Bridging health and community: descriptive analysis of social prescribing for older adults in Cambodia.

Background: Social prescribing supports individual well-being and community engagement by linking people to local resources. In Cambodia, members of the existing Village Health Support Groups have been trained as link workers to deliver social prescribing activities by leveraging existing resources in a limited-resource setting. However, the nature and functioning of social prescribing in limited-resource settings remain poorly understood. This study aims to describe the implementation of social prescribing in Cambodia and examine how a social prescribing intervention for older adults was associated with improved access to healthcare, greater community support, and reduced loneliness, providing initial insights to inform future implementation research. Methods: A cross-sectional study was conducted across ten Cambodian provinces among 1200 older adults aged 60 and above between 1 December 2024 and 31 January 2025. We interviewed older adults in each of the following groups using a structured questionnaire: Group 1 (n = 400, received social prescribing), Group 2 (n = 400, did not receive but lived in areas with trained link workers), and Group 3 (n = 400, lived in areas without trained link workers). Descriptive analyses were conducted to summarise the demographic and contextual characteristics of participants across the three groups. Additional descriptive analyses were conducted for Group 1 to summarise the characteristics of social prescribing activities, and qualitative responses were thematically analysed. Logistic regression analyses were conducted to examine associations between social prescribing exposure and key outcomes. The primary outcomes were overall health status and loneliness. Secondary outcomes included consultation opportunities, healthcare access, unmet needs, and health status. Two comparisons were made: recipients versus non-recipients within trained areas (Group 1 vs Group 2) and non-recipients in trained versus non-trained areas (Group 2 vs Group 3). Models were adjusted for age, sex, marital status, education, household size, and IDPoor Equity Card status-a government measure of household poverty. Findings: Among those who received social prescribing, information was most commonly provided by Village Health Support Groups (82.7%) and village leaders (76.9%) and were most often delivered at home (55.2%). Referrals were mainly to health facilities (84.3%) and community activities (77.2%), and also included counselling at pagoda (20.6%), mental health support (21.4%), and daily life assistance (17.0%). 98.9% of participants reported that social prescribing was helpful. Enhanced health literacy, practical support, and improved psychosocial well-being emerged as themes from the qualitative analysis of the semi-structured interviews, health literacy, practical support, and improved psychosocial well-being emerged as themes from the qualitative analysis of the semi-structured interviews. Compared to Group 2, Group 1 was significantly associated with greater opportunities to consult with community supporters (multivariable-adjusted OR (aOR) 1.65, 95% CI 1.24-2.20, Interpretation: Social prescribing in Cambodia, delivered through existing Village Health Support Groups, appeared feasible and was perceived as highly helpful by older adults. Descriptive findings suggest that trained link workers may enhance community support in limited-resource settings. These insights offer an initial understanding of how social prescribing functions in low-resource contexts and can inform future implementation research. Funding: World Health Organization Regional Office for the Western Pacific.