Long Term Effects of a Social Capital-Based Exercise Adherence Intervention for Breast Cancer Survivors With Moderate Fatigue: A Randomized Controlled Trial.

OBJECTIVES: This study reports on the long-term effects of the Better Life After Cancer: Energy, Strength, and Support (BLESS) program, a 12-week social capital-based exercise adherence program for breast cancer survivors (BCS), implemented using a randomized controlled trial design. The study investigated outcomes related to cancer-related fatigue (CRF), quality of life (QOL), physical activity, depression, anxiety, sleep quality, and social capital. METHODS: Participants who had moderate or greater CRF were randomly assigned to the intervention (n = 24), consisting of supervised and home-based exercise, or the control (n = 26), who received exercise leaflets. Generalized estimating equations models were fitted for the outcome variables. The assessment points were baseline (M1), immediately after completing the intervention at 12 weeks (M2), 1 month (M3), and 6 months post-intervention (M4). RESULTS: A significant reduction in the total CRF score was found for both groups. We observed a significant time by group effect at M2, indicating a reduction of behavioral/severity CRF scores and a higher increase of physical activity. Also, there was an increase in the QOL score of both groups at M2, M3, and M4, compared to M1. Both groups had reduced anxiety at M3 and M4 compared to M1. The time by group effect for depression, sleep quality and social capital was not statistically significant. CONCLUSION: This 12-week exercise adherence program improved behavioral/severity CRF and physical activity post-intervention. Both the experimental group and control group showed significant improvements in CRF, QOL, and anxiety domains compared to the baseline, which extended to 6 months post-intervention. TRIAL REGISTRATION: Korean Clinical Research Information Service (KCT0005763).

The study protocol for the randomized controlled trial of the effects of a theory-based intervention on resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers.

BACKGROUND: The workplace has been identified as a key determinant of health status. There is evidence of innumerable health problems among employees, particularly healthcare workers. Against this background, a holistic-systemic approach together with a good theoretical framework is required to reflect on this issue, and to support the design of effective interventions to promote the health and wellbeing of the given population. The present study aims to evaluate the effectiveness of an educational intervention in improving resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers, utilizing the Social Cognitive Theory integrated into the PRECEDE-PROCEED model. METHODS: This randomized controlled trial will be performed on a large sample of the employees working in two healthcare centers in the city of Shiraz, Iran. The study will proceed with the healthcare workers of one city being given the educational intervention and the healthcare workers of the other city serving as a control group. Using a census method, all healthcare workers in the two cities will be informed of the trial and its purpose, and then invitations to join the study will be issued. The minimum sample size required has been calculated as 66 individuals in each healthcare centers. Recruitment to the trial will by systematic random sampling of eligible employees who submit an expression of interest in joining the trial, and subsequently give informed consent. Data will be collected through a self-administered survey instrument at three stages: at baseline, and both immediately and three months after the intervention. The experimental group members should participate in at least eight of the ten weekly educational sessions of the intervention and complete the surveys in the three stages. There is no educational intervention for the control group, and they simply experience some routine programs, and complete the surveys at the same three timepoints. DISCUSSION: The findings will provide evidence for the possible effectiveness of a theory-based educational intervention to improve resilience, social capital, psychological wellbeing, and health-promoting lifestyle among healthcare workers. If the educational intervention is found to be effective, then its protocol will be exploited in other organizations to boost resilience. Trial registration IRCT20220509054790N1.

Componente curricular projeto de vida: perspectivas de professoras da rede estadual de São Paulo / Curricular component life purpose: perspectives of teachers of the São Paulo state network / Componente curricular proyecto de vida: perspectivas de profesores de la red estadual de São Paulo

O objetivo deste estudo foi conhecer a experiência de alguns professores ao lecionar projeto de vida durante a implementação do componente curricular Projeto de Vida no estado de São Paulo. Realizou-se uma pesquisa qualitativa, de caráter exploratório. Participaram do estudo sete professoras que lecionavam o componente curricular Projeto de Vida em duas escolas públicas, de uma cidade do interior do estado de São Paulo, escolhidas por conveniência. Foram utilizados o Questionário de Dados Sociodemográficos e o Protocolo de Entrevista Semiestruturada para Projeto de Vida de Professores, elaborados para este estudo. As professoras foram entrevistadas individualmente, on-line, e as entrevistas foram gravadas em áudio e vídeo. Os dados foram analisados por meio de análise temática. Os resultados indicaram possibilidades e desafios em relação à implementação do componente curricular Projeto de Vida. Constatou- se que a maioria das docentes afirmou que escolheu esse componente curricular devido à necessidade de atingir a carga horária exigida na rede estadual. As professoras criticaram a proposta, os conteúdos e os materiais desse componente curricular. As críticas apresentadas pelas professoras estão em consonância com aquelas presentes na literatura em relação à reforma do Ensino Médio e ao Inova Educação. Esses resultados sugerem a necessidade de formação tanto nos cursos de licenciatura quanto em ações de formação continuada, para que os professores se sintam mais seguros e preparados para lecionar o componente curricular Projeto de Vida na Educação Básica. Propõe-se uma perspectiva de formação pautada na reflexão e na troca entre os pares para a construção de um projeto coletivo da escola para o componente Projeto de Vida.(AU)

This study aimed to know the experience of some teachers when teaching life purpose during the implementation of the curricular component "Life Purpose" (Projeto de Vida) in the state of São Paulo. A qualitative, exploratory research was carried out. Seven teachers who taught the curricular component "Life Purpose" (Projeto de Vida) in two public schools in a city in the inland state of São Paulo, chosen for convenience, participated in the study. The Sociodemographic Data Questionnaire and the Semi-structured Interview Protocol for Teachers' Life Purposes, developed for this study, were used. The teachers were interviewed individually, online, and the interviews were recorded in audio and video. Data were analyzed using thematic analysis. The results indicated possibilities and challenges regarding the implementation of the Life Purpose curricular component. It was found that most teachers chose this curricular component due to the need to reach the required workload in the state network. The teachers criticized the proposal, the contents and the materials of this curricular component. Teacher's critics are in line with the criticisms present in the literature regarding the reform of High School and Inova Educação. Therefore, training is essential, both in undergraduate courses and in continuing education actions, so that teachers can teach the curricular component Life Purpose in Basic Education. A training perspective based on reflection and exchange between peers is proposed for the construction of a collective school project for the Life Purpose component.(AU)

El objetivo de este estudio fue conocer la experiencia de algunos profesores al enseñar proyecto de vida durante la implementación del componente curricular Proyecto de Vida en el estado de São Paulo. Se realizó una investigación cualitativa, exploratoria. Participaron en el estudio siete profesores que impartían el componente curricular Proyecto de Vida en dos escuelas públicas en un municipio del estado de São Paulo, elegidos por conveniencia. Los instrumentos utilizados fueron el cuestionario de datos sociodemográficos y el protocolo de entrevista semiestructurada para proyectos de vida de profesores, desarrollados para este estudio. Las entrevistas a los profesores fueron en línea, de manera individual, y fueron grabadas en audio y video. Los datos se sometieron a un análisis temático. Los resultados indicaron posibilidades y desafíos en relación a la implementación del componente curricular Proyecto de Vida. La mayoría de los profesores declararon elegir este componente curricular por la necesidad de alcanzar la carga horaria requerida en la red estatal. Los profesionales criticaron la propuesta, los contenidos y los materiales de este componente curricular. Las críticas presentadas están en línea con las críticas presentes en la literatura respecto a la reforma de la educación básica e Inova Educação. Por lo tanto, la formación es fundamental, tanto en los cursos de grado como en las acciones de educación permanente, para que los profesores puedan impartir el componente curricular Proyecto de Vida en la educación básica. Se propone una formación basada en la reflexión y el intercambio entre pares para la construcción de un proyecto escolar colectivo en el componente Proyecto de Vida.(AU)

COVID-19 Risk Management and Stakeholder Action Strategies: Conceptual Frameworks for Community Resilience in the Context of Indonesia.

The coronavirus disease (COVID-19) pandemic has affected people's lives globally. Indonesia has been significantly affected by this disease. COVID-19 has also affected certain social and economic aspects of Indonesia, including community resilience. Through a variety of contexts and geographic locales, we explore the previously mentioned concept of resilience. From existing literature reviews, we develop a holistic framework for community resilience during the COVID-19 pandemic. Then, we formulate crucial factors for community resilience during the COVID-19 pandemic: natural capital, social capital, human capital, stakeholder engagement, community participation, technology, and communication. Strategic stakeholder action in the community resilience domain has facilitated increases in economic as well financial capital for adapting to and surviving deficits in productivity in the face of the COVID-19 pandemic. This study is a reflection on and a comparative review of the existing literature from different countries.

Intergenerational Taekwondo Program: A Narrative Review and Practical Intervention Proposal.

Taekwondo is a modernized martial art that includes various combinations of hand and kicking techniques and core values of Taekwondo philosophy such as courtesy, mutual respect, and self-control. Physical inactivity is highly prevalent among older adults and is a major contributor to health-related problems. Intergenerational physical activity programs are used as an effective tool to make a positive connection between generations and provide additional health benefits for both generations. This review study aimed to examine the theories of intergenerational physical activity programs and propose the Intergenerational Taekwondo Program (ITP). Various theories such as the transtheoretical model, contact theory, social capital theory, situated learning theory, human development theory, personality theory, and whole-person wellness model have been adopted in intergenerational physical activity programs. Our review suggests that to develop the Intergenerational Taekwondo Program, instructors should (1) establishing common goals, (2) understand differences in physical and mental abilities, and (3) offer incentives to encourage participants in physical activity programs. The proposed ITP program has the potential to not just provide unique inherent values and improving physical functions, but also to form generational connections.

Social Capital as a Predictor of Quality of Life: The Czech Experience.

In the paper, we understand social capital as a variable that affects the quality of life. A variable whose change affects another variable is called a predictor. The paper is based on Putnam's understanding of social capital with the dimensions of trust, norms and networks. Trust is considered the most important dimension, and for the purposes of the paper social capital is identified with trust. Quality of life is a holistic concept with two dimensions expressing an assessment of satisfaction with life. After society became richer-in the 1960's in the West and, after the collapse of the bipolar world, also in Central and Eastern Europe-the need for quantity was replaced by the need for quality. The paper is focused on Czechia, with social capital as a predictor of quality of life being investigated geographically at the level of districts. According to the research hypothesis, social capital will have a strong influence on the quality of life of residents in Czechia, i.e., it will be its predictor. To test the validity of the research hypothesis, research was conducted. The aim of the paper is to outline the epistemology of social capital from the aspect of quality of life, description of quality of life and then to test the validity of the research hypothesis by measurements. The result of the quantification of social capital and quality of life at the level of districts and their correlation is important from an epistemological point of view for two reasons. The first is to question the generally accepted premise of the position of social capital as a strong predictor of quality of life. The second is the recognition that the premise of the position of social capital as a strong predictor of quality of life applies in the districts with the highest quality of life.

Using an arts-based approach to explore the building of social capital at a therapeutic recreation camp.

Therapeutic recreation is beneficial for people with and without disabilities, promoting an empowered, connected, and joyful life. The present study aimed to analyse canvas art created on a therapeutic recreation programme called Recovery Camp, to discover what they reveal about the shared experiences which have occurred. This study utilized an arts-based research method and thematic analysis to discover what participants have communicated via their artwork from ten camps between 2018 and 2019. This study adheres to the COREQ guidelines for qualitative studies. Reflexive thematic analysis produced subthemes which informed three main themes and an identified core meaning of Social Capital. The three main themes were Togetherness and teamwork, Positivity, and Gratitude for Recovery Camp. Based on these findings, canvas art has revealed that shared experiences during a therapeutic recreation camp were positive and connecting. Social capital was created and bridged at Recovery Camp through teamwork and prosocial attitudes. Gratitude has also been disclosed by participants for their shared positive experience.

Dimensions of social and political capital in interventions to improve household well-being: Implications for coffee-growing areas in southern Colombia.

This paper studies the influence of community capitals on well-being through a Community Capital Index (CCI) within coffee-growing families in southern Colombia. Our results show different farm typologies, with different levels of capital endowment translated into well-being that, in our case, were represented in the CCI. Specifically, social and political capitals positively affect coffee-growing families' decisions in terms of life strategies. The results of this study increase our understanding of welfare enhancement and its relationship with capital endowment according to the type of coffee producer, having implications for the planning of more effective programs towards the improvement of quality of life.

Psychological capital, well-being, and patient safety attitudes of nurses and midwives: A cross-sectional survey.

Nursing and midwifery are unarguably stressful endeavors requiring high levels of psychological capital and coping strategies. The impact of the work environment on patient safety outcomes suggests that high nurse/midwife stress may be associated with more adverse patient events. The purpose of this study was to explore the psychological capital of clinical nurses and midwives and identify explanatory factors (including psychological capital, well-being, and health-related behaviors) contributing to attitudes to patient safety. A descriptive web- and paper-based survey comprising a convenience sample of nurses and midwives in acute health facilities in Sydney, Australia, was performed (October 2018 and April 2019). Variables included psychological capital, psychological well-being, work culture, and attitudes to patient safety. Descriptive statistics were performed and a regression model was specified (a statistical significance of P < 0.05 was set a priori). Psychological capital, depression score, and work engagement had a significant effect on patient safety perceptions when controlling for other factors. The findings suggest that nurse and midwife well-being is an important consideration when striving to improve patient safety.

Systematic framework to assess social impacts of sharing platforms: Synthesising literature and stakeholder perspectives to arrive at a framework and practice-oriented tool.

(1) BACKGROUND: Research and user experience suggests both positive and negative social impacts resulting from practices in the sharing economy: social cohesion vs. gentrification; inclusiveness vs. discrimination; flexible employment vs. exploitation. However, as yet, there is no framework for understanding or assessing these social impacts holistically. (2) OBJECTIVE: We aim to improve understanding of the social impacts of sharing platforms and develop a systematic framework to assess these impacts. (3) METHODS: We conduct a narrative literature review and stakeholder workshop, integrating insights to produce a systematic social impact assessment framework and a practice-oriented tool. (4) RESULTS: We identify four social aspects-trust, empowerment, social justice, and inclusivity-and eighteen indicators that make up the framework. We describe each indicator and its relevance to the sharing economy as well as suggest measurable variables in the form of a practice-oriented tool. (5) CONCLUSIONS: The framework and tool are the first holistic method for assessing social impact in the sharing economy, which may inform researchers, sharing platforms, regulators, investors, and citizens to mitigate adverse social impacts while enhancing the overall net social value of the sharing economy.

Spiritual Capital: A Framework for Spirituality-Infused Leadership Education and Organizational Spirituality.

This chapter introduces the spiritual capital discourse and spiritual capital theory (SCT). By extending the leadership-spirituality intersect with the notion of "capital," it confirms the value proposition of spirituality for leadership development and extends the discourse to include "structure," an aspect with which leadership theory struggles.

The effect of health on social capital; a longitudinal observation study of the UK.

BACKGROUND: UK health policy increasingly focusses on health as an asset. This represents a shift of focus away from specific risk factors towards the more holistic capacity by which integrated care assets in the community support improvements in both health and the wider flourishing of individuals. Though the social determinants of health are well known, relatively little research has focussed on the impact of an individual's health on their social outcomes. This research investigates how improved health can deliver a social return through the development of social capital. METHODS: An observational study is undertaken on 25 years of longitudinal data, from 1991, drawn from the harmonised British Household Panel Survey (BHPS) and Understanding Society Survey (USS). Fixed effects instrumental variable panel data regression analysis is undertaken on individuals. The number of memberships of social organisations, as a measure of structural social capital, is regressed on subjectively measured general health and GHQ12 (Likert) scores. Distinction is drawn between males and females. RESULTS: Improved general health increases social capital though differences exist between males and females. Interaction effects, that identify the impacts of health for different age groups, reveal that the effect of increased health on social capital is enhanced for males as they age. However, in the case of females increases in general health increase social capital only in connection with their age group. In contrast mental illness generally reduces social capital for males and females, and these effects are reduced through aging. CONCLUSIONS: Investing in health as an asset can improve the social outcomes of individuals. Increasing the outcomes requires tailoring integrated care systems to ensure that opportunities for social engagement are available to individuals and reflect age groups. Targeting improvements in mental health is required, particularly for younger age groups, to promote social capital. The results suggest the importance of ensuring that opportunity for engagement in social and civic organisation be linked to general and mental health care support.

Evaluating the holistic costs and benefits of corn production systems in Minnesota, US.

Global agriculture aims to minimize its impacts on environment and human health while maintaining its productivity. This requires a comprehensive understanding of its benefits and costs to ecosystems and society. Here, we apply a new evaluation framework developed by the Economics of Ecosystems and Biodiversity for Agriculture and Food (TEEBAgriFood) to assess key benefits and costs on the production side of genetically modified (GM) and organic corn systems in Minnesota, USA. The market value of GM corn is $4.5 billion, and only $31.8 million for organic corn using production data and market prices of 2017. GM corn generates revenue of $1488 per hectare (at $121 per MT), which is significantly lower than the organic corn at $2793 per hectare (at $294 per MT). Using a novel three-stage wellbeing valuation, analysis of the associations between corn production intensity and subjective measures of general health and wellbeing indicates that the total non-financial health cost associated with GM corn is $427.50 per hectare or $1.3 billion annually. We also find that the total annual environmental cost associated with GM corn production is $179 per hectare or $557.65 million within Minnesota. The use of the evaluation framework can help to improve decision making at farm and policy level to develop sustainable agriculture in order to minimize environmental and health related costs to society and economy.

Improving social functioning and life satisfaction among patients with personality dysfunction: Connectedness and engagement in integrative group treatment.

Reduced social impairment and improved life satisfaction are important objectives in group treatment for patients with personality dysfunction. Knowledge regarding patient characteristics and group treatment processes that contribute to these outcomes, however, remains limited. Dispositional connectedness, the valuing of interpersonal connections, may be an important patient factor that influences patients' experience of group treatment in ways that facilitate therapeutic benefits. The present study investigated the roles of dispositional connectedness and group engagement in contributing to improvement in social functioning and life satisfaction through integrative group treatment for personality dysfunction. Seventy-nine patients who completed an integrative group treatment programme were assessed for dispositional connectedness at baseline and social functioning and life satisfaction at pretreatment and posttreatment; each also provided ratings of group engagement during treatment. Regression analyses using bootstrap confidence intervals found significant indirect effects for dispositional connectedness regarding improvement in both social functioning and life satisfaction, through the mediating effect of group engagement. Thus, patients who entered treatment with tendencies towards interpersonal connectedness perceived a higher level of engagement in the group environment. Group engagement in turn contributed to greater improvement in social functioning and to greater improvement in life satisfaction following treatment. The findings indicate dispositional connectedness as a salient characteristic in selecting patients for group treatment and highlight the role of an engaged interpersonal climate in facilitating improvement in social functioning and life satisfaction.

The mediating role of social capital in the relationship between socioeconomic status and adolescent wellbeing: evidence from Ghana.

BACKGROUND: Social capital is generally portrayed to be protective of adolescents' health and wellbeing against the effects of socioeconomic inequalities. However, few empirical evidence exist on this protective role of social capital regarding adolescents' wellbeing in the low-and middle-income country (LMIC) context. This study examines the potential for social capital to be a protective health resource by investigating whether social capital can mediate the relationship between socioeconomic status (SES) and wellbeing of Ghanaian adolescents. It also examines how SES and social capital relate to different dimensions of adolescents' wellbeing in different social contexts. METHODS: The study employed a cross-sectional survey involving a randomly selected 2068 adolescents (13-18 years) from 15 schools (8 Senior and 7 Junior High Schools) in Ghana. Relationships were assessed using multivariate regression models. RESULTS: Three measures of familial social capital (family sense of belonging, family autonomy support, and family control) were found to be important protective factors of both adolescents' life satisfaction and happiness against the effects of socioeconomic status. One measure of school social capital (school sense of belonging) was found to augment adolescents' wellbeing but played no mediating role in the SES-wellbeing relationship. A proportion of about 69 and 42% of the total effect of SES on happiness and life satisfaction were mediated by social capital respectively. Moreover, there were variations in how SES and social capital related to the different dimensions of adolescents' wellbeing. CONCLUSION: Social capital is a significant mechanism through which SES impacts the wellbeing of adolescents. Social capital is a potential protective health resource that can be utilised by public health policy to promote adolescents' wellbeing irrespective of socioeconomic inequalities. Moreover, the role of the family (home) in promoting adolescents' wellbeing is superior to that of school which prompts targeted policy interventions. For a holistic assessment of adolescents' subjective wellbeing, both life evaluations (life satisfaction) and positive emotions (happiness) should be assessed concomitantly.

The Relationship between Social Cohesion and Urban Green Space: An Avenue for Health Promotion.

Social cohesion involves the interpersonal dynamics and sense of connection among people. Increased social cohesion can be associated with various physical and psychological health benefits. The presence of urban green spaces can encourage positive social interactions that cultivate social cohesion in ways that enhance health and well-being. Urban green spaces have also been linked to positive health behaviors and outcomes including increased physical activity and social engagement. Understanding the relationship between social cohesion and urban green space is important for informing holistic approaches to health. In this article, we discuss how positive interactions in urban green space can catalyze social cohesion, social capital and critical health-promoting behaviors that may enhance psychological health and well-being. We also summarize the strengths and limitations of previous studies and suggest directions for future research.

Collective Well-Being to Improve Population Health Outcomes: An Actionable Conceptual Model and Review of the Literature.

OBJECTIVES: To propose collective well-being as a holistic measure of the overall "health" of a community. To define collective well-being as a group-level construct measured across 5 domains (vitality, opportunity, connectedness, contribution, and inspiration) and introduce an actionable model that demonstrates how community characteristics affect collective well-being. To review the literature describing each domain's association with health outcomes and community characteristics' associations with collective well-being. METHODS: We came to consensus on topics describing each component of our conceptual model. Because "well-being" is not indexed in MEDLINE, we performed topic-specific database searches and examined bibliographies of papers retrieved. We excluded articles that were limited to narrow subtopics or studies within small subpopulations. Preference was given to quasi-experimental or randomized studies, systematic reviews, or meta-analyses. Consensus was reached on inclusion or exclusion of all articles. RESULTS: Reviewed literature supported each of the proposed domains as important aspects of collective well-being and as determinants of individual or community health. Evidence suggests a broad range of community characteristics support collective well-being. CONCLUSIONS: The health and quality of life of a community may be improved by focusing efforts on community characteristics that support key aspects of well-being. Future work should develop a unified measure of collective well-being to evaluate the relative impact of specific efforts on the collective well-being of communities.

Brothers Building Brothers by Breaking Barriers: development of a resilience-building social capital intervention for young black gay and bisexual men living with HIV.

Young Black gay/bisexual and other men who have sex with men (YB-GBMSM) are disproportionately impacted by HIV/AIDS. Novel intervention strategies are needed to optimize engagement in HIV care for this population. We sought to develop a group-level intervention to enhance resilience by augmenting social capital (defined as the sum of resources in an individual's social network) among YB-GBMSM living with HIV, with the ultimate goal of improving engagement in HIV care. Our multiphase, community-based participatory research (CBPR) intervention development process included: (1) Development and maintenance of a youth advisory board (YAB) comprised of YB-GBMSM living with HIV; (2) Qualitative in-depth interviews with YB-GBMSM living with HIV; (3) Qualitative in-depth interviews with care and service providers at clinics and community-based organizations; and (4) Collaborative development of intervention modules and activities with our YAB, informed by social capital theory and our formative research results. The result of this process is Brothers Building Brothers By Breaking Barriers, a two-day, 10-module group-level intervention. The intervention does not focus exclusively on HIV, but rather takes a holistic approach to supporting youth and enhancing resilience. Intervention modules aim to develop resilience at the individual level (exploration of black gay identity, development of critical self-reflection and coping skills), social network level (exploring strategies for navigating family and intimate relationships) and community level (developing strategies for navigating clinical spaces and plans for community participation). Most intervention activities are interactive, in order to facilitate new social network connections - and accompanying social capital - within intervention groups. In summary, our intensive CBPR approach resulted in a novel, culturally-specific intervention designed to enhance HIV care engagement by augmenting resilience and social capital among YB-GBMSM living with HIV.

Thinking about health care differently: nurse practitioners in primary health care as social entrepreneurs.

INTRODUCTION Challenges facing the primary health-care sector mean that policymakers and clinicians need to think and act differently to move forward. The principles of social entrepreneurship have been implemented successfully for improved health outcomes in other developed nations. There is a knowledge gap around whether nurse practitioners (NPs) in New Zealand primary health care (PHC) align with these principles. AIM To explore whether and how the innovative activities of primary care NPs can be described as socially entrepreneurial. METHODS A descriptive qualitative approach was used with data collected using semi-structured interviews with NPs working in primary care (n = 7). Data were analysed using general inductive thematic analysis techniques. RESULTS Nurse practitioners interviewed worked in government-subsidised private general practice businesses. Two main themes emerged: (1) the nursing model of care aligned with social entrepreneurship; and (2) building social capital. NPs described a desire to see health care delivered differently and this aligned with acting as a social entrepreneur. Social capital emerged through the requirement to establish significant collaborative relationships. DISCUSSION It was found that NPs' work can be described as socially entrepreneurial. The holistic, person and community-centred model of NP care has an ultimate mission of improved health outcomes. Social capital is built through collaborative relationships with other health-care providers, individual service users and the community. However, the juxtaposition of the business model in primary care prevents NPs from initiating and leading sustainable change.