Building self-determination through the lens of the Circle of Courage: a qualitative evaluation of a social prescribing program for children and youth in Canada
Bibliographic record
Abstract
BACKGROUND: Social prescribing is gaining traction globally as a means to achieve global goals for health and wellbeing. In 2023, we launched a social prescribing program in a comprehensive, pediatric integrated health and social service hub in an underserved inner city neighbourhood in Ottawa, Ontario, Canada. The program targeted children and youth with poor social health, including social isolation and loneliness. Program participants were paired with a connector, who worked with them to explore their individual needs, strengths, and interests. Together, they created a social prescription for a child and youth-friendly community activity. The connector then provided a supported referral to aid the program participant in successfully completing their social prescription. The program was piloted at the hub over a period of ten months, during which time a program evaluation took place. As part of our program evaluation, we sought to explore the concept of self-determination, which is thought to be one of the guiding principles of social prescribing. While self-determination has been explored in adult social prescribing, it has not yet been examined in child and youth social prescribing. Thus, the aim of this evaluation was to explore the ways in which our social prescribing program may foster self-determination in children and youth. METHODS: A qualitative descriptive design was employed. Between November 2023 and February 2024, semi-structured interviews were conducted with 33 program participants and 30 caregivers at the six-month mark of enrollment in the program. Interview questions centered around program participants' and caregivers' experiences of the program. Interviews were audio recorded, transcribed verbatim, and anonymized. Using the Circle of Courage - a child and youth-focused theory on self-determination, we conducted deductive thematic analysis. RESULTS: The findings indicated that the program may foster self-determination through each component of the Circle of Courage: (1) Independence: The child's free will is nurtured by increased responsibility; (2) Belonging: The universal longing for human bonds is nurtured by relationships of trust; (3) Mastery: The child's inborn thirst for learning is nurtured; and (4) Generosity: The child's character is nurtured by concern for others. CONCLUSION: This evaluation has shed light on the ways in which social prescribing may foster self-determination in children and youth. The Circle of Courage may be a useful framework to explore the impact of other child and youth social prescribing programs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".