Promoting Physical Activity Through Social Prescribing: A Narrative Review of Literature on the Mechanisms of Change

Abstract

Background: Social prescribing (SP) has received increasing interest in recent years due to its potential to encourage health-promoting behaviours, such as physical activity (PA). However, to develop effective SP interventions, it is critical to enhance our understanding of the mechanisms of change associated with SP and their potential to promote PA. This review aimed to synthesise the mechanisms of change in SP interventions and to develop a logic model illustrating a theoretical framework for SPs potential to promote PA.

Methods: A narrative review was performed, including a systematic literature search in Medline, Embase and PsycINFO. The systematic literature search was finalised on 21 February 2023, and studies investigating mechanisms of change in SP interventions were included. Findings were synthesised and illustrated in a logic model illustrating how SP interventions may promote PA as an outcome.

Results: The systematic literature search identified 340 studies, of which 11 met the inclusion criteria. The SP interventions comprised three processes: referral, linking and engagement. These processes influenced various mechanisms of change, which were classified into two perspectives. From a person-centred perspective, the mechanisms with the potential to promote PA comprised self-efficacy, motivation, empowerment and ‘having a voice’. These mechanisms were associated with crucial elements of SP, such as tailoring to needs, trusted relationships, nonstigmatising activities and peer-to-peer support. From a system-based perspective, the mechanisms with the potential to promote PA included system capacity and resources together with shared understanding and knowledge. These mechanisms were related to crucial elements of SP, including reliance on established communication and network, local agency and accessibility.

Conclusion: A person-centred perspective describes SPs potential to promote PA through various mechanisms of change. However, these mechanisms appear to be intricately connected with the local context. Consequently, SP intervention research could benefit from incorporating contextual factors and, ideally, also integrating system thinking.