Xuxi Zhang

Strengths and limitations The main strength of the current study is that we did an extensive evaluation of process components based on a theoretical framework proposed by Stecklar and Linnan. 22 By combining quantitative and qualitative methods we were able to deepen the understanding of the implementation of the UHCE approach. This study also has some limitations. First, logbooks were completed by staff involved in the UHCE approach. This might have caused a bias and positive reporting of the execution of logbook components. For example, cities reported that shared ‐ decision making was done in almost 100% of cases. However, it was unclear how and to what extent the older person was involved in this process. Perhaps the definition of shared ‐ decision making has been interpreted differently by cities. Secondly, older persons included in the focus groups might have been those that were most positive about the UHCE approach as these persons were selected by care professionals involved in the study. Third, there were many missings for the questions on satisfaction of the UHCE approach. Persons who did not answer could have thought these questions were not applicable to them because they were less involved in the UHCE approach. The responses could have therefore been biased towards the more active participants who might have been more positive about the UHCE approach. Further, although questions on satisfaction were translated from English to local languages and back ‐ translated, there might have been cross ‐ cultural differences in the interpretation of these questions. Last, we did not include a representative number of informal care ‐ givers in the focus groups. Having the perspective of this group would have strengthened our findings. CONCLUSIONS Although coordinated prevented care appears to be received positively, there may be barriers that hinder person’s engagement in care. Care activities that require transport or a higher level of activity might not reach older persons who are limited in their functioning and should be adapted for this group of older persons. Mistrust towards unfamiliar care providers and lack of confidence to engage in certain care activities are main barriers towards engagement in care among older persons. It is therefore important for care professionals to build a trusted relationship with their older clients and focus on psychosocial barriers that might affect their care decisions. 5 117 A coordinated preventive care approach for healthy ageing