Journal of Migration and Health Volume 4, 2021, 100067 (October 2021)
Highlights
- Social prescribing is an important part of the United Kingdom’s national healthcare strategy, and this is the first evidence review on social prescribing for migrants in the UK.
- Improved self-esteem, confidence, empowerment, and social connectivity were frequently reported outcomes.
- Link workers frequently took on additional support roles and/or actively delivered prescribed activities themselves.
- Despite low quality evidence, it is clear that migrants’ specific health and wellbeing needs, including the wider determinants of health, require social prescribing services to be adapted. Services should be tailored as much as possible to migrants’ preferences for language, culture, gender and service delivery format.
- Robust evaluation should be embedded into the planning and commissioning of social prescribing programmes in future. Better recording of sociodemographic characteristics (e.g. indicators of migration like country of birth and migrant typology) will enable a richer understanding of how social prescribing works and for whom.
Abstract
Background
The health needs of international migrants living in the United Kingdom (UK) extend beyond mainstream healthcare to services that address the wider determinants of health and wellbeing. Social prescribing, which links individuals to these wider services, is a key component of the UK National Health Service (NHS) strategy, yet little is known about social prescribing approaches and outcomes for international migrants. This review describes the evidence base on social prescribing for migrants in the UK.
Methods
A systematic review was undertaken, which identified studies through a systematic search of 4 databases and 8 grey literature sources (January 2000 to June 2020) and a call for evidence on the UK government website (July to October 2020). Published and unpublished studies of evaluated social prescribing programmes in the UK were included where at least 1 participant was identified as a migrant. Screening, data extraction and quality appraisal were performed by one reviewer, with a second reviewer checking 20% of studies. A narrative synthesis was conducted.
Findings
Of the 4544 records identified, 32 were included in this review. The overall body of evidence was low in quality. Social prescribing approaches for migrants in the UK varied widely between programmes. Link workers who delivered services to migrants often took on additional support roles and/or actively delivered parts of the prescribed activities themselves, which is outside of the scope of the typical link worker role. Evidence for improvements to health and wellbeing and changes in healthcare utilisation were largely anecdotal and lacked measures of effect. Improved self-esteem, confidence, empowerment and social connectivity were frequently described. Facilitators of successful implementation included provider responsiveness to migrants’ preferences in relation to language, culture, gender and service delivery format. Barriers included limited funding and provider capability.
Conclusions
Social prescribing programmes should be tailored to the individual needs of migrants. Link workers also require appropriate training on how to support migrants to address the wider determinants of health. Robust evaluation built into future social prescribing programmes for migrants should include better data collection on participant demographics and measurement of outcomes using validated and culturally and linguistically appropriate tools. Future research is needed to explore reasons for link workers taking on additional responsibilities when providing services to migrants, and whether migrants’ needs are better addressed through a single-function link worker role or transdisciplinary support roles.
The health needs of international migrants living in the United Kingdom (UK) extend beyond mainstream healthcare to services that address the wider determinants of health and wellbeing. Social prescribing, which links individuals to these wider services, is a key component of the UK National Health Service (NHS) strategy, yet little is known about social prescribing approaches and outcomes for international migrants. This review describes the evidence base on social prescribing for migrants in the UK.
Methods
A systematic review was undertaken, which identified studies through a systematic search of 4 databases and 8 grey literature sources (January 2000 to June 2020) and a call for evidence on the UK government website (July to October 2020). Published and unpublished studies of evaluated social prescribing programmes in the UK were included where at least 1 participant was identified as a migrant. Screening, data extraction and quality appraisal were performed by one reviewer, with a second reviewer checking 20% of studies. A narrative synthesis was conducted.
Findings
Of the 4544 records identified, 32 were included in this review. The overall body of evidence was low in quality. Social prescribing approaches for migrants in the UK varied widely between programmes. Link workers who delivered services to migrants often took on additional support roles and/or actively delivered parts of the prescribed activities themselves, which is outside of the scope of the typical link worker role. Evidence for improvements to health and wellbeing and changes in healthcare utilisation were largely anecdotal and lacked measures of effect. Improved self-esteem, confidence, empowerment and social connectivity were frequently described. Facilitators of successful implementation included provider responsiveness to migrants’ preferences in relation to language, culture, gender and service delivery format. Barriers included limited funding and provider capability.
Conclusions
Social prescribing programmes should be tailored to the individual needs of migrants. Link workers also require appropriate training on how to support migrants to address the wider determinants of health. Robust evaluation built into future social prescribing programmes for migrants should include better data collection on participant demographics and measurement of outcomes using validated and culturally and linguistically appropriate tools. Future research is needed to explore reasons for link workers taking on additional responsibilities when providing services to migrants, and whether migrants’ needs are better addressed through a single-function link worker role or transdisciplinary support roles.
