Integrating Community and Digital Support Through Social Prescribing to Improve Mental Health in Rural Older Adults in South Korea: Quasi-Experimental Study

Background: Mental health issues such as depression, loneliness, and cognitive decline are prevalent among older adults. They are particularly pronounced in rural areas due to socioeconomic disadvantages, limited health literacy, and social isolation. These challenges have been exacerbated by the COVID-19 pandemic, highlighting the urgent need for accessible, community-based mental health strategies. Social prescribing-linking individuals to nonmedical community resources-offers a promising model, especially when coupled with culturally relevant and digitally facilitated interventions. Objective: This study aimed to evaluate the effectiveness of a pilot social prescribing project for individuals aged 65 years and older residing in rural South Korea. Specifically, it examined the changes in social support, loneliness, depression, cognitive function, and life satisfaction among the older adults before and after the intervention and the relationships among these factors. Methods: A quasi-experimental, nonequivalent control group pretest-posttest design was conducted with 294 participants from Wonju City, Gangwon-do (n=148 in the experimental group, n=146 in the control group). The 8-week intervention featured a community-based music storytelling program incorporating local cultural elements and digital education. Statistical analyses, including t tests, difference-in-differences analysis, and structural equation modeling, were conducted to evaluate changes in scores and the effectiveness of the program intervention. Results: The study confirmed that the social prescribing pilot project effectively reduced depression and increased social support and life satisfaction compared with the control group (P<.05, 95% CI). While cognitive function showed slight improvement, the change was not statistically significant. Social support emerged as a key mediating factor, positively influencing cognitive function and life satisfaction, and was negatively associated with depression. There was no statistically significant direct effect found between loneliness and cognitive function or social support. Conclusions: This pilot study supports the feasibility and mental health benefits of integrating community and digital support through culturally embedded social prescribing for rural older adults. The findings highlight the importance of leveraging local resources and social networks to address mental health disparities in underserved aging populations, offering valuable insights for policymakers and practitioners developing inclusive aging and health promotion strategies.