Rafiei Sima, Honary Mahsa, Mezes Barbara, Flowers Susan
Department of Management Science, Lancaster University Management School, Lancaster, UK
Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK.
BMJ Open. 2025 Apr 2;15(4):e094522. doi: 10.1136/bmjopen-2024-094522.
Social Prescribing (SP) programmes hold significant promise, yet there is a critical need to identify the underlying causes of their challenges and develop evidence-based, co-designed solution ideas through a collaborative approach.
This study applied a multimethod participatory design using co-design workshops to generate solutions to root problems and a 2-day Citizen Jury (CJ) event to validate these solutions from different perspectives.
Four co-design workshops were conducted with different stakeholders, including experts-by-experience, community providers, SP link workers and other health and social care professionals who were responsible in SP coordination and leadership.
Data were analysed using thematic analysis, identifying the root causes across several domains: human resources issues, social determinants of health), intrasectoral and intersectoral collaboration in health planning and service delivery, knowledge and awareness, financing, assessment systems for evaluating SP programme effectiveness, information systems and supportive policies/mechanisms.
11 solutions were proposed, including prioritising a human-centric approach, establishing sustainable funding mechanisms, providing sufficient training and knowledge for staff, fostering co-production and shared vision across sectors, adopting a preventive approach to healthcare, enhancing information system support and encouraging self-referrals. These strategies were proposed and refined during the 2-day CJ event.
Using a participatory method enabled a comprehensive understanding of different stakeholders' perspectives and facilitated the development of co-produced solutions based on the identified challenges. This approach has the potential to assist policymakers in developing realistic policies to enhance social care within integrated care systems.
社会处方（SP）计划前景广阔，但迫切需要找出其面临挑战的根本原因，并通过合作方式制定基于证据的、共同设计的解决方案。
本研究采用多方法参与式设计，通过共同设计研讨会来生成针对根本问题的解决方案，并举办为期两天的公民陪审团（CJ）活动，从不同角度验证这些解决方案。
与不同利益相关者举办了四次共同设计研讨会，包括有经验的专家、社区提供者、SP联络人员以及负责SP协调和领导工作的其他卫生和社会护理专业人员。
采用主题分析法对数据进行分析，确定了多个领域的根本原因：人力资源问题、健康的社会决定因素、卫生规划和服务提供中的部门内和部门间合作、知识与意识、融资、评估SP计划有效性的评估系统、信息系统以及支持性政策/机制。
提出了11项解决方案，包括优先采用以人为本的方法、建立可持续的资金机制、为工作人员提供充分的培训和知识、促进各部门间的共同生产和共同愿景、采取预防性医疗保健方法、加强信息系统支持以及鼓励自我推荐。这些策略在为期两天的CJ活动中得到了提出和完善。
采用参与式方法能够全面了解不同利益相关者的观点，并促进基于已确定挑战的共同生产解决方案的制定。这种方法有可能帮助政策制定者制定切实可行的政策，以加强综合护理系统中的社会护理。
