Bos C, Vader S, van Vooren N, Jerković-Ćosić K, Keij B
National Institute for Public Health and the Environment (RIVM), Centre for Public Health, Healthcare and Society, Department of Population Health & Health Services Research, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands.
Research Group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands.
BMC Prim Care. 2025 May 15;26(1):165. doi: 10.1186/s12875-025-02867-1.
Comparative analysis of literature on social prescribing implementation suggests that strategies for implementing social prescribing for people with (complex) multiple-problems may differ significantly from those for people with mild-psychosocial issues. Similar findings have been observed in the Netherlands, where a SP program has been developed in 2018. This study examines the perspectives of health and care professionals, experts-by-experience, and clients regarding the design and implementation of social prescribing in vulnerable neighborhoods in order to better support people with (complex) multiple-problems.
This study includes the first steps of the participatory action research methodology. During the research, 26 semi-structured interviews and observations were applied to gain insight among professionals, experts-by-experience and clients.
The findings indicate that support for people with (complex) multiple-problems requires more than a referral to already existing activities and services. Experts-by-experience and clients highlighted the necessity for a tailored based approach that considers clients' unique circumstances, e.g. the clients' living environment, particularly for those with (complex) multiple-problems and having a multicultural backgrounds. While all participants recognized the importance of addressing wider health needs, they also identified several challenges in doing so. Key themes for improving the support for individuals with (complex)multiple-problems are related to fragmentation due to insufficient collaboration, and to how wider health needs can best be addressed and by whom.
While there is a clear willingness to enhance support for people with multiple-problems, findings reveal significant challenges faced by all parties involved. A key issue identified is the mismatch between what clients need and what professionals are able to provide. Ultimately, a tailored approach is essential for effectively addressing the complex and wider health needs of both individuals and populations, in order to improve their overall health and well-being outcomes. This approach may be feasible by providing clients with (complex) multiple-problem with a single case manager as first point of entry.
对社会处方实施相关文献的比较分析表明,为有(复杂)多重问题的人群实施社会处方的策略可能与为有轻度心理社会问题的人群实施社会处方的策略有显著差异。在荷兰也观察到了类似的结果,该国于2018年开展了一项社会处方计划。本研究探讨了健康和护理专业人员、有经验的专家以及客户对在弱势群体社区设计和实施社会处方的看法,以便更好地支持有(复杂)多重问题的人群。
本研究包括参与式行动研究方法的第一步。在研究过程中,进行了26次半结构化访谈和观察,以深入了解专业人员、有经验的专家和客户的情况。
研究结果表明,对有(复杂)多重问题的人群的支持需要的不仅仅是转介到现有的活动和服务。有经验的专家和客户强调了采取量身定制方法的必要性,该方法应考虑客户的独特情况,例如客户的生活环境,特别是对于那些有(复杂)多重问题且具有多元文化背景的客户。虽然所有参与者都认识到满足更广泛健康需求的重要性,但他们也指出了这样做存在的几个挑战。改善对有(复杂)多重问题个体支持的关键主题与合作不足导致的碎片化有关,以及如何最好地满足更广泛的健康需求以及由谁来满足这些需求。
虽然各方明显愿意加强对有多重问题人群的支持,但研究结果揭示了所有相关方面临的重大挑战。确定的一个关键问题是客户需求与专业人员能够提供的服务之间的不匹配。最终,量身定制的方法对于有效满足个人和人群复杂且更广泛的健康需求至关重要,可以改善他们的整体健康和福祉结果。通过为有(复杂)多重问题的客户提供单一的个案经理作为第一接入点,这种方法可能是可行的。