The Acceptability and Usability of Outcome Measures for Social Prescribing Services

Abstract

Background: Social prescribing has gained momentum within healthcare systems globally, bridging the gap between medical and non-medical services. It offers significant benefits, particularly in improving mental health and social connectedness. Despite its promise, the evidence base for social prescribing remains under debate, primarily due to the variety of outcomes it seeks to address and the diverse outcome measures used across services. Standardising outcome measures is crucial to enhance service quality, consistency, scalability, and research. This standardisation can make social prescribing more evidence-based and sustainable. This study therefore aims to assess the acceptability, feasibility, and usability of three outcome measures used in social prescribing services in Ireland: the Measure Yourself Concerns and Wellbeing (MYCAW), the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), and the Measure of Community Connectedness.

Methods: A convergent parallel mixed-methods design was employed, with quantitative data gathered through the three outcome measures and qualitative data collected via reflective logbooks from link workers and semi-structured interviews with both link workers and service users. Data were collected from nine link workers and 43 service users across three Irish health regions (Community Health Organisations 4, 6, and 7). Quantitative data were analysed using descriptive and non-parametric methods, while qualitative data were analysed using thematic analysis.

Findings: The use of the three outcome measures in social prescribing services yielded varied responses from link workers and service users. Quantitative findings indicated improvements in service users' wellbeing, community connectedness, and a reduction in self-reported concerns, as measured by SWEMWBS, Measure of Community Connectedness, and the MYCAW.

Experiences of Using the Outcome Measures - Most link workers and service users reported positive experiences with the outcome measures. SWEMWBS was well received, though some link workers hesitated to use it with emotionally vulnerable users. MYCAW was described as clear and easy to use, however some link workers tended to change ‘problems and concerns’ to ‘goals’. The Measure of Community Connectedness was also positively received, though there was some confusion around the definition of ‘community’.

Considerations When Administering the Outcome Measures - Link workers and service users emphasised the importance of flexibility in timing, format, and completion of the outcome measures. Most preferred completing them during the initial appointment to establish a baseline, though some felt it might be better to complete them later. Many favoured an in-person, conversational approach to completion.

Benefits of Using the Outcome Measures - Both link workers and service users highlighted several benefits of using outcome measures, such as strengthening relationships, providing insights into emotional wellbeing, and structuring appointments. Link workers found the outcome measures helped build trust, while service users appreciated how the measures encouraged them to reflect on their emotions and future plans.

Barriers to Completion - Both link workers and service users noted that paperwork was a barrier to completion. Additionally, link workers reported that some service users’ lack of knowledge of social prescribing posed challenges. Difficulties in collecting follow-up data and concerns about using the outcome measures with emotionally or cognitively vulnerable individuals were also reported.

Conclusion: This study highlights the need for flexibility and clarity in administering outcome measures in social prescribing. Improved training for key stakeholders, and enhanced data management could optimise their usability and ensure greater consistency across services.