Xuxi Zhang

INTRODUCTON Europe has the highest proportion of persons over 65 years compared to any other continent. 1 As the number of older persons is increasing, there will be relatively fewer beds available in inpatient care facilities. Because of this, it is important to have a well ‐ functioning primary care system that promotes healthy ageing among older persons. The European Union has identified priority areas for healthy ageing, which are: polypharmacy, falls and frailty. 2 These are highly prevalent among older persons, and are associated with negative health outcomes and higher care use. 3 ‐ 5 Loneliness is another large problem among older persons; around 20 ‐ 30% report loneliness 6 . Loneliness has been associated with frailty 7 and a fall in the previous year 8 . Hence, the co ‐ occurrence of these and other health problems is common. 9, 10 Coordinated preventive care interventions which integrate health and social care services have been proposed to address health problems among older persons. 11, 12 These interventions usually include a preventive multidimensional assessment of health, development of a care plan and coordinated care. 13 ‐ 15 This care plan is often made through a process of shared decision ‐ making, in which the patient is involved in care decisions. 16 Care coordination is typically done by a nurse to alleviate the workload for the general practitioner. Background Evidence for a positive effect of coordinated preventive care interventions on quality of life and independent functioning among older persons is mixed. 17 ‐ 20 This may be explained by differences in groups reached by the intervention, fidelity to the intervention and context of implementation. However, a recent study revealed that coordinated preventive care studies often do not report how such specific aspects of the intervention are carried out. 21 Insight in these so ‐ called ‘process components’ could increase the understanding of underlying reasons for why some studies do find positive effects while another do not. Steckler and Linnan have developed a framework to study process components for public health interventions. 22, 23 In this framework, process components which are evaluated include: reach of the target population, dose of the intervention actually delivered to and received by participants, and satisfaction of main stakeholders with the intervention.22 The Stecklar and Linnan framework is recommended for the development and reporting of complex interventions. 24 The Urban Health Centres Europe approach (UHCE approach) was a preventive coordinated care approach aimed at promoting healthy ageing by decreasing falls, polypharmacy, loneliness and frailty among community ‐ dwelling older persons. 25 The UHCE approach consisted of a preventive assessment of fall risk, polypharmacy, loneliness and frailty and, only if the person had a need or indication for care, shared ‐ decision making on a care plan and enrolment in coordinated care ‐ pathways. 26 The UHCE approach showed promising, but minor positive effects in tackling recurrent falls and frailty and promoting physical health ‐ related quality of life and mental well ‐ being compared to care as usual. 26 Further, only 54% 5 103 A coordinated preventive care approach for healthy ageing