Abstract：
Social prescribing (SP) typically involves linking patients in primary care with a range of local, community-based, non-clinical services. While there is a growing body of literature investigating the effectiveness of SP in improving healthcare outcomes, questions remain about how such outcomes are achieved within the everyday complexity of community health systems. This qualitative case study, informed by practice theory, aimed to investigate how SP practices relevant to people at high risk of type 2 diabetes (T2D) were enacted in a primary care and community setting serving a multi-ethnic, socioeconomically deprived population. We collected different types of qualitative data, including 35 semi-structured interviews with primary care clinicians, link workers and SP organisations; 30 hours of ethnographic observations of community-based SP activities and meetings; and relevant documents. Data analysis drew on theories of social practice, including Feldman\'s (2000) notion of the organisational routine, which emphasises the creative and emergent nature of routines in practice. We identified different, overlapping ways of practising SP: from highly creative, reflective and adaptive (\'I do what it takes\'), to more constrained (\'I do what I can\') or compliant (\'I do as I\'m told\') approaches. Different types of practices were in tension and showed varying degrees of potential to support patients at high risk of T2D. Opportunities to adapt, try, negotiate, and ultimately reinvent SP to suit patients\' own needs facilitated successful SP adoption and implementation, but required specific individual, relational, organisational, and institutional resources and conditions. Feldman, M.S., 2000. Organizational Routines as a Source of Continuous Change. Organ. Sci. 11, 611-629.
摘要：
社会处方(SP)通常涉及将初级保健中的患者与一系列当地、以社区为基础,非临床服务。虽然有越来越多的文献研究SP在改善医疗保健结果方面的有效性，关于如何在社区卫生系统的日常复杂性中实现这些结果的问题仍然存在。这个定性的案例研究，以实践理论为依据，旨在调查如何在服务于多种族的初级保健和社区环境中制定与2型糖尿病（T2D）高危人群相关的SP实践，社会经济贫困人口。我们收集了不同类型的定性数据，包括对初级保健临床医生的35次半结构化访谈，联系工人和SP组织；对基于社区的SP活动和会议进行30小时的人种学观察；和相关文件。数据分析借鉴了社会实践理论，包括费尔德曼(2000)的组织例行程序概念，这强调了惯例在实践中的创造性和紧迫性。我们确定了不同的，练习SP的重叠方式：来自高度创造性，反射和自适应（\'我做它需要\'），更多的约束（\'我尽我所能\'）或兼容（\'我做我\'被告知\'）的方法。不同类型的实践处于紧张状态，并显示出不同程度的支持T2D高风险患者的潜力。适应的机会,尝试,谈判,并最终重新发明SP以满足患者自身的需求，促进了SP的成功采用和实施，但需要特定的个人，关系,组织,以及体制资源和条件。费尔德曼,M.S.,2000.组织惯例是持续变革的源泉。器官.Sci.11,611-629。
