A Realist Exploration of Social Prescribing Evaluation

  • Megan Elliott

    Student thesis: Doctoral Thesis


    This thesis critically explores the topic of social prescribing evaluation, bringing together evidence from three inter-linked projects. Project 1 is a participatory mixed methods evaluation of a community-based Falls Awareness programme. This involved a small-scale evaluation, which identified methodological issues and informed development of projects 2 and 3. Projects 2 and 3 sit within the ACCORD study, which aims to develop an evaluation framework and reporting standards for social prescribing. Project 2 comprises a Realist Review exploring how and why social prescribing evaluations work. Project 3 comprises a Group Concept Mapping consensus study to develop a framework of good practice for social prescribing evaluation. Each project is supported by a selection of outputs which support the arguments made in this thesis and demonstrate how the author meets the QAA Doctoral Descriptors.

    This portfolio is the first to use Realism and Complexity as a theoretical backdrop to explore the subject of social prescribing evaluation. To date, evaluations have been criticised for poor methodological rigour, but researchers have not explored reasons for limitations, nor explained how they may be addressed. This critical commentary presents an argument as to ‘what works, for whom and in what circumstances’ for social prescribing evaluation. Four analytical strands are identified; using mixed methods, collecting data that matters, involving stakeholders and considering the evaluation context. Evidence from the projects and extant literature is considered within each of these strands. From this analytical discussion, principles of good practice and implications for evaluators, commissioners, policy makers, social prescribing service providers and social prescribing service users are explored. The utility and application of three different research approaches; participatory research, Realist Review and consensus methods, for addressing complexity is also critically appraised.

    This thesis highlights the need for evaluators to carefully design and deliver mixedmethods social prescribing evaluations in partnership with stakeholders to develop the evidence base. The research presented forms a basis for the development of a social prescribing evaluation framework, reporting standards and training materials. It will support better evaluation, which can be translated into practice so that service provision is grounded in robust and rigorous evidence.
    Date of AwardJun 2022
    Original languageEnglish
    SupervisorCarolyn Wallace (Supervisor) & Mark Davies (Supervisor)

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