TY - JOUR
T1 - Exploring the contribution of social enterprise to health and social care: a realist evaluation
AU - Calo, Francesca
AU - Roy, Michael James
AU - Donaldson, Cam
AU - Teasdale, Simon
AU - Baglioni, Simone
N1 - Acceptance from webpage
OA article funded by RCUK block grant (MRC project) ET
CC-BY licence, funding note on VoR:
This work was supported by the Economic and Social Research Council [MR/L003287/1]; Medical Research Council [MR/L003287/1].
Project link added by library.
PY - 2019/2
Y1 - 2019/2
N2 - Since the late 1990s social enterprises have been increasingly utilised as a means of delivering of health and social care services. However, there is little evidence on if, and how, provision by social enterprise might achieve positive health outcomes, particularly in comparison to other modes of delivery. In this paper, we draw upon the multiple perspectives offered by stakeholders involved in a rural social enterprise initiative based in Scotland, UK, and in a nearby comparator public sector organisation. Both types of organisation aim to increase the physical activity levels of people with chronic health conditions. In order to gain perspectives on the range of mechanisms and outcomes involved in different types of organisation providing similar interventions, realist evaluation of data gathered from in-depth semi-structured interviews (n = 68) was undertaken. Interviews were carried out with beneficiaries, service providers and external stakeholders and Context-Mechanism-Outcome (CMO) configurations developed to support our explanations for how, and in what ways, social enterprise might impact differently on health. Our findings highlight that the social enterprise is differentiated from the publicly-run service in two distinct ways: firstly, the social enterprise was better able to flexibly deliver a bespoke programme designed around the needs of service users; and secondly, their role as a community ‘boundary spanner’ helped facilitate strong ties and feelings of connectedness between beneficiaries, organisational staff and community stakeholders. However, these advantages were significantly compromised when funding was constrained. Our findings serve as an important basis for future research to better understand the means by which social enterprises might deliver health outcomes, particularly in comparison with public sector providers.
AB - Since the late 1990s social enterprises have been increasingly utilised as a means of delivering of health and social care services. However, there is little evidence on if, and how, provision by social enterprise might achieve positive health outcomes, particularly in comparison to other modes of delivery. In this paper, we draw upon the multiple perspectives offered by stakeholders involved in a rural social enterprise initiative based in Scotland, UK, and in a nearby comparator public sector organisation. Both types of organisation aim to increase the physical activity levels of people with chronic health conditions. In order to gain perspectives on the range of mechanisms and outcomes involved in different types of organisation providing similar interventions, realist evaluation of data gathered from in-depth semi-structured interviews (n = 68) was undertaken. Interviews were carried out with beneficiaries, service providers and external stakeholders and Context-Mechanism-Outcome (CMO) configurations developed to support our explanations for how, and in what ways, social enterprise might impact differently on health. Our findings highlight that the social enterprise is differentiated from the publicly-run service in two distinct ways: firstly, the social enterprise was better able to flexibly deliver a bespoke programme designed around the needs of service users; and secondly, their role as a community ‘boundary spanner’ helped facilitate strong ties and feelings of connectedness between beneficiaries, organisational staff and community stakeholders. However, these advantages were significantly compromised when funding was constrained. Our findings serve as an important basis for future research to better understand the means by which social enterprises might deliver health outcomes, particularly in comparison with public sector providers.
KW - social enterprise
KW - health and social c are
KW - rural social enterprise initiative
U2 - 10.1016/j.socscimed.2019.01.007
DO - 10.1016/j.socscimed.2019.01.007
M3 - Article
VL - 222
SP - 154
EP - 161
JO - Social Science and Medicine
JF - Social Science and Medicine
SN - 0277-9536
ER -