Using Self-Determination theory to understand the social prescribing process: a qualitative study

Background: Social prescribing assists patients to engage in social activities and connect to community supports as part of a holistic approach to primary care. Rx: Community was a social prescribing project, implemented within 11 community health centres situated across Ontario, Canada.

Aims: To explore how social prescribing as a process facilitates positive outcomes for patients.

Design and setting: We used qualitative methods, conducting 18 focus groups involving 88 patients and 8 additional in-depth interviews.

Methods: Interviews and focus groups were transcribed verbatim and analyzed thematically using a theoretical framework based on self-determination theory.

Results: Participants who had received social prescriptions described social prescribing as an empathetic process that respects their needs and interests. Social prescribing facilitated the patient’s voice in their care, helped patient’s develop skills in addressing needs important to them, and fostered trusting relationships with staff and other participants. Patients reported their social support networks were expanded, and they had improved mental health and ability in self-management of chronic conditions. Patients who became involved in social prescribing as voluntary “health champions” reported this was a positive experience and they gained a sense of purpose by giving back to their communities in ways that felt meaningful for them.

Conclusion: Social prescribing produced positive outcomes for patients, and fit well within the community health centre model of primarycare. Future research should examine the impact on health outcomes and examine the return on investment of developing and implementing social prescribing programs.