Health & Social Care in the Community最新文献

{"title":"Green Social Prescribing: A Before and After Evaluation of a Novel Community-Based Intervention for Adults Experiencing Mental Health Problems","authors":"P. M. Darcy,&nbsp;H. Armitt,&nbsp;A. Hurd,&nbsp;L. W. Paton,&nbsp;P. C. L. White,&nbsp;P. A. Coventry","doi":"10.1155/hsc/2016261","DOIUrl":"https://doi.org/10.1155/hsc/2016261","url":null,"abstract":"<div>\u0000 <p>There is a strong body of evidence that points to the mental health and well-being benefits of nature alongside a growing evidence based on the health and well-being benefits of green social prescribing. Central to the UK government’s commitment to transform mental health services, seven successful ‘test and learn’ green social prescribing sites were identified across England, including the Humber and North Yorkshire green social prescribing programme. We used a cohort design to compare participants’ mental health and well-being outcomes before and after exposure to nature-based interventions offered via a referral from social prescribing organisations linked to the green social prescribing initiative. Data were collected between February 2022 and March 2023 using before and after questionnaires to determine the impact of green social prescribing on mental health and well-being outcomes using ONS-4 and Hospital and Anxiety Depression scales. In total, two hundred and twenty-three participants from across Humber and North Yorkshire were included in the cohort evaluation. Survey data were analysed quantitatively using descriptive and multivariable analyses. After adjustments for deprivation and health status, larger benefits for improvements in well-being were found to be associated with nature-based activities with durations of nine to 12 weeks compared to those with durations of one to four weeks. Horticultural and care farming activities were also shown to be associated with some improvements in well-being over nature-based sports and exercise activities. We have undertaken the first longitudinal and quantitative evaluation of the NHS England green social prescribing “test and learn” programme across Humber and North Yorkshire. Our evaluation in Humber and North Yorkshire showed green social prescribing is beneficial for mental health and well-being among community-based adults, suggesting potential as a timely and relevant community-based intervention to address the demand for mental health care in an era of high unmet need.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/2016261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stay or Return: A Qualitative Exploration of the Experiences of Malawian Migrants Who Returned From South Africa During Covid-19","authors":"Wilson Majee,&nbsp;Ifeolu David,&nbsp;Gashaye M. Tefera,&nbsp;Martina Lembani","doi":"10.1155/hsc/9508497","DOIUrl":"https://doi.org/10.1155/hsc/9508497","url":null,"abstract":"<div>\u0000 <p>Covid-19 created unprecedented disruptions on human migration. Business closures and travel bans disproportionately impacted economic migrants who were neither able to support their families nor travel to their home countries. The primary aim of the study was to explore the experiences of Malawian migrants who returned from South Africa during Covid-19. A secondary objective was to explore solutions to the migration-related challenges that migrants experienced. A qualitative approach involving 15 in-depth interviews with Malawian migrants living in South Africa who returned home during Covid-19 was used. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Three main themes emerged from the data and revolved around the migration stages, namely, the pre-return/departure stage, the travel/transit phase, and the return and reintegration. Within these migration phases, participants reported failure to integrate with host community, fear of dying in a foreign country, financial hardship, corruption, risk of contracting diseases due to limited hygiene, and economic hardships in the home country as some of the main challenges they dealt with. Reintegration with family members was generally very positive as most migrants indicated that their family members were happy to see them alive. To effectively mitigate these challenges at various phases of the migration cycle, there is a need for swift and better coordination and policy change at the governmental level to take actions that support and protect migrants, as well as community and individual level actions such as saving money for emergencies.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/9508497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Prescribing Data and Outcome Recording Practices: An Interview-Based Study Into the Opinions and Experiences of Social Prescribing Stakeholders in the Liverpool City Region, UK","authors":"F. Wobi,&nbsp;C. E. Brett,&nbsp;R. Harrison,&nbsp;T. M. Kidd,&nbsp;H. Timpson","doi":"10.1155/hsc/8094184","DOIUrl":"https://doi.org/10.1155/hsc/8094184","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Social prescribing (SP) is a system-wide approach to reducing health inequalities through nonclinical healthcare interventions. The aim of this study was to explore the practices undertaken and the opinions held by various stakeholders involved in SP in relation to data collection and information utilisation within and between SP programmes/schemes.</p>\u0000 <p><b>Methods:</b> Semistructured interviews were conducted with nine stakeholders involved in SP planning and delivery within the Liverpool City Region (LCR), including SP link workers, service managers and commissioners. A deductive thematic analysis approach was used to analyse the transcripts.</p>\u0000 <p><b>Results:</b> Three themes were identified pertaining to quantitative data recording, qualitative data recording and the utilisation of data. The interviews revealed considerable variations in systems and consistency of data collection among stakeholders. While some data were collected via existing outcome measurement tools, their adequacy for use within SP in particular was critiqued. Case studies and qualitative feedback (formal and informal) were more frequently used and were felt to be more effective in capturing impact. Strengths of data sharing included the creation of data intelligence to inform more targeted service provision. Knowledge of national guidance pertaining to SP data collection and outcome recording was lacking.</p>\u0000 <p><b>Conclusion:</b> Further research on the acceptability of incorporating further SP-specific indicators within commissioner reporting systems is needed, including formal acknowledgement of qualitative impact reporting on existing, quantitative health inequality indicators or key performance indicators. However, the burden of this on existing structures needs to be assessed. Support for data linkage arrangements and data recording processes, combined with wider routine outcome data recording, can support a targeted approach to increasing the evidence base for SP’s impact on health and wellbeing.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/8094184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Participation in Nature Prescriptions: Evidence From a Cross-Sectional Survey of Adults in Australia, India, Singapore, the United Kingdom, and the United States","authors":"Michelle Kondo,&nbsp;Deepti Adlakha,&nbsp;Melissa Marselle,&nbsp;Nicole Odell,&nbsp;Katarzyna Olcon,&nbsp;Katherine Deutsch,&nbsp;Xiaoqi Feng,&nbsp;Aaron Hipp,&nbsp;Thomas Astell-Burt","doi":"10.1155/hsc/6635387","DOIUrl":"https://doi.org/10.1155/hsc/6635387","url":null,"abstract":"<div>\u0000 <p>Cities, states, and countries across the globe are recognizing the interconnections of human and planetary health, and are investing in greening. Nevertheless, environmental improvements may not bring adequate changes in exposure needed to reduce chronic disease and improve mental health. Nature prescription, in which a health provider refers a patient to spend time outdoors, is a potential behavioral intervention that could connect people to accessible green spaces. However, formidable patient barriers could reduce the potential to scale-up implementation in equitable and sustained ways. We surveyed 2625 adult respondents within Australia, India, Singapore, the United States, and the United States about their perceptions of a set of seven potential barriers to participation in nature prescriptions. Analyses revealed that respondents in India and Singapore, although most aware of and experienced with nature prescriptions, reported facing greater barriers than in other countries. Weather was the most commonly reported barrier, followed by the lack of time and distance. A lack of interest was a greater barrier among young, urban respondents with a college degree. The barrier of the lack of company was greater for urban residents and for those experiencing financial difficulty. In addition, contrary to many prior studies, we observed greater overall perceived barriers for respondents with higher education levels. Many of the perceived barriers covered by our survey are structurally modifiable, and programs developing in each of these locations may draw from these findings to tailor outreach strategies.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/6635387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Physical Activity Through Social Prescribing: A Narrative Review of Literature on the Mechanisms of Change","authors":"Julie Sandell Jacobsen,&nbsp;Rasmus Østergaard Nielsen,&nbsp;Nanna Holt Jessen,&nbsp;Halfdan Thorsø Skjerning,&nbsp;Sebastian Skejø,&nbsp;Lene Gissel Rasmussen,&nbsp;Dea Kejlberg Andelius,&nbsp;Solvej Videbæk Bueno,&nbsp;Per Kallestrup,&nbsp;Jeanette Reffstrup Christensen,&nbsp;Knud Ryom","doi":"10.1155/hsc/3898705","DOIUrl":"https://doi.org/10.1155/hsc/3898705","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Social prescribing (SP) has received increasing interest in recent years due to its potential to encourage health-promoting behaviours, such as physical activity (PA). However, to develop effective SP interventions, it is critical to enhance our understanding of the mechanisms of change associated with SP and their potential to promote PA. This review aimed to synthesise the mechanisms of change in SP interventions and to develop a logic model illustrating a theoretical framework for SPs potential to promote PA.</p>\u0000 <p><b>Methods:</b> A narrative review was performed, including a systematic literature search in Medline, Embase and PsycINFO. The systematic literature search was finalised on 21 February 2023, and studies investigating mechanisms of change in SP interventions were included. Findings were synthesised and illustrated in a logic model illustrating how SP interventions may promote PA as an outcome.</p>\u0000 <p><b>Results:</b> The systematic literature search identified 340 studies, of which 11 met the inclusion criteria. The SP interventions comprised three processes: referral, linking and engagement. These processes influenced various mechanisms of change, which were classified into two perspectives. From a person-centred perspective, the mechanisms with the potential to promote PA comprised self-efficacy, motivation, empowerment and ‘having a voice’. These mechanisms were associated with crucial elements of SP, such as tailoring to needs, trusted relationships, nonstigmatising activities and peer-to-peer support. From a system-based perspective, the mechanisms with the potential to promote PA included system capacity and resources together with shared understanding and knowledge. These mechanisms were related to crucial elements of SP, including reliance on established communication and network, local agency and accessibility.</p>\u0000 <p><b>Conclusion:</b> A person-centred perspective describes SPs potential to promote PA through various mechanisms of change. However, these mechanisms appear to be intricately connected with the local context. Consequently, SP intervention research could benefit from incorporating contextual factors and, ideally, also integrating system thinking.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/3898705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting Staffs’ Beliefs About Values of Mealtime Situations for Long-Term Care Residents’ Health and Well-Being Into Practice: A Qualitative Study","authors":"Stefan Andersson,&nbsp;Anna Sandgren,&nbsp;Carina Werkander Harstäde,&nbsp;Kristiina Heikkilä,&nbsp;Erika Lagerbielke,&nbsp;Carina Persson","doi":"10.1155/hsc/7938096","DOIUrl":"https://doi.org/10.1155/hsc/7938096","url":null,"abstract":"<div>\u0000 <p>In the context of long-term care facilities, mealtime situations have been linked to residents’ health and well-being. The optimisation of mealtime situations is dependent on multiple aspects and is complex. To better understand this complexity, this qualitative study aimed to identify staffs’ beliefs about the values of mealtime situations for residents’ health and well-being and to explore the facilitators of, barriers to, and challenges and actions in accomplishing and upholding these values. The results demonstrated that staffs’ belief consisted of achieving social and relational values, vitality values, self-strengthening values and atmospheric values. During mealtimes, participating staff had to constantly balance these values in relation to mealtime situational preconditions and residents’ individual and communal needs. Experienced facilitators, challenges, barriers and actions could be traced to and explained by identified beliefs, implying that knowledge regarding beliefs about values could be helpful for understanding and managing the complexity inherent in the mealtime situation.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/7938096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Telemedicine With Life Satisfaction and Satisfaction With Care in Rural China","authors":"Xintong Zhao,&nbsp;Qi Wang,&nbsp;Shaojie Zhou,&nbsp;Miao Yu","doi":"10.1155/hsc/9651831","DOIUrl":"https://doi.org/10.1155/hsc/9651831","url":null,"abstract":"<div>\u0000 <p><b>Objectives:</b> The effectiveness of telemedicine in rural areas with low-quality primary care remains unclear. This study examined the relationship of telemedicine adoption with life satisfaction and satisfaction with care in rural China. It also investigated the association of telemedicine with health-seeking behaviour, healthcare utilisation and heterogeneity in the type of telemedicine collaboration and the quality of healthcare workforce.</p>\u0000 <p><b>Methods:</b> Data were retrieved from the China Livelihood Survey, a nationally representative multi-level survey conducted in 2021. Ordinary least-squares regression models were employed to analyse the relationship between telemedicine adoption at the village level and rural households’ life satisfaction and satisfaction with healthcare. Propensity score matching was used to address the potential selection bias.</p>\u0000 <p><b>Results:</b> A total of 4638 households were included in the analysis. The results show that telemedicine adoption in village clinics was associated with higher levels of life satisfaction and satisfaction with healthcare among rural households. This improvement was primarily attributed to an increased likelihood of seeking care at primary care facilities, rather than a reduction in healthcare expenditures. The association was stronger when village clinics collaborated with township health centres in telemedicine initiatives, compared to those partnering with higher-level hospitals. Moreover, the association was more pronounced in villages with lower-quality healthcare workers compared to those with higher-quality staff.</p>\u0000 <p><b>Conclusion:</b> These findings highlight telemedicine as an effective tool for improving rural residents’ satisfaction. Strategies such as promoting strengthened telemedicine collaboration at local levels and targeting telemedicine resources to remote areas with deficient primary care workforces are recommended to optimise telemedicine adoption in primary care in China and other developing countries.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/9651831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Influence of End-of-Life Care on the Quality of Death in Aging Individuals: A Representative Study Conducted in China","authors":"Zhuo Wang,&nbsp;Yunhui Wang,&nbsp;Rong Zhou,&nbsp;Shu Wen","doi":"10.1155/hsc/1550175","DOIUrl":"https://doi.org/10.1155/hsc/1550175","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> The relationship between end-of-life care and the quality of death remains inconclusive. This study explores the association between end-of-life care and the quality of death among aging individuals in China and examines its heterogeneity.</p>\u0000 <p><b>Methods:</b> This study utilized three waves of data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) focusing on aging individuals in their final phase of life (<i>N</i> = 9974). By employing structural equation modeling (SEM) and the SEM-based regression models, we examined the impact of end-of-life care on the quality of death among aging individuals.</p>\u0000 <p><b>Results:</b> These findings indicate that the current provision of end-of-life care falls short in improving the quality of death for aging individuals (<i>β</i> = −0.3177; <i>p</i> ≤ 0.001), while lifestyles factors have a significant positive effect (<i>β</i> = 1.7054; <i>p</i> ≤ 0.001). Furthermore, the impact of end-of-life care on the quality of death varies based on gender (<i>β</i> = −0.3370, −0.3301; <i>p</i> ≤ 0.001) and rural–urban disparities (<i>β</i> = −0.3768, −0.3083; <i>p</i> ≤ 0.001). Various aspects of end-of-life care exhibit distinct influences on specific dimensions of death quality in aging individuals.</p>\u0000 <p><b>Conclusion:</b> These results underscore the necessity of enhancing end-of-life and death education in China. It is essential to reshape traditional perspectives concerning life and death, raise awareness and acceptance of end-of-life care, increase the availability of end-of-life care services, and improve the professionalism of care.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/1550175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Mental Health, Major Conditions and Social Prescribing: A Rapid Review","authors":"A. Edwards-Smith,&nbsp;A. Ajiboye,&nbsp;S. Pywell,&nbsp;A. Kenyon,&nbsp;F. Routh,&nbsp;J. Williams","doi":"10.1155/hsc/2917260","DOIUrl":"https://doi.org/10.1155/hsc/2917260","url":null,"abstract":"<div>\u0000 <p>This rapid review explores the use of social prescribing for individuals with mental health needs. Mental health conditions are one of the six areas of focus in the UK government’s major conditions strategy, which aims to increase healthy life expectancy, alleviate pressure on the health system, and recognise the impact of comorbidity. It aims to improve the treatment of patients through the integration of mental health and physical health pathways. Social prescribing shows promise in contributing to positive mental health outcomes and could be a viable option as part of this strategy. Fifty-three articles were included in this rapid review from 4 databases (CINAHL, Cochrane, PubMed and Scopus) which discussed the use of social prescribing in addressing mental health conditions. Social prescribing activities, the roles and responsibilities of practitioners, and the need for further underpinning research are all explored. Overall, this review highlights the potential benefits of social prescribing for individuals with mental health conditions.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/2917260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Scope, Range and Use of Voluntary Sector Specialist Sexual Violence Services in England: Findings and Recommendations From a National Study","authors":"Caroline Bradbury-Jones,&nbsp;Sarah Damery,&nbsp;Kirsten Fruin,&nbsp;Clare Gunby,&nbsp;Jenny Harlock,&nbsp;Lucy Hebberts,&nbsp;Louise Isham,&nbsp;Anne-Marie Jones,&nbsp;Fay Maxted,&nbsp;Amelia Mighty,&nbsp;Priti Parmar,&nbsp;Laura Patterson,&nbsp;Jason Schaub,&nbsp;Fee Scott,&nbsp;Harriet Smailes,&nbsp;Debs Smith,&nbsp;Julie Taylor","doi":"10.1155/hsc/9368961","DOIUrl":"https://doi.org/10.1155/hsc/9368961","url":null,"abstract":"<div>\u0000 <p>Sexual violence is a global problem with significant individual and societal health and social costs. Services that support victim-survivors of sexual violence across a range of sectors are crucial. This study investigated the scope, range, funding and commissioning of voluntary sector specialist (VSS) sexual violence services in England and victim-survivors’ experiences of using such services. The specialist voluntary sector plays a pivotal role in providing crisis and longer-term support to victim-survivors. However, there is limited empirical evidence about the scope, range and use of VSS provision, or what victim-survivors value and want from services. The aim of the study was to address this gap and provide much-needed evidence to inform the VSS sector nationally. This co-produced study included five co-researchers and one co-applicant with lived experience of sexual violence. There were three empirical phases: (1) exploratory interviews with commissioners and service providers and focus groups with victim-survivors; (2) national survey of service providers and commissioners; (3) in-depth case study analysis in four areas of England. The purpose of this paper is to synthesise the findings from each of these phases and map them onto a conceptual model, encompassing six themes: the complex and precarious funding landscape; the challenge of competition for funding and contracts; the role of partnership working; the pressured environments within which VSS services work; the different roles, scope and eligibility of voluntary and statutory services within an area; the ways services are delivered, underpinned by services’ values and philosophies. The study provides new, empirical insights into how these arrangements affect those connected with the services—namely, staff, volunteers and victim-survivors. The paper sets out 14 recommendations for all parties involved in the funding and commissioning of specialist services, including commissioners, grant funders and VSS organisations in England.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/9368961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}