Abstract

Background: Conwy West Primary Care Cluster seeks to examine the evidence on the effectiveness of social prescribing for prediabetes patients and to determine the Social Return on Investment (SROI) of the MY LIFE programme. This programme is a priority for Conwy West Cluster due to a high number of citizens with Type 2 Diabetes or who are at risk of developing this chronic condition. In Conwy West, 60% of adults are of an unhealthy weight and 47% are not meeting physical activity guidelines. The MY LIFE programme seeks to prevent Type 2 Diabetes by referring prediabetes patients to a Diabetes Technician who provides information and advice, and signposts patients to community-based Social Prescribing (SP) activities that promote physical activity and a healthy diet.

Aim: The aim is to examine the evidence to identify if SP interventions in the UK are effective for managing prediabetes and to determine the SROI of the MY LIFE programme for preventing prediabetes in Conwy West, North Wales.

Methods: An SR was conducted to examine the evidence to identify if SP interventions in the UK are effective for the prevention of prediabetes. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven high-quality studies and three low-quality studies were selected for inclusion in the SR, and a thematic analysis of the included studies was conducted.

An SROI analysis was conducted to evaluate the MY LIFE social prescribing programme in North Wales. The SROI analysis consisted of six stages: identifying stakeholders, developing a theory of change, calculating inputs, evidencing, and valuing outcomes, establishing impact, and calculating the SROI ratio.

Results: The evidence from the SR suggested that participant enrolment onto SP programmes for prediabetes prevention resulted in improvements in cardiometabolic health, physical activity, psychological wellbeing, and weight-loss.
Results from the SROI analysis showed that the MY LIFE programme for prediabetes participants in North Wales generated SROI ratios ranging from £4.70 to £5.86 for every £1 invested for participants who experienced Diabetes Technician plus SP intervention, and £4.23 to £6.46 for every £1 invested for participants who experienced the Diabetes Technician Only.
The results also indicated that most of the social value (between 54% and 69%) generated for MY LIFE participants could be attributed to the Diabetes Technician, who provided telephone support and motivation to participants every two weeks during the 8-week study.
Discussion:
Although the SROI ratios for the MY LIFE project are promising, there are some limitations in this study including the small sample size, lack of a control group and use of only one study site. Future research should use a larger sample size, multiple research sites with more than one Diabetes Technician and conduct a similar study during a non-COVID period. Conducting this study during COVID may have resulted in fewer participants attending face-to-face SP interventions for prediabetes management.
Conclusion: Evidence from the SR showed that SP interventions can generate positive outcomes such as, improved cardiometabolic health, improved physical activity, improved psychological wellbeing, and reduced weight. In addition, the Diabetes Technician was key in generating positive SROI ratios for the MY LIFE programme. Further, SP programmes for prediabetes, such as KindEating, Slimming World, and the National Exercise Referral Scheme (NERS) contributed important additional social value.