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From Referrals to Relationships: Reframing Engagement as an Implementation Strategy and Outcome in Age-Friendly Care
Amanda L Sease1, Kimberly Posey2, Gina K Alexander2
1Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA.
Journal of Aging & Social Policy
|February 9, 2026
Summary
Many older adults struggle to connect with services due to motivational barriers, not just access issues. Building trust and aligning care with personal values are key to improving engagement and aging-in-place outcomes.
Area of Science:
- Gerontology
- Public Health
- Health Services Research
Background:
- Significant investment in age-friendly models and social prescribing has not fully resolved service disconnection for older adults.
- Existing services often align with identified needs, yet engagement remains a challenge.
Purpose of the Study:
- To investigate the engagement gap experienced by older adults in accessing services.
- To identify critical, often overlooked, drivers of service uptake and sustained engagement.
Main Methods:
- Analysis of findings from the Age-Friendly Integrative Mobile Services (AIMS) pilot program.
- Qualitative assessment of barriers including motivational factors, relational mistrust, and value misalignment.
Main Results:
- The engagement gap is significantly influenced by motivational barriers, relational mistrust, and value misalignment, comparable to access and infrastructure limitations.
- Motivational engagement, defined by aligning care with individual values, readiness, and trust, is a crucial factor for service uptake.
Conclusions:
- Addressing motivational barriers, fostering trust, and ensuring value alignment are essential for enhancing service uptake and engagement among older adults.
- Implementation strategies should prioritize relational support and meaningful care to improve aging-in-place outcomes and equity.
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