The SPHERE model
Social Prescribing and Health Equity through Responsive Evaluation
Bibliographic Data
| ID | 22086650 |
|---|---|
| Authors | Bo Kim (0000-0001-7730-1627, Harvard University, corresponding author) |
| Year | 2026 |
| Volume | 13 |
| Pages | 1696615-1696615 |
| Publication date | 2026-02-18 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2025.1696615 |
| PMID | 41788224 |
| OpenAlex | W7130401182 |
| Language | EN |
| References cited | 29 |
Social prescribing has emerged as a promising approach to improve health and advance health equity by connecting individuals to non-clinical services that address social determinants of health, such as housing, food access, legal aid, and community-based supports. While referral pathways and link worker roles have received significant attention, far less focus has been given to the public policies that govern access to these services. The success and sustainability of social prescribing efforts depend on whether these enabling policies are well-implemented, community-responsive, and rigorously evaluated, yet few models exist to guide this work. The SPHERE model—Social Prescribing and Health Equity through Responsive Evaluation—addresses this gap. Drawing from implementation science, evaluation theory, and health equity-centered design, SPHERE extends existing implementation frameworks by focusing on how public policies themselves function as implementation infrastructure for social prescribing. The model was refined through considering policy examples and aligning with operational realities of cross-sector, referral-based health systems. SPHERE consists of eight interrelated components: (i) Policy Foundation; (ii) Implementation Infrastructure; (iii) Community Engagement and Co-Production; (iv) Contextual Assessment; (v) Implementation Strategies; (vi) Process Measures; (vii) Outcome Measures; and (viii) Feedback Loops and Learning Mechanisms. These components are grounded in health equity principles and designed to support adaptive and accountable policy delivery. This article illustrates the model’s relevance through three examples of policies that enable social prescribing: Housing First initiatives, Medicaid reentry provisions, and local food policy councils. SPHERE positions policy as a critical, actionable driver of social prescribing systems, helping ensure enabling policies are not only enacted but implemented in community-responsive ways. By integrating SPHERE into the design, implementation, and evaluation of policies that enable social prescribing, governments and communities can transform referral systems into adaptive, health equity-driven platforms for structural change
Health equity · Health promotion · Medicaid · Public health · Public policy · Social determinants of health · Art Therapy and Mental Health · Community Health and Development · Homelessness and Social Issues · Health Policy
Implementation Research in Mental Health Services
Social prescribing
Making sense of implementation theories, models and frameworks
Meanings and Misunderstandings
Social prescribing
RE-AIM Planning and Evaluation Framework
A refined compilation of implementation strategies
A new framework for developing and evaluating complex interventions
Systems science and systems thinking for public health
Fostering implementation of health services research findings into practice
Implementation of carceral medicaid suspension and enrollment programs
The process of co‐designing a model of social prescribing
Non-clinical community interventions
What approaches to social prescribing work, for whom, and in what circumstances? A realist review
Participatory action research
Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis
Advancing health equity through implementation science
| Highly cited | No |
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