Associations of dietary quality and physical activity with glycemic control in patients with type 2 diabetes: the moderating role of trait mindfulness.

Health and well-being are shaped by the social, economic, and environmental conditions in which people live, and not solely by biomedical factors (, ). Many health systems continue to face persistent challenges related to loneliness, financial strain, housing insecurity, poor mental well-being, and limited opportunities for community participation, all of which are associated with poorer health outcomes and increased demand for health and social care (). These unmet social and practical needs contribute to avoidable illness, reduced quality of life, and pressure on services that are primarily designed to respond to clinical problems. Because conventional clinical encounters often lack the time, resources, or community links needed to address these wider determinants, interest has grown in approaches that connect individuals with community-based support. Social prescribing (SP) has emerged as one such approach, connecting people with non-clinical resources intended to enhance social connection, daily functioning, and overall well-being (, ). SP is commonly described as an umbrella term for community-linked programs that provide personalized support. Broad categories include link worker models, creative and cultural activities, nature-based initiatives, opportunities for learning or volunteering, and practical assistance with social or welfare needs (, ). Although these approaches differ in format and delivery, they collectively aim to complement clinical care by connecting individuals with community-based support. Existing reviews of nature-based interventions, programs for older adults, and community mental health initiatives illustrate the breadth of modalities and populations encompassed by SP, as well as the diversity of contexts in which such programs are implemented (). SP is not a single standardized intervention but a family of approaches that vary in intensity, referral pathway, professional involvement, and relationship with community assets. A useful way to characterize this diversity is provided by a three-tier social identity framework, which situates SP along a continuum from upstream, largely incidental forms to downstream, explicitly purposive forms (). At the upstream end, Tier 1 comprises community initiatives and social infrastructure, such as libraries, parks, community centers, and neighborhood activities, that build social connection at a population level, often as a by-product of everyday community life rather than as a targeted health intervention. Tier 2 consists of group programs directed at specific populations or needs, in which agencies or practitioners connect individuals to structured group activities intended to address social disconnection. At the downstream end, Tier 3 involves person-centered interventions in which an individual prescriber, such as a link worker, community navigator, or community connector, works directly with a single client who often presents with complex and long-standing needs. These tiers are interdependent rather than mutually exclusive, and a single community asset may function simultaneously as a community initiative and as a site for targeted group activity. In some settings, particularly in Southern Europe and Latin America, related approaches may be described using different terminology, including assets recommendation, formal recommendation of community resources, health assets, or asset-based community approaches. These differences in terminology reflect variation in health system organization, primary care traditions, and the role of community health structures across countries.