Effectiveness and value of relationships in link worker social prescribing over an 18-month follow up period

Abstract

Background: To make confident referrals to link worker social prescribing (LWSP) programs, GPs and other health providers need evidence of their overall effectiveness and the value of the relationships and social activities that contribute to their outcomes. This research aimed to examine these questions in data collected from participants of a LWSP program over an 18-month follow-up period. Methods: Sixty-four participants (Mage = 53.59) enrolled in the LWSP arm of a controlled trial provided data at three timepoints: baseline (T1, n = 64), + 8-weeks (T2, n = 50) and + 18-months (T3, n = 30) on group activities, relationship quality with link worker and community group facilitators, and outcomes on loneliness (single-item and ULS-8), distress (K6), wellbeing (WEMWBS), trust and rating of overall health. Results: Participants were referred to a diverse range of social group programs. The number of meaningful social groups that participants belonged to increased from a median of two groups at T1 to three groups at T2; this effect was maintained at T3 (median 3 groups).Linear mixed-effects models found significant improvements across time for loneliness, psychological distress, and self-rated health. Correlations revealed participants’ relationships with link workers and group facilitators’ skill in fostering belonging at T2 (but not at T1), were associated with improved outcomes at T3. Conclusions: Findings demonstrate positive effects of LWSP on loneliness and health outcomes at 18-month follow-up. The relational skills of link workers in building interpersonal rapport and community group facilitators in enabling a sense of belonging were key to participants’ positives outcomes. These findings emphasise that social prescribing is a multifaceted and highly relational health pathway. Strong relational and integrated care are important in achieving improved health outcomes. Trial registration: ANZ Clinical Trials Registration number ACTRN12622000801718, retrospectively registered on 08/06/2022.