Defining Social Prescribing: Fostering Common Understanding of a Vital Tool in the Integrated Care Toolbox

Abstract

According to the World Health Organization, social prescribing is a holistic approach to health and wellbeing that promotes integrated care. There is growing interest in social prescribing around the world, with over 20 countries involved in the social prescribing movement. However, an agreed definition of social prescribing has yet to emerge. This is problematic for social prescribing research, policy, and practice. Since there are two types of definitions – conceptual and operational, agreement on both types of definitions is needed. The aim of this study was to establish internationally accepted conceptual and operational definitions of social prescribing. This study was conducted for the social prescribing community to support the advancement of the social prescribing movement. The research team – one doctoral student and four committee members, collectively designed, implemented, and monitored this research. This study involved an international, multidisciplinary panel of experts. The expert panel (n=48) represented 26 different countries across five continents and numerous expert groups, including service providers, service users, researchers, students, and representatives of the Global Social Prescribing Alliance, the Social Prescribing Network, the Social Prescribing Youth Network, the National Academy for Social Prescribing, and the Canadian Institute for Social Prescribing. A three-round Delphi study was conducted. Consensus was defined a priori as ≥80% agreement. In Round 1, participants were asked to list key elements that are essential to the conceptual definition of social prescribing and to provide corresponding statements that operationalize each of the key elements. In Round 2, participants were asked to rate their agreement with items from the first round for inclusion in the conceptual and/or operational definitions of social prescribing. Based on the findings from this round, the conceptual and operational definitions of social prescribing were developed, including long and short versions of the conceptual definition. In Round 3, participants were asked to rate their agreement with the conceptual and operational definitions of social prescribing. Consensus was reached on the definitions in this round, which signified the successful development of internationally accepted conceptual and operational definitions of social prescribing. The definitions were transformed into the Common Understanding of Social Prescribing (CUSP) conceptual framework. For the first time in the history of the social prescribing movement, we now have internationally accepted conceptual and operational definitions of social prescribing. Additionally, the conceptual definitions are distinct from pre-existing definitions, and to our knowledge, the operational definition is the first in the world. Together, the CUSP conceptual framework and the definitions offer a common thread – a shared sense of what social prescribing is. Social prescribing researchers, policymakers, and practitioners are encouraged to use the outputs of this work in social prescribing research, policy, and practice to foster common understanding of this concept.