Social prescribing is a way of addressing the ‘non-medical’ needs (e.g. loneliness, debt, housing problems) that can affect people’s health and well-being. Connector schemes (e.g. delivered by care navigators or link workers) have become a key component to social prescribing’s delivery. Those in this role support patients by either (a) signposting them to relevant local assets (e.g. groups, organisations, charities, activities, events) or (b) taking time to assist them in identifying and prioritising their ‘non-medical’ needs and connecting them to relevant local assets. To understand how such connector schemes work, for whom, why and in what circumstances, we conducted a realist review. A search of electronic databases was supplemented with Google alerts and reference checking to locate grey literature. In addition, we sent a Freedom of Information request to all Clinical Commissioning Groups in England to identify any further evaluations of social prescribing connector schemes. Included studies were from the UK and focused on connector schemes for adult patients (18+ years) related to primary care. Our searches resulted in 118 included documents, from which data were extracted to produce context-mechanism-outcome configurations (CMOCs). These CMOCs underpinned our emerging programme theory that centred on the essential role of ‘buy-in’ and connections. This was refined further by turning to existing theories on (a) social capital and (b) patient activation. Our realist review highlights how connector roles, especially link workers, represent a vehicle for accruing social capital (e.g. trust, sense of belonging, practical support). We propose that this then gives patients the confidence, motivation, connections, knowledge and skills to manage their own well-being, thereby reducing their reliance on GPs. We also emphasise within the programme theory situations that could result in unintended consequences (e.g. increased demand on GPs).

中文翻译：

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通过将人们与当地资产联系起来，支持初级保健中的社会处方：现实主义评论。

社会处方是解决可能影响人们健康和福祉的“非医疗”需求（例如，孤独感，债务，住房问题）的一种方式。连接器方案（例如，由护理导航员或链接工作人员提供）已成为社会处方交付的关键组成部分。担任此职务的人通过以下方式为患者提供支持：（a）将他们签到相关的当地资产（例如团体，组织，慈善机构，活动，活动）；或（b）花时间帮助他们确定和优先考虑“非医疗”需求，以及将它们连接到相关的本地资产。为了了解这种连接器方案是如何工作的，针对谁，为什么以及在什么情况下工作，我们进行了现实主义者的审查。对电子数据库的搜索得到了Google警报和参考检查的补充，以查找灰色文献。此外，我们向英国的所有临床调试小组发送了“信息自由”要求，以确认对社会处方连接器方案的任何进一步评估。纳入的研究来自英国，侧重于与初级保健相关的成年患者（18岁以上）的连接器方案。我们的搜索结果包括118所包含的文档，这些文档从中提取数据以产生上下文机制-结果配置（CMOC）。这些CMOC支持了我们新兴的程序理论，该理论以“购买”和联系的基本作用为中心。通过转向关于（a）社会资本和（b）病人激活的现有理论，进一步完善了这一理论。我们的现实主义者的评论强调了连接者的角色，尤其是连接工人的角色如何代表了积累社会资本的手段（例如信任，归属感，实际支持）。我们建议这样可以使患者有信心，有动力，有联系，有知识和有能力管理自己的幸福，从而减少对全科医生的依赖。我们还强调计划理论中可能导致意想不到的后果（例如，对全科医生的需求增加）的情况。