟姐妹；36名父母）。基线生活质量和幸福感指数平均低于总体标准。联络工作人员在支持家庭方面非常有效（只有6/151个目标未实现）。未满足的需求在6个月内有所减少（支持之星，p < 0.001）。家庭报告称，在联络工作人员干预之前，试图适应诊断/出院后的新生活方式时感到不堪重负，在满足非医疗需求方面几乎没有得到支持。父母、联络工作人员和医疗保健专业人员发现联络工作人员的支持对于获得社区服务非常宝贵。家庭随后感觉与社区的联系更加紧密，不再那么孤立，对自我效能的信心增强。家庭和医疗保健专业人员认为，支持的时长和资格标准应该延长。为1年（49个家庭）提供该服务的投入估计为74,736英镑：所研究的18个家庭的结果估计价值为205,861英镑。
医院内的社会处方是可行的、可接受的，满足了患有神经残疾的儿童及其家庭一系列原本未得到满足的需求，显示出积极的社会投资回报。其他弱势群体也可能从这种方法中受益。
ISRCTN23306751（2022年8月2日）
