A framework to conceptualize social prescribing services from a prevention perspective

Objective: Social prescribing models are expanding worldwide to serve multiple goals, such as attending to social conditions that affect people's health, supporting patients with mental health issues or other long-term conditions, facilitating community building and reducing demands on the health care system. Implicitly, many social prescribing services seek to promote health, prevent morbidity or deterioration of disease. Given that the scientific literature currently does not systematically describe these services as preventive service models, we propose a framework to explicitly conceptualize social prescribing from a prevention perspective. Methods: Based on concepts from prevention science (e.g., classifications of prevention approaches), and a comparison of social prescribing models in different countries, we compiled a framework allowing to conceptualize, plan and evaluate social prescribing from a prevention perspective. Examples of social prescribing models were identified using systematic reviews and focused key-word-searches. Results: Our framework outlines a systematic process for explicitly designing social prescribing models for prevention purposes. It consists of the following steps: defining target populations (e.g., young people with mild mental health issues), formulating intended outcomes (e.g., improved social participation), determining a prevention approach (e.g., universal or indicated prevention), deciding on the implementation setting (e.g., primary or specialized care) and selecting services for prescription (e.g., physical activity outdoors). Conclusion: The framework advances the field by guiding the conceptualization, development and evaluation of social prescribing services. It contributes to widening possible settings for social prescribing and considers potential adverse consequences. Thereby the framework opens up new avenues for social prescribing as preventive service model.