From Referrals to Relationships: Reframing Engagement as an Implementation Strategy and Outcome in Age-Friendly Care

Despite growing investment in age-friendly models and social prescribing, many older adults remain disconnected from services, even when those services align with identified needs. Findings from the Age-Friendly Integrative Mobile Services (AIMS) pilot indicate that this engagement gap (motivational barriers, relational mistrust, and value misalignment) is as limiting as access or infrastructure. Motivational engagement - defined as aligning care with a person's values, readiness, and trust - emerged as a critical yet overlooked driver of uptake. Centering trust, values alignment, and relational support within implementation strategies may enhance service uptake, sustain engagement, and improve equity in aging-in-place outcomes by ensuring care is both accessible and meaningful.