Professionals and clients’ perspectives on how to improve support for people with multi-problems through social prescribing in a vulnerable neighborhood 

Background: There are people who access primary health care services who experience multiple-problems in different living areas (e.g. financial, housing, unemployment, alcohol or drugs) and also lack a social support network. These issues are related to wider determinants of health. Supporting people with multiple-problems is a major challenge for general practitioners, as these people might not need medical help (first), but require help from other sectors. Social prescribing (SP) is a holistic, person-centered community-based approach to address clients’ wider health needs. This approach creates a bridge between medical and non-medical sectors. Clients in vulnerable neighborhoods more often experience multiple problems at the same time. Therefore implementing SP in vulnerable neighborhoods differs from implementation in non-vulnerable neighborhoods. We applied the method of participatory action research to co-create and realize a plan together with relevant stakeholders. The goal was to better respond to the wider support needs of people with multi-problems. This research methodology starts with exploring the different perspectives of health and care professionals and clients on the design and implementation of SP in a vulnerable neighborhood. Methods: For this study, interviews were conducted with an divers group of professionals from different sectors, clients and experts-by-experience who received care and support in the past and are currently working as volunteers to help people with multi-problems. We used guiding principles for successful implementation of social prescribing and a methodological framework of system exploration in data collection and analysis. Results:Results of the system exploration provide valuable insights into the experiences of professionals and client in the current situation and what is needed towards the desired situation of improved support for people with multi-problems. For example, one experience is that in the current situation addressing wider health needs is not yet the norm, the current offer of care is not always aligned with wider health needs and there is insufficient cohesion in providing care and support. To create the desired situation a case manager, customization of supporting wider health needs of client, and structural collaboration between sectors are needed. Discussion: Internationally, SP has gained increasing attention, and many countries are implementing SP. However, there is little attention for social prescribing in vulnerable neighborhoods. We will reflect on how guiding principles for successful implementation of SP relate to the experiences and perspectives on how to better support people with multi-problems through SP in an vulnerable neighborhood. Conclusion: This study provides insight into different perspectives on improving the support for people with multi-problems through SP in a vulnerable neighborhood. These insights are useful when implementing SP in the context of an vulnerable neighborhood for people with multi-problems. Lessons learned: The insights of the experiences and perspectives gives the opportunity to start with a action plan to better support people with multi-problems through SP in an vulnerable neighborhood. Suggestions for future research: This study only describes the first phase of action research: system exploration. Future research should focus on cocreating an action plan together with the involved stakeholders and on monitoring and evaluating this action plan.