Keywords: Primary Health Care, Social Prescribing, Community Health Indicators, Evaluation Studies

Introduction:

Social Prescribing (SP) enables primary care professionals to refer patients to community resources to address social determinants of health. While the use of this tool is increasing in primary care, its evaluation remains a significant challenge.
The objective is to define a set of indicators for evaluating social prescribing schemes within the primary healthcare setting in Spain.

Method:

A literature review was conducted to gather evidence on the evaluation of SP. Then, two qualitative techniques were employed to reach a consensus on a set of indicators. Five nominal groups were formed, involving 48 participants, including primary care professionals, public health experts, community asset managers, and beneficiaries. The results led to the creation of 116 quality criteria.
Criteria were subjected to a consensus process using the Delphi technique over two rounds (Round 1: 101 participants, 77.7% response rate; Round 2: 97 participants, 96% response rate). The research group drafted a list of indicators, refined in a workshop with experts to assess clarity, feasibility, and clinical utility. These indicators were then piloted in clinical practice by primary care teams in the public health service of Aragon (Spain). Following data analysis and participant feedback from two additional nominal groups, the final list was reviewed and approved by eight experts.

Results:

A total of 35 indicators were established:
11 Structure indicators: e.g. health authority validation of resources prescribed, integration of SP protocols into electronic health records.
14 Process indicators: e.g. patient participation, satisfaction levels.
10 Outcome indicators: e.g. improvement in quality of life, reduction in medication use, community involvement.
Seven recommendations for implementation process were provided to ensure feasibility and integrated evaluations in primary healthcare teams.

Conclusions:

This set of indicators provides a robust evaluation framework for the SP. It allows for the adaptation of the proposal to diverse clinical realities while providing guidelines for successful implementation.