Social prescribers’ referral processes and decision-making about healthy eating and physical activity

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Abstract Background Social Prescribing (SP) connects primary care patients with non-medical sources of support within the community. There are various SP models, with different referral routes. Many involve patients being referred to a link practitioner, who considers their needs and then “prescribes” or links them to appropriate local support services or resources, typically provided by the third sector. The present study aimed to explore the SP process and the decision-making of link practitioners, particularly around food and physical activity practices. Methods Sixteen semi-structured interviews were conducted with link practitioners working across Aberdeen City. A pragmatic Thematic Framework analysis was undertaken. Findings Participating link practitioners described their approach with clients as building rapport and trust while maintaining boundaries and managing expectations, and their community role as resource mapping and networking. Three broad categories of factors were considered during referral: 1) practicality (e.g., location, transport, cost, mobility, availability), 2) clients’ engagement (e.g., interest, motivation, readiness for change), and 3) link practitioners’ past experiences with services. Challenges identified included navigating waiting lists and service limitations, clients’ engagement and expectations, under-resourced services, navigating waiting lists with caseloads and the emotional burden of seeing people in very difficult situations. All link practitioners considered diet and exercise to fit within the remit of social prescribing but emphasised that clients should lead this discussion. Dietary support via social prescribing typically revolved around poverty rather than health. Discussion The study provides insight into the practical reality of making social prescribing decisions and has the potential to inform training and evaluation processes and support the development of health-focused social prescribing lifestyle interventions. Key messages • Social prescribing – a personalised approach, with clients supported to identify and achieve their health and wellbeing goals based on their strengths and resources available in the local community. • Social Prescribing - a promising platform for offering healthy eating interventions tailored to individual needs.

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