Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT

Background: Social prescribing link workers support patients to connect with community resources to improve their health and well-being. These roles are prominent in policy, but there is limited evidence on what support is provided by link workers and what factors influence implementation of link wo...

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Main Authors: Bridget Kiely, Ivana Keenan, Sonali Loomba, Natalie Mack, Vivienne Byers, Emer Galvin, Muireann O’Shea, Patrick O’Donnell, Fiona Boland, Barbara Clyne, Eamon O’Shea, Susan M. Smith, Deirdre Connolly
Format: Article
Language:English
Published: Ubiquity Press 2024-12-01
Series:International Journal of Integrated Care
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Online Access:https://account.ijic.org/index.php/up-j-ijic/article/view/8586
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author Bridget Kiely
Ivana Keenan
Sonali Loomba
Natalie Mack
Vivienne Byers
Emer Galvin
Muireann O’Shea
Patrick O’Donnell
Fiona Boland
Barbara Clyne
Eamon O’Shea
Susan M. Smith
Deirdre Connolly
author_facet Bridget Kiely
Ivana Keenan
Sonali Loomba
Natalie Mack
Vivienne Byers
Emer Galvin
Muireann O’Shea
Patrick O’Donnell
Fiona Boland
Barbara Clyne
Eamon O’Shea
Susan M. Smith
Deirdre Connolly
author_sort Bridget Kiely
collection DOAJ
description Background: Social prescribing link workers support patients to connect with community resources to improve their health and well-being. These roles are prominent in policy, but there is limited evidence on what support is provided by link workers and what factors influence implementation of link worker interventions. Methods: A convergent, mixed methods process evaluation of an exploratory randomised trial of a one-month general practice-based link worker intervention targeting adults with multimorbidity in deprived areas. Qualitative data from interviews with 25 patients, 10 general practitioners, 10 link workers and eight community resource providers were thematically analysed and integrated with quantitative data to explore implementation, adaptations, context and mediators. Results: GPs reported recruitment challenges related to complicated research documentation and COVID-19 related workload and restrictions. Despite most components of the intervention being delivered, the intervention was considered too short to support people with complex needs to connect with resources, particularly in the context of COVID-19 restrictions. Timing of the referral, location within general practice and link workers’ person-centred approach facilitated the intervention. Conclusions: For future evaluations, recruitment procedures need to be simplified and integrated into everyday practice. For patients with multimorbidity, a longer intervention is indicated to achieve connection with community resources.
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spelling doaj-art-c43ddd6f35e64107af7774af02785c9c2025-08-20T01:48:38ZengUbiquity PressInternational Journal of Integrated Care1568-41562024-12-0124161610.5334/ijic.85868482Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCTBridget Kiely0https://orcid.org/0000-0002-5752-0432Ivana Keenan1Sonali Loomba2Natalie Mack3Vivienne Byers4https://orcid.org/0000-0001-7163-4172Emer Galvin5https://orcid.org/0000-0001-8047-5599Muireann O’Shea6https://orcid.org/0000-0002-6025-450XPatrick O’Donnell7https://orcid.org/0000-0001-7710-7832Fiona Boland8https://orcid.org/0000-0003-3228-0046Barbara Clyne9https://orcid.org/0000-0002-1186-9495Eamon O’Shea10Susan M. Smith11https://orcid.org/0000-0002-1186-9495Deirdre Connolly12https://orcid.org/0000-0001-8539-8123Clinical Lecturer, Department of General Practice, Royal College of Surgeons; University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2Research Officer, Irish College of GPs, Lincoln Place, Dublin 1Medical Student, Royal College of Surgeons; University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2Medical Student, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2Senior Research Fellow, Environment Sustainability and Health Institute, Technological University Dublin, Dublin 7Royal College of Surgeons in Ireland University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2Research Assistant, Public Health & Primary Care, Trinity College, DublinGraduate Entry Medical School, University of Limerick, LimerickData Science Centre, Royal College of Surgeons; University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2Senior Lecturer, Department of Public Health and Epidemiology, Royal College of Surgeons; University of Medicine and Health Sciences, 123 St Stephens Green, Dublin 2School of Business and Economics, University of Galway, GalwayProfessor of General Practice, Discipline of Public Health and Primary Care, Trinity College, DublinDiscipline of Occupational Therapy, Trinity College, DublinBackground: Social prescribing link workers support patients to connect with community resources to improve their health and well-being. These roles are prominent in policy, but there is limited evidence on what support is provided by link workers and what factors influence implementation of link worker interventions. Methods: A convergent, mixed methods process evaluation of an exploratory randomised trial of a one-month general practice-based link worker intervention targeting adults with multimorbidity in deprived areas. Qualitative data from interviews with 25 patients, 10 general practitioners, 10 link workers and eight community resource providers were thematically analysed and integrated with quantitative data to explore implementation, adaptations, context and mediators. Results: GPs reported recruitment challenges related to complicated research documentation and COVID-19 related workload and restrictions. Despite most components of the intervention being delivered, the intervention was considered too short to support people with complex needs to connect with resources, particularly in the context of COVID-19 restrictions. Timing of the referral, location within general practice and link workers’ person-centred approach facilitated the intervention. Conclusions: For future evaluations, recruitment procedures need to be simplified and integrated into everyday practice. For patients with multimorbidity, a longer intervention is indicated to achieve connection with community resources.https://account.ijic.org/index.php/up-j-ijic/article/view/8586social prescribingmultimorbidityprimary carelink workersprocess evaluation
spellingShingle Bridget Kiely
Ivana Keenan
Sonali Loomba
Natalie Mack
Vivienne Byers
Emer Galvin
Muireann O’Shea
Patrick O’Donnell
Fiona Boland
Barbara Clyne
Eamon O’Shea
Susan M. Smith
Deirdre Connolly
Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT
International Journal of Integrated Care
social prescribing
multimorbidity
primary care
link workers
process evaluation
title Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT
title_full Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT
title_fullStr Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT
title_full_unstemmed Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT
title_short Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT
title_sort implementing a general practice based link worker intervention for people with multimorbidity during the covid 19 pandemic a mixed methods process evaluation of the linkmm rct
topic social prescribing
multimorbidity
primary care
link workers
process evaluation
url https://account.ijic.org/index.php/up-j-ijic/article/view/8586
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