Black-focused social prescribing:the importance of an Afrocentric approach
PMCID: PMC11346758
PMID: 38916558
Abstract
Abstract The Black-Focused Social Prescribing (BFSP) project is a unique initiative by the Alliance for Healthier Communities that intertwines Afrocentric principles with social prescribing. Going beyond conventional social prescribing models, BFSP addresses specific health needs within Black communities. It is rooted in the Alliance Black Health Strategy, advocates for Black health, and is guided by Afrocentric principles. The evaluation framework prioritizes client voices, ensuring cultural safety and, by taking time for trust-building, underscores the importance of an inclusive approach. BFSP holds the potential to foster community trust and engagement, and enhance health outcomes in the Black community.
Full Text
Social prescribing integrates social and clinical aspects of health, and recognizes the interconnectedness of physical, mental and social well-being. Through social prescribing, a formal referral pathway documented in the client’s electronic medical record links them to local, nonclinical services to address issues such as social connectedness, mild depression or anxiety. Social prescribing emphasizes a strengths-based approach to co-creating solutions with clients, as well as regular collection of client self-reported experience measures as meaningful data. While social prescribing is effective in various communities, there is a growing acknowledgement of the necessity for tailored interventions addressing the unique experiences of ethnic and cultural populations.1 In this article, we delve into the importance of an Afrocentric approach within Black-focused social prescribing (BFSP), emphasizing cultural context and community focus in improving the health outcomes of Black individuals.
The Alliance for Healthier Communities, a network of community-governed, team-based primary health care organizations in Ontario, conducted Rx: Community—Social Prescribing,2 Canada’s first social prescribing research project, from 2018 to 2020. Over 1100 adult clients participated in the pilot at 11 community health centres. Nearly half were aged 61 to 80 years old and over a third identified as non-White. A mixed-methods evaluation was implemented using pre- and post-intervention surveys and focus groups to assess key themes and changes in self-reported health outcomes. Participants reported reduced stress and anxiety, increased self-confidence and purpose, and improved health management skills. The pilot demonstrated improvements in client well-being, including perceived decreases in loneliness and mental health, and an increase in participation in social activities. Repeat visits to clinicians also decreased.2
The Black Health Strategy’s work informed the BFSP project, recognizing that social prescribing could be a valuable tool to address the unique needs of the Black population by incorporating cultural competence and targeted interventions that consider the historical and systemic factors influencing health and well-being in the Black community.3
The Black-Focused Social Prescribing project charter lists the three main goals of the project:4
An Afrocentric approach aims to celebrate and reinforce cultural identity within the Black communities by connecting individuals with culturally relevant resources, activities and support networks. An Afrocentric approach can be used to provide holistic, culturally appropriate health care.5
When creating programming for BFSP in a local community served by a CHC, taking into account the values of the different communities ensures that participants feel and share a sense of belonging. To ensure that programming reflects the local community’s cultural values, staff from the CHCs held a peer-led session to learn about Afrocentric perspectives, including the seven principles of Kwanzaa, which are derived from the Swahili language:6
TAIBU CHC introduced Kemetic yoga, an African-based movement system designed from African dance and ancestral teachings from the Kemetic people of ancient Egypt.7 This therapeutic practice was added to their social prescribing programs for Black seniors to provide an Afrocentric option rooted in the mind-body-spirit connection, holistic values and historical experiences of people of African descent. The program manager noted: “This not only nurtures physical health but also fosters a sense of cultural connection and self-awareness. Through social prescribing we have been able to offer our seniors a sense of belonging, enhancing their overall quality of life.”8
Several tools have emerged, including the Wheel of Life,9 a tailored BFSP version of the client referral form from the pilot that includes eight life domains: spiritual, family, health, finance, career, friends, growth, and social life, plus “other” (if a category needs to be replaced). This tool aids in identifying and prioritizing relevant client concerns, as well as creating meaningful and affirming social prescriptions. Moreover, Black patients, who have often faced harm in the health care system, find additional benefits in working with Black health care staff with shared lived experiences.
The evaluation framework is rooted in the Afrocentric principles and designed to ensure that client voices and experiences are brought into the centre of the evaluation, data collection, analysis and reporting. The framework, adapted from Hood et al.,10 is structured using the following criteria:
Sections
"[{\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B01\"], \"section\": \"Introduction\", \"text\": \"Social prescribing integrates social and clinical aspects of health, and recognizes the interconnectedness of physical, mental and social well-being. Through social prescribing, a formal referral pathway documented in the client\\u2019s electronic medical record links them to local, nonclinical services to address issues such as social connectedness, mild depression or anxiety. Social prescribing emphasizes a strengths-based approach to co-creating solutions with clients, as well as regular collection of client self-reported experience measures as meaningful data. While social prescribing is effective in various communities, there is a growing acknowledgement of the necessity for tailored interventions addressing the unique experiences of ethnic and cultural populations.1 In this article, we delve into the importance of an Afrocentric approach within Black-focused social prescribing (BFSP), emphasizing cultural context and community focus in improving the health outcomes of Black individuals.\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B02\", \"B02\"], \"section\": \"Rx: Community\\u2014Social Prescribing pilot project\", \"text\": \"The Alliance for Healthier Communities, a network of community-governed, team-based primary health care organizations in Ontario, conducted Rx: Community\\u2014Social Prescribing,2 Canada\\u2019s first social prescribing research project, from 2018 to 2020. Over 1100 adult clients participated in the pilot at 11 community health centres. Nearly half were aged 61 to 80 years old and over a third identified as non-White. A mixed-methods evaluation was implemented using pre- and post-intervention surveys and focus groups to assess key themes and changes in self-reported health outcomes. Participants reported reduced stress and anxiety, increased self-confidence and purpose, and improved health management skills. The pilot demonstrated improvements in client well-being, including perceived decreases in loneliness and mental health, and an increase in participation in social activities. Repeat visits to clinicians also decreased.2\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B03\"], \"section\": \"The Black Health Committee and Black Health Strategy\", \"text\": \"The Black Health Strategy\\u2019s work informed the BFSP project, recognizing that social prescribing could be a valuable tool to address the unique needs of the Black population by incorporating cultural competence and targeted interventions that consider the historical and systemic factors influencing health and well-being in the Black community.3\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B04\"], \"section\": \"Black-focused social prescribing project\", \"text\": \"The Black-Focused Social Prescribing project charter lists the three main goals of the project:4\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B05\"], \"section\": \"The Afrocentric perspective\", \"text\": \"An Afrocentric approach aims to celebrate and reinforce cultural identity within the Black communities by connecting individuals with culturally relevant resources, activities and support networks. An Afrocentric approach can be used to provide holistic, culturally appropriate health care.5\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B06\"], \"section\": \"Traditional knowledge\", \"text\": \"When creating programming for BFSP in a local community served by a CHC, taking into account the values of the different communities ensures that participants feel and share a sense of belonging. To ensure that programming reflects the local community\\u2019s cultural values, staff from the CHCs held a peer-led session to learn about Afrocentric perspectives, including the seven principles of Kwanzaa, which are derived from the Swahili language:6\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B07\", \"B08\"], \"section\": \"\", \"text\": \"TAIBU CHC introduced Kemetic yoga, an African-based movement system designed from African dance and ancestral teachings from the Kemetic people of ancient Egypt.7 This therapeutic practice was added to their social prescribing programs for Black seniors to provide an Afrocentric option rooted in the mind-body-spirit connection, holistic values and historical experiences of people of African descent. The program manager noted: \\u201cThis not only nurtures physical health but also fosters a sense of cultural connection and self-awareness. Through social prescribing we have been able to offer our seniors a sense of belonging, enhancing their overall quality of life.\\u201d8\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B09\"], \"section\": \"Working collectively\\u2014thinking as a village\", \"text\": \"Several tools have emerged, including the Wheel of Life,9 a tailored BFSP version of the client referral form from the pilot that includes eight life domains: spiritual, family, health, finance, career, friends, growth, and social life, plus \\u201cother\\u201d (if a category needs to be replaced). This tool aids in identifying and prioritizing relevant client concerns, as well as creating meaningful and affirming social prescriptions. Moreover, Black patients, who have often faced harm in the health care system, find additional benefits in working with Black health care staff with shared lived experiences.\"}, {\"pmc\": \"PMC11346758\", \"pmid\": \"38916558\", \"reference_ids\": [\"B10\"], \"section\": \"Evaluation framework\", \"text\": \"The evaluation framework is rooted in the Afrocentric principles and designed to ensure that client voices and experiences are brought into the centre of the evaluation, data collection, analysis and reporting. The framework, adapted from Hood et al.,10 is structured using the following criteria:\"}]"
Metadata
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