Social prescribing for refugee populations: a rapid realist review of international evidence.

Background: Social prescribing offers potential for addressing social determinants of health and supporting health equity among disadvantaged groups. However, evidence for refugee populations remains limited, despite this group facing profound social and systemic barriers. This rapid realist review synthesizes social prescribing and comparable social-capital based intervention evidence to address this gap. Methods: We conducted a RAMESES-compliant rapid realist review supported by an expert advisory board. Searches across six databases (2014-2024) were supplemented by grey literature and citation chasing strategies. Eligible studies included refugee, asylum-seekers and forcibly displaced populations engaged in either formal social prescribing or comparably operationalized social-capital interventions. Synthesis developed Context-Mechanism-Outcome configurations organized into intervention families and articulated as If-Then programme theories. Results: From 7,436 records, 39 studies contributed to synthesis. As anticipated, formal social prescribing evidence was limited; findings are therefore substantially theory-informed extrapolations from social-capital interventions rather than direct evidence. Five intervention families were identified, spanning barrier-reduction, co-produced navigation, trauma-responsive, community-connected, and skills-training approaches. Of 15 prioritized programme theories, five demonstrated strong-to-moderate evidence, with the majority of actionable insights concentrated in appointment and onward referral stages. Discussion: Social prescribing appropriateness and effectiveness depends on alignment between contextual barriers, activated mechanisms, and support infrastructure. Three key cross-cutting concepts were identified: co-production as bidirectional exchange; safety as spatial and relational; and enabler provision as a barrier-matching requirement. Evidence limitations restrict wider generalizability, particularly regarding population reporting, further marginalized subgroups, and context considerations. Conclusion: Social prescribing for refugee support requires distinct consideration through adapted design, targeted barrier reduction, workforce investment, and genuine co-production with refugee-serving communities, rather than transferring dominant-population models. Evidence is strongest for in-appointment and onward referral strategies; access pathways into social prescribing remain the most critical evidence gap.