Social prescribing for people in vulnerable situations in Europe: protocol for a process evaluation of an RCT in eight countries

Objective
Social prescribing is a pathway that connects individuals to non-clinical services. It supports and addresses social needs, such as those related to loneliness, housing instability and mental health. Social Prescribing Europe (SP-EU), a European Union funded project, seeks to co-create an adaptation of the social prescribing pathway based on the needs of the following target groups: LGBTIQ+ people, refugees and first-generation immigrants, older people living alone. This adapted social prescribing pathway will be tested in a pragmatic randomised controlled trial (RCT) in ten hubs, covering eight countries, across Europe.

The aim of this process evaluation is to explore the implementation of the SP-EU RCT social prescribing pathway, and the experiences of the link workers, general practitioners, intervention staff, and patients from the groups listed above in both the intervention and control groups.

Methods
We will adopt a convergent parallel mixed methods approach. Data will be reported using appropriate reporting guidelines. Both quantitative and qualitative data will be collected, analysed and integrated to examine levels of convergence, divergence, or complementarity.

Discussion
Overall, the findings from this process evaluation will contribute to the interpretation of the main SP-EU trial results. More generally, it will add to our understanding of how social prescribing pathways may be used to engage people in vulnerable situations in activities that have the potential to increase health and wellbeing across a European context. The results will feed into a research policy document on social health care intervention RCTs in primary care across Europe.