Skip to main content
  • European Centre for Environment & Human Health

  • University of Exeter Medical School
  • Menu
  • Search
  • Home
  • About us Our mission and vision
    • Our Mission, Vision and Purpose
    • WHO Collaborating Centre on Natural Environments and Health
    • Peninsula Environment & Human Health Forum
    • Public Engagement
    • Our Mission, Vision and Purpose
    • WHO Collaborating Centre on Natural Environments and Health
    • Peninsula Environment & Human Health Forum
    • Public Engagement
  • Research Learn about our science
  • Impact Informing policy and practice
  • Education Explore our MSc and CPD courses
  • People Meet our staff and students
  • News & blog Updates from people and projects
  • Contact

A realist review of approaches to social prescribing

Tagged:
  • Nature, Biodiversity and Health

The use of non-medical referral, community referral or social prescribing interventions has been proposed as a cost-effective alternative to help those with long-term conditions manage their illness and improve health and well-being. However, the evidence base for social prescribing currently lags considerably behind practice.

This paper explores what is known about whether different methods of social prescribing referral and supported uptake do (or do not) work. Supported by an Expert Advisory Group, the realist review was conducted in two phases. The first identified evidence specifically relating to social prescribing in order to develop programme theories in the form of ‘if-then’ statements, articulating how social prescribing models are expected to work. The second phase,  aimed to clarify these processes and include broader evidence to better explain the proposed mechanisms.

The first phase resulted in 109 studies contributing to the synthesis, and the second phase 34. This generated 40 statements relating to organising principles of how the referral takes place (Enrolment), is accepted (Engagement), and completing an activity (Adherence). Six of these statements were prioritised using web-based nominal group technique by the Expert Group.

Studies indicate that patients are more likely to enrol if they believe the social prescription will be of benefit, the referral is presented in an acceptable way that matches their needs and expectations, and concerns elicited and addressed appropriately by the referrer. Patients are more likely to engage if the activity is both accessible and transit to the first session supported. Adherence to activity programmes can be impacted through having an activity leader who is skilled and knowledgeable or through changes in the patient’s conditions or symptoms. However, the evidence base is not sufficiently developed methodologically for us to make any general inferences about effectiveness of particular models or approaches.

The full paper is published here.

A realist review of approaches to social prescribing

Authors

  • Prof Ruth Garside

    Prof Ruth Garside

  • Dr Rebecca Lovell

    Dr Rebecca Lovell

Related content

Research project

Nature-on-prescription

This project will design a programme of nature-based group activities for people with common mental health conditions.

Research project

Nature on Prescription handbook

An evidence-based guide to how 'Nature on Prescription' can be implemented to support mental health.

Research project

Barriers to entrepreneurship in Cornwall

Exploring the factors preventing low-income individuals in Cornwall from accessing funding and starting new ventures.

Contact details

European Centre for Environment and Human Health

University of Exeter Medical School

Peter Lanyon Building 12

Penryn, Cornwall, TR10 8RD

  • T: +44 (0) 1326 371859
  • E: ECEHHAdmin@exeter.ac.uk

Sign up to our mailing list

Fill in our form to receive updates on our latest projects, events and publications.

Subscribe

Follow us

  • @ecehh.bsky.social
  • LinkedIn
  • YouTube
  • @ecehh
  • Terms & Conditions
  • Privacy
  • Accessibility

Copyright © 2025. European Centre for Environment & Human Health. All rights reserved.