Xuxi Zhang

Valencia, some new care provisions were newly developed and in Pallini all care provisions were newly developed. Falls care ‐ pathways varied among settings, including group ‐ based exercise programs, home adjustments and physiotherapy. In Rijeka and Valencia persons who had a frailty indication were offered to enrol in the falls care ‐ pathway. In Rijeka and Pallini, the polypharmacy care ‐ pathway included a self ‐ managed medication adherence application. In the other settings, persons entering this care ‐ pathway received a medication review by a pharmacist. The loneliness care ‐ pathway included group ‐ based activities and support groups. No additional monetary incentives were provided to staff within existing care. In settings where new care provisions were developed, the staff was hired on a voluntary bases or sometimes compensated. The participants received no monetary incentives. For some of the interventions, participants borrowed materials that were needed for care activities. Design We applied a convergent mixed ‐ methods evaluation design 31 alongside the effect evaluation of the UHCE approach. This was done in all cities between May 2015 and June 2017. Quantitative and qualitative data was collected and analysed separately. Participants Older persons and informal caregivers The target population consisted of persons living independently, aged 75 years or older, who were, according to their physician, able to participate in a care ‐ pathway for at least 6 months. This timeline was chosen because the care pathways were to last at least 6 months. In two cities; Pallini and Valencia, the age of the population was lowered to 70 years or older due to difficulties encountered during recruitment. Older persons who participated were recommended to involve an informal caregiver, particularly in shared ‐ decision making, as described earlier. Older persons were not eligible to participate if they were not able to comprehend information in the local language or if they were unable to cognitively evaluate the risks/benefits of participation and were not expected to make an informed decision regarding participation, according to their physician. 25 We aimed for a purposeful sample of 250 older persons in each city, as previously described. 25 Professionals In each city, health and social care professionals participated in the UHCE approach. Care decisions were made by a physician, together with a care coordinator, older person and sometimes an informal caregiver. Other professionals involved in the care ‐ pathways were physiotherapists, occupational therapists, physical educators, psychologists, social workers, pharmacists and volunteers, depending on context as described in Table 1. Data collection Specific process components were evaluated: reach of the target population, dose of the intervention actually delivered and received by participants, and satisfaction and experience of main stakeholders with the intervention as proposed by Stecklar and Linnan. 22 Table 2 5 107 A coordinated preventive care approach for healthy ageing