EPIC-ND: a multi-site, randomised controlled trial evaluating the effectiveness of social prescribing for the unmet social needs of children with a neurodisability and their parent/carers - a study protocol

Abstract

Background: The social determinants of health contribute to health inequities experienced by children with neurodisability and pose barriers to engaging with healthcare systems. At an individual level, adverse social determinants of health are experienced as unmet social needs (USNs), for example, housing insecurity and financial hardship. Emerging evidence supports social prescribing interventions that systematically identify USNs and refer families to services to address these needs. This study aims to evaluate the effectiveness of a co-designed social prescribing programme to address the USNs of children with neurodisability and their parents/carers, its cost-effectiveness and cost-utility, and implementation and translation across the healthcare system.

Methods and analysis: The study will be conducted at the tertiary Paediatric Rehabilitation Services in New South Wales, Australia. A standardised screening tool will identify parents/carers experiencing USNs. Parents/carers who report one or more USN and consent will be eligible to participate in the randomised controlled trial. Participants will be randomised to an active control group or social prescribing intervention group (total sample size=392). The active control group will receive self-navigation via a resource pack containing information about services that can address USNs. The social prescribing intervention group will receive in-person Community Linker support, in addition to the resource pack. The screening tool, resource pack, and social prescribing intervention were co-designed with parents/carers of children with cerebral palsy and their healthcare professionals. The primary outcome is the effectiveness of interventions in reducing USNs. Secondary outcomes include parent/carer referrals to and engagement with support services, out-of-pocket expenses, child/young person and parent/carer health-related quality of life, parent/carer psychological distress, and child/young person hospital service use and emergency department presentations.