221 - Barriers and Facilitators to Pediatric Social Prescribing: A Qualitative, Exploratory Study

Publication Number: 2213.221

Armaan Jaffer, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Ethan Fong, University of British Columbia Faculty of Medicine, San Francisco, CA, United States; Shalaka Dixit, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Britt R. Udall, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Matthew Carwana, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada

Background: Social prescribing (SP) is an intervention where patients are referred to non-medical and community-based supports to address the determinants that can influence health. These activities can be wide-ranging and multifaceted, including exercise, counselling, housing, and food security. However, while SP tools and implementation are robust in some settings, there is less evidence of its application to children and young people in North America. Studies have highlighted pediatric SP’s effectiveness in supporting young people’s overall health, but they have not systematically explored facilitators and barriers pediatricians face when engaging in SP. Consequently, a large provider know-do gap exists between the praxis and practice of SP. The Theoretical Domains Framework (TDF) is an established implementation science approach for systematically identifying barriers and facilitators to practice change.

Objective: The objective of this study is to explore barriers and facilitators to pediatric SP among pediatric healthcare providers using the TDF.

Design/Methods: An interview guide that aligned with key domains of the TDF was developed. The project was approved by the local Institutional Review Board. Pediatricians, child and adolescent psychiatrists, and pediatric neurologists from across British Columbia (BC), Canada were invited to participate in the study via passive and purposive recruitment strategies. Eighteen semi-structured interviews were conducted via Zoom, with verbatim transcription completed. Thematic analysis consisted of inductive and deductive approaches. Inductive themes were deductively coded under the TDF domains.

Results: Inductively identified facilitators and barriers were deductively mapped to nine TDF domains (Tables 1 & 2). Analysis revealed three domains functioned predominantly as facilitators to implementation, three functioned predominantly as barriers, and three contained both facilitating and impeding elements (Table 1). Nine facilitator themes and eight barrier themes were identified (Table 2).

Conclusion(s): Findings suggest that a broad range of facilitators and barriers can influence the practice of pediatric SP in BC. While providers recognize SP as integral to pediatric practice and actively share resources, systemic workforce shortages and institutional disincentives impede widespread adoption By identifying modifiable barriers and existing facilitators, this study provides evidence to inform policy and practice reforms necessary for scaling SP practice to improve quality of life, mitigate social impacts of disease, and enable upstream prevention at the population level.

QURGP033 (1).pdf

Table 2: Classification of TDF domains by implementation function: facilitators, barriers, or mixed.
PAS_26_Table2.pdf