Effectiveness and Value of Relationships in Link Worker Social Prescribing Over an 18-month Follow Up Period

Background: To make confident referrals to link worker social prescribing (LWSP) programs, GPs and other health providers need evidence of their overall effectiveness and the value of the relationships and social activities that contribute to their outcomes. This research aimed to examine these questions in data collected from participants of a LWSP program over an 18-month follow-up period. Methods: Sixty-four participants ( M _age = 53.59) enrolled in the LWSP arm of a controlled trial provided data at three timepoints: baseline (T1, n =64), +8-weeks (T2, n =50) and +18-months (T3, n =30) on group activities, relationship quality with link worker and community group facilitators, and outcomes on loneliness, distress, wellbeing, trust and health. Results: Participants were referred to a diverse range of social group programs, and the number of meaningful social groups increased from a median of 2 groups at T1, to 3 groups at T2 and T3. Loneliness reduced at T2 and T3, and these effects were large. Moderate-to-large effects were also found at 18-months for psychological distress and self-rated health. Participants’ relationships with link workers and group facilitators’ skill in fostering belonging at T2 (but not at T1), were associated with participant improvements at T3. Conclusions: Positive effects of LWSP were found in all outcome measures at 18-months follow-up. There was also evidence that the relational skills of link workers in building interpersonal rapport and community group facilitators in enabling a sense of belonging were key to participants’ positives outcomes. These findings emphasise that social prescribing is a multifaceted and highly relational health pathway. Strong relational and integrated care are important in achieving improved health outcomes. Trial registration: ANZCTR, retrospectively registered on 08/06/2022, https://www.anzctr.org.au/ACTRN12622000801718.aspx