Older adults’ engagement with social prescribing to active ageing centres in Singapore: a qualitative study from public primary care
July 29th, 2026
Singapore
Jun Heng Goh, Shu Yun Tan, Hou De Mark Li, Kai Ping Sze
This qualitative study explored how older adults in Singapore engage with social prescribing to Active Ageing Centres. Interviews with 12 participants identified four key factors: referral legitimacy, access, social fit, and perceived value. Findings suggest that trusted primary care referrals and reducing structural barriers can improve participation and sustained engagement among older adults.
DOI: https://doi.org/10.1186/s12877-026-08067-5
Posted byAnandita Gupta
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Abstract/Description
Background
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.
Objective
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.
Methods
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.
Results
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.
Conclusions
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.
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.
Objective
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.
Methods
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.
Results
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.
Conclusions
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.
