Fostering social participation among older adults: Perspectives of stakeholders

Abstract

Background

Fostering social participation for active and healthy ageing among older adults is an urgent issue in a changing society that requires new approaches from occupational therapists as well as from society at large.

Aim

To explore possibilities to foster social participation for older adults in society from the perspective of stakeholders.

Material and methods

A qualitative design was applied. 18 key informants, engaged in supporting older adults in their organisational roles as either professionals or volunteers, participated in five different focus groups discussions.

Results

The results involved two overarching themes that reflects different perspectives on key informants’ possibilities to foster social participation for older adults. The first theme describes how they direct their attention towards their roles within the organisations to foster social participation in their own context. The second theme describes the broader societal perspectives that they address to establish a common ground for collaboration and knowledge-sharing among different stakeholders.

Conclusions

The findings emphasise how addressing common challenges and developing collaboration are essential to foster older adults’ social participation. It is therefore necessary to involve policy-makers and decision-makers. Occupational therapists and researchers should consider the value of occupational justice to drive collective and social approaches.

Keywords:

• Active ageing
• healthy ageing
• occupational justice
• professionals
• social inclusion
• volunteers

Introduction

In a rapidly changing society, fostering social participation for active and healthy ageing among older adults is an urgent issue that requires new approaches from occupational therapists and professionals within health and social care as well as from society. Ongoing societal changes, such as the progression of digitalisation [1] and demographic development involving an increasingly older population [2], have various impacts on older adults’ active and healthy ageing. These societal changes also imply changing conditions in health and social care globally and in Sweden, with limited workforces encountering increasingly complex needs [3,4]. This challenges various organisations in society to develop their services and collaborate in new and innovative ways [5].

Sweden is a country with a developed welfare state that is committed to the well-being of its citizens. Health and social care are mainly tax-funded and are thus the legal responsibility of municipalities and regions [6]. The range of services offered by municipalities varies but may encompass support for social participation. However, it is important to note that owing to increased demands in municipalities and regions, public resources are strained [7]. Hence, there is a growing emphasis within health and social care on adopting a health-promoting approach, including a focus on social participation and digital solutions that encourage older adults to act proactively to maintain their health [8]. Nonetheless, this approach is still in the early stages of development and implementation.

A promising trend in Sweden is the reported improvement in health and longevity among the older population [9,10]. However, creating suitable conditions for active and healthy ageing and fostering social participation are important concerns in society [11,12]. The ageing process is associated with challenges related to declining health [13], loneliness [14], social isolation [15] and transitions related to retirement or relocation [16]. While social participation [17] is essential for active and healthy ageing, as it facilitates engagement within the community [18], older adults often encounter difficulties in remaining engaged within society, accessing places, maintaining community ties, and developing relationships [19,20].

Recent theories within occupational therapy emphasise people’s right to access, choose and sustain meaningful occupations that foster participation, health, and social inclusion [21]. Occupational therapy theory provides a foundation for enabling social change but also adheres to the belief that social structures, policies and institutional environments can enable and limit occupation [21]. This requires a focus on social policies, governance, and environmental factors that structure daily activities and inclusion in society [22–24]. An occupational justice perspective can highlight both the facilitators of and barriers to social participation [25]. Occupational justice can be defined as equity and fairness for individuals, groups, and communities regarding resources and opportunities for their engagement in diverse and meaningful occupations [26]. To achieve occupational justice for older adults, occupational therapists can play a vital role in advocating for social policies that could better support older adults in meaningful occupations and social participation. For this to be achieved, collaboration is required between various stakeholders in society [27]. Nevertheless, it has been demonstrated that communication barriers exist between different stakeholders [28]. Furthermore, stakeholders also encounter difficulties in obtaining the necessary resources to facilitate activities to foster social participation [29].

A variety of stakeholders from different organisations in society can contribute to fostering social participation for active and healthy ageing among older adults [30]. Stakeholders are, for example, professionals in health and social care, pastoral care practitioners, and volunteers engaged in various non-profit and community organisations and different types of support groups [31]. Stakeholders within these different organisations can provide support for older adults both individually and in groups. However, these organisations are governed by different legal requirements or have a confessional, ideological, or political foundation that influences the values and activities they offer to older adults.

Societal changes present challenges regarding the distribution of public resources, prompting the need for innovative strategies to foster social participation among older adults. Additionally, this calls for the formation of new collaborative initiatives that necessitate the involvement of stakeholders in society. However, knowledge of stakeholders’ current possibilities to foster social participation is scarce and important for developing a more profound understanding of how to facilitate active and healthy ageing among older adults in society. This study thus aimed to explore possibilities to foster social participation for older adults in society from the perspective of stakeholders.

Methods

Design

A qualitative design was applied with the aim of exploring stakeholders’ shared understanding of the possibility of fostering social participation for older adults. The collection of data through focus group methodology enables various thoughts, ideas, and insights to be explored and discussed, which can reveal multiple meanings and understandings that contribute to different perspectives and a common understanding of a given topic [32,33]. This study was approved by the Swedish Ethical Review Authority (Dnr: 2020-00103).

Participants and recruitment

Throughout the recruitment process, contacts were made with a variety of stakeholders from several different organisations in a northern Swedish municipality. A diverse range of stakeholders, hereafter referred to as key informants, was sought to gain a comprehensive understanding of various possibilities to foster social participation for active and healthy ageing in society. Therefore, we sought key informants from health and social care in the municipality and from different non-profit and community organisations. To reach participants with relevant knowledge and experience, a purposeful sampling strategy was applied via snowball sampling techniques [34]. The purpose was to achieve multifaceted views on possibilities to foster social participation for older adults. Those who were interested in participating received an information letter about the study. ML (first author) compiled multiple groups of four key informants each on the basis of similar associations, workplaces and professions and coordinated a date and time that suited all participants. In line with the methods described by Krueger and Casey [35], both homogeneity and heterogeneity were pursued when creating the groups to stimulate a beneficial discussion.

A total of 18 key informants participated in five focus group discussions (Table 1).

Table 1. Focus group composition of key informants.

Focus group	Number of participants	Organisation	Key informants
1	4 (3 Women, 1 Man)	Municipality social support (tax-funded)	Professionals; (Caregiver counsellor, Dementia care specialist, Social support workers)
2	4 (4 Women)	Municipality health- and social care (tax-funded)	Professionals; (Unit managers at residential care facilities, Development manager)
3	3 (3 Women)	3 different Church congregations (tax-funded)	Professionals; (Deaconess)
4	4 (2 Women, 2 Men)	2 different pensioners associations	Volunteers
5	3 (3 Men)	3 different pensioners associations	Volunteers

Table 2. The overarching themes with subthemes.

Utilising context-specific conditions to foster social participation	Being accessible and inclusive in the community
	Providing meeting places with desired and interesting activities
	Creating community and facilitating relations
A common ground in society to foster social participation	Enhancing collaboration and knowledge-sharing among organisations
	Recognising the need for changes at a societal level

Data collection

The data were collected in April and May 2023. The two focus groups with volunteers were held at the university. The three focus groups consisting of professionals were held in conference rooms at one of the participants’ workplaces. All the groups were carried out in a calm and secluded environment. The focus group discussions lasted approximately one and a half hours.

The focus group sessions were moderated by ML together with GI (fourth author), who has extensive experience conducting focus group studies. ML encouraged interactions within the group and ensured that participants had equal opportunities to engage in the discussion. The moderator began each discussion by emphasising the importance of being respectful of each other both during and after the discussion and that all the comments and ideas were equally important and valuable, thereby fostering an open climate and encouraging honesty. The discussions were guided by four open-ended thematic key questions: What possibilities do you have to support social participation for older adults through your work/engagement? How do you think it is possible to develop support for older adults to maintain and develop their social participation? What possibilities do you have through your work/engagement to support social participation through digital tools? What do you need to support the social participation of older adults in your organisation/role? Related supplementary questions were also formulated prior to the group discussions. The thematic key questions were developed on the basis of findings from previous studies exploring older adults’ social participation. These questions were developed in dialogue among the authors.

All focus group discussions were digitally audio recorded. GI observed the discussions and was responsible for taking fieldnotes and ending every group session by inviting the participants to respond to a summary of the discussions. After each group session, GI and ML joined in a debriefing about reflections from the focus group discussions to gain a shared understanding.

Data analysis

The analysis was performed in line with focus group methodology [32], which was explorative and aimed to capture the prevailing common understandings thematically while accounting for the contrasts among professionals and volunteers. The focus group discussions were transcribed verbatim by ML. Repeated listening to the discussions and readings of the transcripts and fieldnotes enabled a deeper understanding of the material. Notes were made on preliminary interpretations that subsequently formed five initial preliminary themes derived from the discussions, for example, ‘reaching out to older adults’, ‘developing collaborations’, and ‘influencing on a structural level’. Hereafter, all the data were sorted in accordance with those five preliminary themes. Nevertheless, to capture and highlight the distinctions and essence inherent to the different key informants, the data specific to volunteers and professionals were juxtaposed in relation to the key questions. After this, the initial themes were further developed, and the data for each theme were sorted into subthemes representing different aspects of the theme. The initial parts of the analysis were performed in collaboration with ML and GI. As the analysis progressed, the developing themes and subthemes were contrasted with the total data material and progressively condensed, revised, compiled and written as descriptive text. The reflections from the debriefing sessions contributed to the development of the themes. Finally, the analysis formed two overarching themes with subthemes (Table 2) that visualised a collective shared understanding derived from the focus group discussions. Throughout the analysis, all the authors discussed the meaning and interpretation of the data, thereby exploring and contesting different understandings and interpretations.

Results

The results involved two overarching themes representing different perspectives on possibilities to foster social participation for older adults in society. The first theme describes how key informants direct attention to their role within the organisation to foster social participation in their own context. The second theme describes the broader societal perspectives that key informants address to establish common ground to foster social participation.

Utilising context-specific conditions to foster social participation

This theme, which includes three subthemes, illustrates how the key informants utilise their context-specific conditions to foster social participation within three interrelated aspects. These specific conditions refer to their different roles and responsibilities within organisations. The key informants actively address aspects of being accessible and inclusive to diverse groups of older adults, providing meeting places, creating community and facilitating relations. These different aspects are further developed in the following subthemes.

Being accessible and inclusive in the community

This subtheme reflects the joint understanding of how a central part of being able to foster social participation originates from opportunities to be accessible to older adults in various ways. This was discussed in relation to having possibilities for making initial contacts and establishing prolonged engagements with older adults in the community. Key informants’ discussions revealed how they tried to adapt in their own organisational context to be more accessible to older adults with varying interests and prerequisites. Reaching older adults and engaging with them early in the phase of retirement could increase the likelihood of fostering social participation in the long term. Additionally, there was compliance present in discussions about attracting people who are not easily motivated to join communities on their own; according to the key informants, such individuals are considered at risk for social isolation or consolidating loneliness. To reach older adults the key informants reflected upon how to be accessible to them in vulnerable positions, for example, those carrying for a partner who cannot maintain social participation without assistance or minorities struggling with language or cultural boundaries.

The key informants highlighted the importance of effective ways to communicate as an organisation to invite older adults to visit their meeting places. The volunteers recognised the need to adopt various approaches to invite older adults to join their activities. They discussed how they used public arenas such as local grocery stores to provide information about their activities. Additionally, they made home visits in the neighbourhood, personal phone calls, and visited nursing homes. Professionals reported disseminating information about their offers of activities through advertisements and their own and public channels. Additionally, they discussed trying to attract older adults through different support services or groups that are already part of their regular commitments. All the key informants discussed addressing their activities through digital channels. However, they all agreed on the challenges and risk of excluding older adults, for example, if the older adults were not used to accessing information or activities digitally.

To improve the accessibility of their services and activities, the key informants discussed the potential to form visitor groups that could interact with both independent older adults and those residing in assisted living facilities. The ambition of visitor groups was discussed as a way not only to reach new individuals to join activities but also to attract potential volunteers who wish to contribute to their local community. However, challenges remain as to how such visitor groups could be developed; especially in relation to changes in society and distances between people, where anonymity and scepticism about unknown or unfamiliar persons or organisations can pose problems reaching out to new people.

Providing meeting places with desired and interesting activities

This subtheme shows how key informants make efforts to provide meeting places with desired and interesting activities to foster social participation. Discussions revealed how the key informants reflected upon how to determine what to offer, i.e. by examining the value of existing activities or programmes and revising them to be interesting and to attract older adults. The key informants emphasised the importance of engaging in dialogue with older adults to understand their preferences and thereby promoting their engagement in actively joining their community, being both consumers and cocreators of activities. However, the key informants approached this from slightly different viewpoints because of their different roles and responsibilities. The professionals emphasised the importance of adopting a person-centred approach and seised the opportunity in everyday meetings with individual older adults, addressing their needs in the best possible way. Additionally, they reflected upon the need to guide older adults to the right type of support if they could not offer what they expected in their context. Volunteers actively sought ways to make their organisations appealing and relevant. They were willing to adapt to keep their activities and offerings up to date to meet their members’ requests. They recognised the importance of maintaining a vital membership base to sustain their efforts in offering interesting activities. Therefore, they invited and encouraged older adults to join boards and committees and lead groups and to provide input. However, volunteers faced challenges in engaging and retaining older adults in their associations. They experienced changes in society that manifested in a lack of interest in involvement and expressed concerns about future development in keeping voluntary initiatives viable.

Moreover, attempting to appeal to the diversity of older adults’, key informants discussed how to offer informative, educational and leisure content in activities. One example involved providing activities to support the enhancement of digital skills. Volunteers’ discussions revealed how they provided short courses for training in digital skills, such as smartphone use. They recognised the need to reinforce existing support. In addition to engaging their own members as instructors, they had to involve experts to teach older adults, for example, internet security. The professionals discussed how they tried to encourage older adults to take part in digital developments. The key informants described the shortages faced by some older adults in meeting digital challenges and how the digitalisation of society can hamper social participation, for example, in accessing information, using apps for communication, accessing parking or public transport, and more. The discussions highlighted the necessity for older adults to develop and enhance their digital literacy. Furthermore, the key informants revealed that their organisations were limited in their capacity to provide support to older adults in this regard.

Creating community and facilitating relations

This subtheme provides insights from key informants regarding the importance of a personalised and empathetic approach and continuity to create community and facilitate relationships. They discussed how an initial personal meeting was important for facilitating relations. Additionally, personal guidance and visits to meeting places together facilitated older adults’ familiarity with the context and activities. The key informants reported prioritising a welcoming atmosphere for older adults to be acknowledged, remembered, and cared for in their context. Their intention was to establish an environment that could encourage casual social interactions as well as facilitate reflection on existential and spiritual aspects of life. They also strived to create places for groups of older adults to come together. Furthermore, they discussed that the formation of groups could be facilitated by bringing together different generations and engaging in cross-cultural cooperation. Additionally, key informants discussed that fostering social participation involves supporting older adults in building relationships and social networks by encouraging them to engage continuously. They emphasised the need for a stable context that offers regular meetings, gatherings, and activities continuously throughout the year to create a sense of continuity that could lead to sustainable community building, as illustrated by focus group number 3:

Professional 1: Yes, you have to help and encourage them [older adults] not only to be passive participants but also to engage. That you feel a responsibility to acknowledge others. In addition, that you actually make some coffee, you do not sit like a guest in a café. That is what I think.

Professional 2: Integrate with new people.

Professional 1: And encourage each other to help each other. Therefore, they get closer to each other or visit each other.

Professional 2: However, I think that in our organisation, we have this conscious reflection and dialogue. Creating new relationships, interacting with and being welcoming to someone who is new and so on. We have a great awareness of such importance, and we constantly need to invite and be able to create new relations.

Professional 3: And personal meetings.

Professional 1: And it’s difficult for people to be creative. They want to be supported. Now, every Wednesday in the summer, we offer a community in the morning from 9-11. I can hear the disappointment, they want to be here all day. Then I encourage them to do things together because we cannot support them every hour of the day.

Professional 2: No, although this may reveal something about the fact that many people want routines.

A common ground in society to foster social participation

This theme, which includes two subthemes, illustrates how key informants reasoned that addressing wider societal perspectives beyond their own context was necessary to foster social participation for older adults. This theme reflects how aspects of collaboration and knowledge-sharing and societal changes were central in discussions on establishing a common ground for achieving developments to foster social participation for older adults. Learning from each other’s organisational structures, practices and commitments was discussed as a way to enhance mutual understanding and open new possibilities.

Enhancing collaboration and knowledge-sharing among organisations

This subtheme highlights the need to address common challenges through collaboration and engaging in dialogue and the sharing of knowledge among organisations. This engagement could enhance the level of preparedness related to meeting the diverse needs of older adults, as different stakeholders possess different types of knowledge. Furthermore, it was suggested that collaborative efforts could add additional value. Professionals discussed how they ought to seek extended collaborations to meet the needs of demographic challenges as well as to facilitate possibilities for social participation among older adults. Given the limitations of their own resources, they anticipated that they would not be able to meet the range of needs of older adults within their organisation. Volunteers discussed the need for closer collaboration and knowledge exchange with municipality services, as well as the exchange of ideas regarding how to develop activities for older adults. Discussions revealed how working together could improve possibilities for social participation, for example, working jointly to enhance digital competencies or reaching out to vulnerable or socially isolated older adults. Linking civil society with municipal efforts was discussed as an opportunity to generate new ideas and development for both parties. Some municipal services could provide expert knowledge on how to meet older adults with specific needs, whereas volunteers hold considerable grassroots knowledge of what happens in neighbourhoods and meeting places on a day-to-day basis. Learning from each other could help establish common ground for improving services on both sides. The following discussion by a group of volunteers demonstrates their intentions to collaborate with other stakeholders:

Volunteer 1: I think like this, there are kind of closed borders. It would be great if the home care service could be slightly more open and flexible. In addition, if you could somehow determine through them who have home care, for example.

[Volunteer 2 and volunteer 3 agree.]

Volunteer 1: However, they have their confidentiality.

Volunteer 2: And it sounds positive [talking about collaboration with professionals] when you’re in contact with the municipality. I think it is also different in the meeting with each unit manager. Some are very welcoming, and others may not be. Therefore, it depends a bit on their attitudes. However, it is worth trying to make contact.

Volunteer 4: What I am thinking about is whether our various associations should pay a visit to those who work in the municipality.

Volunteer 3: That would be good, well, the municipality should have more knowledge of what’s happening in town [talking about different kinds of support for older adults]. Because they [professionals within the municipality] certainly have a lot of knowledge. We’re just amateurs.

In addition to the volunteers, professionals also discussed the possibility of extending knowledge-sharing and collaboration, exemplified by the following quote:

Professional 4: I think we could cooperate both internally and externally, with society at large. However, this also requires many resources. It takes a lot of time and planning… Therefore, I absolutely believe that it can be developed, but it also requires people from both sides to do it.

Professional 5: I agree with you. I think some municipalities have very good programmes… In addition, we have plenty of resources from the municipality, but we need greater cooperation with civil society and volunteers. In addition, I think this is a prerequisite if we are to succeed in the future… However, as you say, it takes a lot of work… I think it takes time too.

Professional 4: I think so.

Professional 5: Yes, it looks different in different municipalities too… We can certainly influence some things, but not all. We need help.

Professional 6: Absolutely.

Furthermore, key informants recognised the need to develop collaboration through dialogue with policy-makers and decision-makers. This was discussed as necessary for addressing and acknowledging issues concerning older adults’ social participation that extend beyond the grassroots level. However, volunteers also expressed concerns that their ideas and suggestions would not always be recognised. They emphasised the need to raise issues together among the different volunteer associations to reach a better impact.

The key informants discussed the need for enhanced collaboration to integrate various ideas, such as implementing successful models from other municipalities and connecting various types of support for older adults, for example, engaging homecare services to assist older adults to meeting places. However, such issues need coordination; discussions revealed that this was challenging. Time, resources, and a focus on collaboration demand prioritisation; however, they agreed that the future will require a focus on collaboration.

Recognising the need for changes at a societal level

This subtheme reflects the key informants’ shared perspectives on the need to address older adults’ social participation at the societal level in a proactive and strategic way. They highlighted the importance of political and governmental commitment in establishing the necessary prerequisites to foster social participation. Key informants discussed the challenges of organising cost-bound activities for older adults without financial resources. When discussing the limited economic resources, it became evident that there is a lack of clear connections between the goals within the organisation and the available resources in terms of what is required to foster social participation among older adults. The professionals struggled with offering cost-free activities and agreed that they would like to invest some resources to attract older adults, and some had raised this issue at higher levels within their organisations. Furthermore, they discussed how the costs of staff and digital tools are not fully covered to foster social participation. Both professionals and volunteers were seeking to develop activities even when they lack allocated funds. Volunteers concluded that they could reach a wider group of older adults by offering their activities on a general basis without charge, considering the perspective of older adults, who may be hesitant to pay fees for activities. However, they acknowledged that doing so would require support at the political level. In reflecting upon improving their efforts to strengthen opportunities for social participation, key informants discussed the need for changes at the societal level that ought to be underpinned by economic initiatives. This was discussed in relation to, for example, providing transportation services that would support possibilities for social participation. They also considered potential enhancements, such as housing alternatives that facilitate social interaction, access to public transportation, and support for digital literacy, for example, installing Wi-Fi or purchasing hardware and software. However, discussions also evolved on how to support older adults in digital development. Even though they discussed challenges, key informants were optimistic about possibilities for further improvements and emphasised the importance of acknowledging the contextual and structural factors that impact social participation.

Discussion

This study contributes to an understanding of stakeholders’ opportunities to foster social participation among older adults in society. The results reflect how key informants directed attention to their role within the organisation to foster social participation in their own context. Additionally, how they addressed a broader societal perspective to establish common ground to foster social participation.

The first overarching theme highlights how the key informants strived to be accessible and inclusive and provide meeting places and activities, as well as building community. In this strive they used different approaches by utilising their context-specific conditions. The results revealed challenges reaching and inspiring older adults to join meeting places and activities, especially those in vulnerable life situations. Being accessible and inclusive was a way to invite older adults to different activities arranged by volunteers and professionals. Additionally, reaching older adults who faced challenges related to remaining engaged in society was an important strategy. Being invited to join places and activities in society has previously been shown to be important for older adults to promote inclusion and provide access to meaningful occupations [36]. Our results are in line with a previous study [37] showing that older adults also benefit from different types of support or motivations to foster social participation. In providing meeting places with desired and interesting activities, it was essential to inspire older adults to be both consumers and cocreators. In this context, it is important to acknowledge the variety of interests and preferences among the older population. Occupational therapy theory [21] emphasise the importance of providing opportunities for individuals to access, choose and sustain meaningful occupations to experience participation and health.

The creation of community and relationships was reflected in the results as vital for fostering social participation. The results show how key informants were engaged in facilitating a safe and inviting atmosphere to create a sense of togetherness and possibilities for community building. In line with this, previous research [36] has shown that being part of enacted togetherness has the potential to promote a sense of belonging and safety that create meaning in ongoing life during ageing. These aspects should be considered when developing support that aims to foster social participation. In this regard, occupational therapists, as well as other health and social care professionals, should consider how to use a collaborative relationship-focused approach [21] to create an environment that facilitates continuity and relationships.

This study reflects how the digitalisation of society might hamper opportunities for social participation among older adults in different ways, such as through access to information. Even though key informants tried to support the development of digital skills among older adults, they had limited capacities and economic resources. Previous research [38] has also identified economic resources as key factors for supporting older adults’ social participation. As reflected in the results, challenges related to supporting the development of digital skills and literacy among older adults need to be addressed at the societal level.

In this study, collaboration and knowledge-sharing among different organisations as well as recognition of the need for changes at the societal level were found to be important for creating common ground to foster social participation. Previous research emphasised the importance of collaboration between various stakeholders in society to increase possibilities for social participation and encourage active and healthy ageing [39]. In contrast, failures in collaboration among different organisations can result in exclusion and a sense of not belonging among older adults [40,41]. The results imply that there is a risk that social participation becomes less prioritised than other responsibilities within organisations. This emphasises the importance of raising awareness about the meaning of social participation for active and healthy ageing.

The present study underscores the need to enhance collaboration and knowledge-sharing among various stakeholders in society. Fostering social participation in the ageing population can be considered a matter of occupational justice. From an occupational justice perspective, one can argue that stakeholders play an important role in promoting inclusion in society and access to meaningful occupations among the older population. Furthermore, they play an important role in fostering social participation among older adults, especially those in vulnerable life situations, as they can be considered at risk for loneliness and isolation. Occupational therapists and researchers could more accurately consider how occupational justice can be transformed into professional actions focused on collective and social approaches [42]. This could also include taking on the challenges related to societal changes and developing services and collaborating in new and innovative ways to foster social participation for active and healthy ageing among older adults.

Methodological considerations

The advantages of focus group discussions include opportunities to reach and explore participants’ knowledge and experiences and allowing them to generate their own questions and pursue their own priorities [43]. Furthermore, participants had the opportunity to develop new perspectives or explore ideas together, as demonstrated in this study. One strength of the study is the contribution of heterogeneity in the data, as the participants were professionals and volunteers from different organisations, allowing for diverse inputs and experiences from various contexts. The focus group method also recommends homogeneity within each group to explore shared experiences [43]. To achieve homogeneity, participants from related organisations, for example, voluntary associations, were brought together and placed in the same discussion groups.

Additionally, compared with those in the methodological descriptions, the number of participants in each group was relatively small [32,43]. However, the rather small groups still resulted in vivid discussions during which all participants were given space to comprehensively express themselves. However, a limitation of this study is that the findings provide insight only from key informants in a single municipality. Throughout the study, careful consideration was given to follow a systematic methodological procedure [32]. To ensure trustworthiness, all the authors were involved in discussions about the meaning and interpretation of the data and explored and contested different understandings and interpretations. To strengthen the credibility of the findings, quotations from the focus group discussions have been included. Finally, these findings do not represent the variety of existing welfare models and voluntary commitments or varying levels of municipal support provided to older adults. Nevertheless, the findings of the current study can provide valuable insights and be useful in further research on social participation among older adults in society.

Conclusions

This study provides insight into how stakeholders in society can foster social participation among older adults. The possibilities for this depend on their role within their organisational context, and the possibilities to establish a common ground for collaboration and structural improvements on a societal level. The results showed that it is important for stakeholders to be accessible and to provide services that meet the diverse needs of activities among older adults as well as to facilitate community building. The results also indicate that access to technology and digital literacy were considered important for fostering social participation among older adults. Furthermore, the necessity of joint strategies and collaboration to tackle digital challenges. Additionally, to develop a common ground among stakeholders in different organisations in society knowledge-sharing and collaboration required prioritisation. The results emphasise the importance of addressing common challenges and accessing appropriate societal resources. To achieve this, it is necessary to involve policy-makers and decision-makers. To conclude, occupational therapists, in collaboration with other health and social care professionals, should expand their role to foster social participation among older adults by actively engaging with other stakeholders and increasing awareness of the issues from a broader societal perspective.

Acknowledgements

The authors gratefully thank all participants taking part in the focus group discussions.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This study was not funded.