Tailoring cultural offers with and for diverse older users of social prescribing (TOUS): A realist evaluation

Problems in life that affect how people feel cannot always be fixed with tablets or medication. For example, loneliness can lower people's mood, or worries about money can cause them to feel anxious. This may stop people looking after their health. A way of getting them help with such problems is through social prescribing.

Social prescribing involves connecting people to 'community assets' - groups, organisations, services in their local area. Community assets can include exercise classes, art groups, volunteering and advice services. Such connections can provide people with social, emotional or practical support. Link workers are a key part of social prescribing. They are employed (by the NHS, local councils or charities) to help people find support, often from voluntary or community organisations.

Older people might benefit from social prescribing. For example, if they have experienced a bereavement or lack purpose in life following retirement. Or they might have concerns about money as the cost of shopping, electricity and gas increases. As part of social prescribing, a link worker might connect an older person to support in the cultural sector; for example, to a dance or singing or craft group, activities run at a museum or volunteering at a community theatre.

Our previous research has highlighted that being connected to the cultural sector might: a) distract older people from concerns in life, b) help them make new friends, c) provide them with a space where they feel safe and welcomed, d) increase their confidence as they gain knowledge or skills through trying new things. Our previous research involved mainly talking to older people who described themselves as 'White British'. This new study will build on what we learnt from the previous research. We will focus on cultural offers and opportunities that have been developed for or with people who may not have English as their first language and/or do not identify as White British. This will allow us to develop recommendations about producing accessible, acceptable and appropriate social prescribing cultural offers for older people [aged 60 and older] from ethnic minority groups. The research will:

• Identify what is already known about creating cultural activities or events for older people from ethnic minority groups. We will do this by reviewing relevant literature.
• Map what is provided by the cultural sector in the UK; things that link workers could refer older people from ethnic minority groups to as part of social prescribing. We will contact a wide range of cultural organisations and ask them to complete a short questionnaire.

Explore what we can learn from cultural organisations that have tried to provide cultural offers that appeal to older people from diverse backgrounds. We will do this by spending time at six organisations that complete the questionnaire for the mapping referred to above. They will become our 'cases'. We will watch what happens there. We will also talk to people who work for the organisation or older people from ethnic minority groups engaging with it. We will pick these six cases so they are varied in terms of a) where they are located in the UK, b) groups they aim to attract, c) type of cultural offer provided, d) size of the organisation/operation. We will compare and contrast what we learn from each case. We will explain differences that may arise across these cases.

We will develop an explanation of how, why and in what circumstances cultural provision that could form part of a social prescription might be beneficial (or not) to the well-being of older people from ethnic minority groups.

For further details, please contact one of the study's principal investigators:

• Stephanie Tierney (stephanie.tierney@phc.ox.ac.uk)
• Kamal Mahtani (kamal.mahtani@phc.ox.ac.uk)

A protocol for the study can be found here.