How shared-site intergenerational programs support psychosocial well-being in residential aged care: a realist...

Shared-site intergenerational programs, which co-locate services to enable interaction across generations, have gained attention for their potential to enhance psychosocial well-being in later life. However, evidence explaining how and under what conditions these programs are effective remains limited. This study examined how one of Australia's few shared-site intergenerational programs supported older adults' psychosocial well-being, staff experiences, and program sustainability.

A realist evaluation was used to develop, test, and refine program theories explaining how contextual conditions interact with underlying mechanisms to generate outcomes. Data included realist interviews with residents, aged care staff, early childhood educators, and senior managers; organizational policy and procedure documents; and staff observation notes. Data were analyzed using inductive, deductive, and retroductive reasoning to develop context-mechanism-outcome configurations.

Seven program theories were developed from twenty context-mechanism-outcome configurations. Psychosocial well-being was enhanced when intergenerational engagement occurred in safe and accessible environments, supported by skilled facilitation and organizational leadership, enabling participation to be experienced as meaningful and valued. These conditions activated mechanisms of belonging, reciprocity, and purpose, improving emotional well-being, social connection, and identity continuity. Staff experienced professional fulfillment and motivation when supported to facilitate quality engagement, while strong organizational culture contributed to sustainability. Outcomes varied where contextual supports were constrained.

Shared-site intergenerational programs function as complex relational and organizational interventions. Psychosocial benefits for residents, alongside staff well-being and program sustainability, depend on alignment between facilitation practices, organizational culture, and everyday institutional conditions.