Inquiry. 2025 Jan-Dec;62:469580251382758. doi: 10.1177/00469580251382758. Epub 2025 Oct 31.
ABSTRACT
Older adults in rural areas often face barriers to accessing formal health services. Community-based programs serve as alternative models for delivering preventive care and psychosocial support. However, the effectiveness of specific program types on well-being outcomes remains underexplored. This cross-sectional study analyzed secondary data from 1033 older adults across 44 rural communities in Taiwan. Participants were involved in 5 types of community-based programs. Subjective well-being was assessed using the WHO-5 index. Associations between participation hours and well-being were examined using ANOVA, OLS regression, and linear mixed models, with community-level clustering and individual demographics controlled. Health promotion and recreational activities were positively associated with well-being, while horticultural therapy and social participation showed negative associations. Food and agricultural education was positively associated with well-being only after controlling for community context. Neither age nor gender significantly predicted outcomes. Community context moderated several program effects. Community-based programs impact rural older adults’ well-being in diverse ways depending on program type and local implementation. Tailored, context-sensitive interventions and ongoing program evaluation are essential for optimizing care outcomes in aging rural populations.
PMID:41170594 | DOI:10.1177/00469580251382758
