Intervention Characteristics and Mechanisms and their Relationship with the Influence of Social Prescribing: a Systematic Review

Introduction. Social Prescribing (SP) is an integrated care program aimed to improve individuals' health and wellbeing. Understanding the influence of SP and determining best practices and processes is challenging due to variability in its delivery, implementation, and intervention characteristics between different studies and countries. This study aimed to identify the intervention characteristics, mechanisms, and outcomes associated with SP research, and explore how these factors relate to the influence of SP on health and wellbeing, healthcare utilization, and care experiences. Method. A comprehensive search was conducted in 12 databases, Google Scholar, and reference lists of relevant studies published from January 2010 up to April 2023. Searches were limited to literature written in English or Dutch. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool and the risk of bias was evaluated using the Cochrane RoB2 and the ROBINS-I. We coded all intervention characteristics, mechanisms, and relevant outcomes. Qualitative data were visually presented using Harvest Plots and qualitative data were narratively summarized. Results and discussion. In total, 49 papers were included, of which seven qualitative, seventeen quantitative, and 25 mixed method studies. Moreover, the findings highlights the importance of social-related mechanisms, including loneliness and social connectedness, in contributing to the observed positive influence of SP on mental health and wellbeing. The observed outcomes seem to be influenced by various characteristics, including gender, age, the presence of a link worker, and the use of behavior change techniques. However, we should be cautious when interpreting these results due to limitations in study designs, such as the lack of controlled trials and statistical considerations. Further rigorous research is needed to comprehensively understand the impact and potential benefits of SP. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols ### Funding Statement This work was supported by ZonMw; The Netherlands Institute for Health Research and Development [grant number 10390052010010]. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data used to support the findings of this systematic review are available from the corresponding author upon request.