Older adults' engagement with social prescribing to active ageing centres in Singapore: a qualitative study from...

Social prescribing (SP) has emerged internationally as a structured approach to link individuals with non-medical community resources to improve health and wellbeing. In Singapore, SP through referrals to Active Ageing Centres (AACs) is in the early stages of implementation within public primary care. Therefore, it is important to understand the perspectives of patients who are referred to such settings from primary care providers.

To explore older patients' perspectives on social prescribing and factors influencing uptake and sustained engagement following referral to AACs from public primary care in Singapore.

We conducted a qualitative descriptive study using semi-structured, in-depth interviews with adults aged ≥ 60 years who had accepted, declined, or dropped out of SP referrals from a public primary care clinic. Purposive maximum-variation sampling sought to capture diversity in engagement status and ethnicity. We analysed the interviews using thematic analysis and performed interpretive mapping using the COM-B model.

Of the sixteen participants approached, twelve participated: four were currently engaged in AAC activities, four had declined referral, and four had discontinued participation after initial attendance. Four interrelated themes described a familiar pathway of engagement: (1) referral legitimises participation; (2) access shapes entry; (3) social fit shapes belonging; and (4) perceived value turns attendance into habit.

Uptake and sustained engagement with SP via AAC referral appeared to be shaped less by individual capability than by physical opportunity, social opportunity and motivation. Primary care providers are well placed to facilitate engagement by leveraging trusted patient relationships, while centre managers and policymakers should address structural barriers such as zoning restrictions, language mismatch and age-identity mismatch. These findings offer actionable insights to optimise the reach and sustainability of social prescribing within Singapore's primary care landscape.