Social Prescribing Improving Mental Health Study

Study Overview
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Brief Summary
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This study aims to evaluate a new social prescribing service delivered by Mind Cymru in four communities in Wales. Mind Cymru have made a new social prescribing service, where a link worker works with a patient who has mild/moderate mental or emotional health problems, to understand their needs and set them goals for the future. The link worker will then help them find a service in their local community that might help them achieve their goals. The study uses a waitlist trial, which means that some participants will get to meet the link worker and have the intervention straight away, while others will have to wait for 20 working days. From this, the researchers can compare the people who had the intervention straight away with the people who had to wait. Scores on well-being, quality of life and loneliness questionnaires will be used to see the effects of the intervention on patients, whilst information like patient attendance at the General Practioner surgery will be used to see if there is a difference in the patient's use of health services.

Detailed Description
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This trial will employ a randomised wait-list control design. The study has been co-designed with the research team at University of South Wales, Mind Cymru, the link workers and General Practioners working within the study sites. The study will assess the effectiveness of services provided through making three sets of comparisons (based on a set of individual- and service-level outcomes over time - comparing between: - The four Local Mind sites (Merthyr and Valleys, Vale of Clwyd, Brecon and District, Ystradgynlais); Those who complete the intervention immediately, with those who are in the waitlist group; Those who fully complete the social prescribing intervention with those who do not complete or partially the full social prescription but receive care as usual (either because they do not attend or only partially attend); and Participants will be randomly allocated to receive the social prescribing link worker intervention either immediately, or after a waiting period of 20 working days. Participants will be recruited through consultations with healthcare professionals, either their General Practioner, a practice nurse or the Total Nurse Triage system within the doctors surgery. If the healthcare professional identifies that the prospective participant meets the eligibility criteria of the study (experiencing mild/moderate mental health and/or emotional wellbeing disorders, aged 18+ and registered with a General Practioners in Wales), they will provide the prospective participant with an information pack, and ask for permission to contact. If this permission is given they will be subsequently contacted by the link worker at least 2 working days later, to gain verbal consent and for baseline data collection and randomisation. The study recruitment target is 1,000 participants, randomized into two groups (a control group, n = 500 and an intervention group n = 500). The sample collected across the 3 General Practice clusters over the 24-month period that the study is open. An attrition rate of 5% is expected. Recruitment will end after 18-months, allowing for 6 months to complete the study and follow-up on participants. The service may continue independently of the study. Data will be collected at a maximum of five time points: Prior to randomisation to either the immediate or wait-list arm For wait-list controls: in a reminder telephone call at the end of the 20 day wait At the end of their intervention with the link worker Four weeks after the end of their intervention with the link worker Three months after the end of the previous data collection point Data will be collected either over the telephone or during the intervention with the link workers. All link workers who are collecting data will have study specific training for receiving consent and data collection. The study will take place over a 24-month period, with participant recruitment lasting a total of 18-months. Data analysis will take place at the end of the 24-month period, although transfer of data from the link workers to the research team at University of South Wales will be continuous over the 24-month period. A final report will be produced at the end of the study for the Welsh Government.

Official Title
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A Mental Health Social Prescribing Trial (Mind Cymru)

Conditions
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Mental Health Wellness 1

Intervention / Treatment
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* Behavioral: Immediate Appointment
* Behavioral: Delayed appointment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary care service users who are, at the point of referral: Experiencing mild/moderate mental health and/or emotional wellbeing disorders (e.g. anxiety or depression) Aged 18+ years Registered with a General Practioner in Wales Exclusion Criteria: Unable to give written, informed consent Unable to answer all questions (WEMWBS and EQ-5D) at baseline Worsening of mental health condition to the point where more intensive support is required

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This study will employ a randomised waitlist trial design with mixed methods using a co-productive participatory approach.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Immediate Appointment<br>Intervention group who receive the Social Prescription without delay. The effectiveness of the consultation and referral process will be assessed. | Behavioral: Immediate Appointment<br>* The participant will meet with the MIND Cymru link worker and decide upon a course of action requiring the use of local services appropriate for the participant.<br>|
| Active Comparator: Delayed Appointment<br>Waitlist control group who receive social Prescribing after a delay of 20 working days. The effectiveness of the consultation and referral process will be assessed. | Behavioral: Delayed appointment<br>* After a period of delay (Control) The participant will meet with the MIND Cymru link worker and decide upon a course of action requiring the use of local services appropriate for the participant.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline. The Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) Score | SWEMWBS is completed by the participants and allows self reflection on mental well-being before and during involvement in health enhancing activities. Each of the 7 statements can be scored 1 to 5, from none of the time to all of the time. A total score is calculated by summing the 7 individual statement scores. The minimum score is 7 and the maximum is 35. The higher score signifies better mental well-being. | At Baseline, 4 weeks and 3 months after randomisation. | 
| Change from Baseline. Recovering Quality of Life questionnaire (ReQol - 20) | The Recovering Quality of Life questionaire is completed by the participants and allows self-reporting on their journey to recovery. There are twenty statements with five answers, and can be scored 0-4. The minimum score is 0 and the maximum is 80, where 0 indicates poorest quality of life and 80 indicates highest quality of life. | At Baseline, 4 weeks and 3 months after randomisation | 
| Change from Baseline. The UCLA 3-Item Loneliness Scale | The UCLA 3-Item Loneliness Scale is completed by the participants and allows self-reporting of subjective feelings of loneliness and social isolation. There are three statements, with three answers, with hardly ever, scoring 1 and often scoring 3. The minimum score is 3 and the maximum 9. A score of 3-5 is considered not lonely and 6-9 lonely. | At Baseline, 4 weeks and 3 months after randomisation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Waitlist