The Development of a Method to Activate Vital Communities’ Facilitation of Older People Ageing in Place: A Community-Based Participatory Research Study

The Development of a Method to Activate Vital Communities’ Facilitation of Older People Ageing in Place: A Community-Based Participatory Research Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Development of a Method to Activate Vital Communities’ Facilitation of Older People Ageing in Place: A Community-Based Participatory Research Study Katinka E. Pani-Harreman, Gerrie Bours, Joop M.A. Duren, Sandra Zwakhalen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7046695/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Jan, 2026 Read the published version in BMC Geriatrics → Version 1 posted 12 You are reading this latest preprint version Abstract Background The ageing population is emerging as a key policy issue for governments and healthcare organisations. Welfare states with ageing populations promote the substitution of expensive forms of care, such as residential care, with less expensive forms, such as ageing in place with additional support by vital communities. There is limited evidence on how to activate communities to facilitate ageing in place. Hence, this study aims to develop a method that can be of assistance for community members, professionals, volunteers, care partners and older people when selecting helpful strategies and interventions to activate a community to facilitate ageing in place. Methods A community-based participatory research methodology was applied to involve parties in an iterative and interactive approach to develop the activation method. Results This study resulted in the creation of the Community Activation Compass, a guide and infographic containing a set of development steps, strategies, interventions and formats that could be of assistance to activate vital communities’ facilitating ageing in place. Conclusion Activating a community could be an intensive, time-limited intervention and is often multi-disciplinary in nature. An inclusive approach seeks to work with all kinds of people and organisations. Still, supporting ageing in place by vital communities may just seem the right thing to do. Ageing in place vital communities guidance activation support Figures Figure 1 Background The ageing population is emerging as a key policy issue for governments and healthcare organisations. One reason for this is that the number of older people in populations around the world is increasing ( 1 ). In Europe, the percentage of people aged 65 and over is expected to account for over 30% of the population by 2060 ( 1 ). Within the Europe, approximately nine out of ten older people in Germany, France, Finland and the United Kingdom live independently in their own homes. In the Netherlands, the percentage is even higher (95%) ( 2 ). In addition, older people prefer to live independently and to stay in their own homes, a situation known as ageing in place ( 3 ). Many older people, however, face declining health, limitations in their functioning and/or other complex issues that affect their ability to live independently. As a result, the demand for care and support for older people will continue to increase ( 4 ). European welfare states with ageing populations promote the substitution of expensive forms of care, such as residential care, with less expensive forms, such as ageing in place with additional support. The Canadian Index of Wellbeing ( 5 ) describes vital communities as those that can cultivate and marshal strong, active and inclusive relationships among residents, the private sector, the public sector and civil-society organisations in order to create, adapt to and thrive in the changing world and thus improve the individual and collective well-being of citizens. The aim of vital communities is to meet individual and common needs: “in a vital community people of all generations work together to find the right balance between meeting individual needs and meeting the needs of the community as a whole” ( 6 ). Vital communities seem to be able to contribute to ageing in place and the quality of life directly as providers of support ( 7 ). There is limited evidence on how to activate communities to facilitate ageing in place. Hence, this study aims to develop a method that can be of assistance to community members, professionals, volunteers, care partners and older people to select helpful strategies and interventions to activate a community in order to facilitate ageing in place. We, therefore, formulated the following research question: “What method can activate a community to support older people ageing in place?” This insight is needed to enhance the quality of life of older people who are ageing in place. A more comprehensive understanding of the development phases, the helpful strategies and the interventions for activating communities could be beneficial for community members in activating a vital community and customising the support they give older people. Methods Context and Design The research was conducted in a living lab specially set up for this study in the south of the Netherlands. The living lab is a physical location as well as a joint approach in which participating parties experiment, co-create and test in a lifelike environment, delimited by geographical and institutional boundaries ( 8 ). A design-oriented research methodology was applied to involve parties in an iterative and interactive approach ( 9 , 10 ). Study Population and Sampling Participants in this study were older people (n = 20) and other stakeholders involved in practice from the housing, healthcare and welfare sectors, municipalities and local associations (n = 33) living and working in the community setting of the living lab. The older people were recruited by distributing a flyer through the letterboxes in the neighbourhood. The selection of the stakeholders was based on snowball sampling ( 11 , 12 ). The inclusion and exclusion criteria are shown in Table 1 . Table 1 Inclusion and Exclusion Criteria Study Population Study Population Inclusion Criteria Exclusion Criteria Older People Age ≥ 75 No Dutch speaking ability Independent living with some formal and/or informal support Score Tilburg Frailty Indicator 0–4 ( 13 ) Living in the living lab environment Stakeholders from Practice Working in the housing, healthcare, or welfare sectors or for a municipality Delivering (in)formal care or activities aimed at older people Members of local associations in the living lab environment Participants were informed in writing that their participation in the study was voluntary and that they were free to end their participation whenever they wanted. The study was approved by the regional Medical Ethical Review Board (METC Zuyderland) in the Netherlands (METCZ20210166) and aligned with the principles outlined in the Declaration of Helsinki. This study did not fall under the scope of the Medical Ethical Review because it did not involve subjecting participants to actions or imposing a manner of behaviour on them. The online sessions via Microsoft Teams were recorded with the verbal permission of the participants. Data Collection The approaches in this study followed the principles of co-creation by involving stakeholders as full and equal partners in all phases of the research process. Co-creation leads to outcomes that are more likely to be acceptable, valuable and enduring compared to traditional research ( 14 , 15 ). To develop the activation method, a systematic development process was followed comprising five phases: 1) needs assessment, 2) design, 3) selection, 4) finalising for further evaluation and 5) testing and improvement (Coulter et al., 2013). The phases are detailed in the following section. Needs-Assessment Phase. The first phase of the data collection was a needs assessment performed by context mapping ( 16 ) and was carried out by older people. Context mapping is a co-creative method to gain insight into the living environment, emotions and needs of participants, who draw a collage or mood board and tell their story. Context mapping goes a layer deeper than the usual interview methods do ( 16 ).Twenty older people who were ageing in place signed up for these meetings in small groups and were asked to express their needs for support while ageing in place. The output of these group conversations, mood boards, and minutes taken during the sessions were analysed and translated into a list of support needs. In addition to the meetings with older people, we organised two online sessions (using Microsoft Teams) with other 33 stakeholders involved. We obtained two smaller groups for the online sessions because smaller groups might be more suitable for complex topics, give the participants more time to voice their views and provide more detailed information ( 17 ). During these online stakeholder sessions, we presented the results of the needs assessment with older people and asked the stakeholders for additions and comments. In the second part of these online stakeholder sessions, we asked the participants what they thought was necessary to activate a community. In addition, we made an inventory of the preferred design of the method in practice. During this inventory, we used open-ended questions regarding the preferred design without giving any examples. Design Phase. Based on the gathered data from phase 1, the second phase aimed to develop prototypes (a valid method that addressed the user requirements) containing a set of steps, strategies and interventions for activating a community to facilitate ageing in place. Selection Phase. The selection phase aimed to select the most suitable prototype. During an online session, the researcher presented the developed ( 18 ) prototypes via a PowerPoint presentation to the participating stakeholders. After the presentation, based on a prepared script ( 18 ), the researcher asked the participants to give their first reaction to the developed prototypes, including the content and design of the prototypes. The participants were also asked to choose the most applicable prototype. Finalising Phase. Phase 4 aimed to determine the final version of the chosen prototype. The researcher processed the received feedback of phase 3 in a final test version for evaluation and dissemination. Testing and Improvement Phase. Phase 5 aimed to test and improve the final prototype in a maximum of three iterations, involving all participants (older people and stakeholders) by cognitive walkthrough ( 19 ). This phase consisted of three physical meetings in the living lab environment. During the first meeting, the researcher presented the final test version and asked participants to evaluate this version on paper for its relevance, comprehensiveness, comprehensibility ( 20 ) and usability ( 21 , 22 ). The testing took place by the use of the co-creation method of evaluation cards containing pre-established hypotheses ( 23 ). The participants discussed how they could use the prototype and what steps they should take to activate a community. They noted their feedback on the evaluation cards. During the second meeting, the improved versions were presented, and the participants were asked whether their feedback from the first round had been properly incorporated into this version and whether they had any additions. A third and final meeting took place in which the final version was presented. During this meeting, all participants involved were asked how this guidance could be implemented and developed further in practice. Analyses The data, consisting of minutes and mood boards from the needs assessment with the older people, were deductively coded ( 24 ) by researcher one (KPH). This analysis was compared with the analysis of researcher two (CK) and determined based on consensus. If no consensus could be reached, a third researcher (JvD) was consulted. The categories were based on the six dimensions of the Positive Health approach contributing to people’s ability to deal with the physical, emotional and social challenges in life. The dimensions used were body functions, mental well-being, meaning, quality of life, participation and daily functioning ( 25 ). The analysis resulted in an overview of support needs. The data, existing minutes and recordings from the stakeholder sessions were deductively coded ( 24 ) by researcher one (KPH) by the use of the OGSM (Objective, Goals, Strategies and Measurement) model ( 26 ). This analysis was compared with that of researcher three (JvD) and determined based on consensus. The used categories were objectives, goals, strategies and measures ( 26 ). The data, existing minutes and evaluation cards from the testing sessions were deductively coded ( 24 ) by researcher one (KPH). This analysis was compared with that of researcher three (JvD) and determined based on consensus. The used categories were the pre-established hypotheses to test the relevance, comprehensiveness, comprehensibility ( 20 ) and usability of the created method ( 21 , 22 ). Results Characteristics of the Participants In phase 1, the needs assessment, ten out of twenty older people participated in the four meetings in the living lab environment. The other ten participants cancelled their participation due to the Covid-19 pandemic. Table 2 shows the characteristics of the participants. Table 2 Characteristics of Participants, Needs Assessment: Older People (n = 10) Characteristics Results Average score on the Tilburg Frailty Indicator (TFI) ( 13 ) 2.1 Experiencing more than two chronic illnesses 3 out of 10 Experiencing lack of support of people in their own living environment 3 out of 10 Experiencing feelings of loneliness and sadness 7 out of 10 Female 8 out of 10 Male 2 out of 10 Average age 75–80 years In total, 22 out of 33 stakeholders participated in the two online stakeholder and/or test sessions. Five stakeholders worked for the municipal government, two in the healthcare sector, two in the housing sector, six in the welfare sector and seven in voluntary organisations and senior citizens' associations. Need Assessments for Older People Due to the Covid-19 pandemic, four sessions took place in groups of two or three older people. According to the participants, vital communities can contribute to ageing in place for the categories of: quality of life, participation, daily functioning and meaning ( 25 ), especially in the areas of living arrangements, social contacts, the ability to ask for support, taking care of oneself and having a meaningful life. This could be achieved by facilitating services and facilities, suitable housing, senior-friendly design of public space, a pleasant and safe living environment, activities in the neighbourhood, information and communication, (in)formal support, domestic help, mobility and participation. Table 3 provides an overview of the results. Table 3 Results, Need Assessments: Older People According to the participants, vital communities can contribute to ageing in place for the categories: In the field of support for: By facilitating: Daily functioning Being able to ask for support Taking care of yourself • Information and communication • Services and facilities • (In)formal support • Independent living • Domestic help • Mobility • Accessibility of the living environment Quality of life Feeling happy Enjoyment Housing circumstances Feeling safe Having enough money • Well-being • Services and facilities • Suitability of the property • Design of the public space • Pleasant living environment • Budget friendly Participation Doing fun things together Being taken seriously Social contacts Doing meaningful things • Interventions and events in the neighbourhood • Services and facilities • Information and communication • Participation Meaning Having a meaningful life Lifelong learning • Participation • Independent living Online Stakeholder Sessions Two online stakeholder sessions took place. The participants recommended dividing the activation process into four logical steps: mapping out the current situation, drawing up a plan, implementing a plan and safeguarding the activation process. In addition to these four process steps, the participants provided an overview of goals, strategies, performance indicators and interventions. The goals are related to: what do we want to achieve by a vital community in specific terms? The strategy: what is the best way to achieve these goals? The measures: what are our critical performance indicators? The interventions: what are we going to do? Table 4 shows the results of the sessions. Table 4 Results from Online Stakeholder Sessions Objectives (What are we striving for?): Forming a vital community together to facilitate ageing in place . Goals (What do we want to achieve in concrete terms?) Strategy (What is the best way to achieve this?) Measures (What are our critical performance indicators?) Interventions (What are we going to do?) • Quality of life: Safe and pleasant living environment No loneliness and/or sadness • Well-being: Happy older people • Belonging: Participation Empowerment • Increase openness, trust and awareness through information and communication • Apply co-creation • Start small and grow autonomously • Activate people to implement ideas themselves by using a booster to get things going • Facilitate initiatives by professionals • Promote collaboration between residents and professionals • Connect key figures (ambassadors), residents and professionals in the neighbourhood • Promote intergenerational traffic by diversity in the composition of residents and housing arrangements • Reinforce the existing initiatives • Fewer feelings of loneliness and sadness • Happier residents • Larger social network • Increased co-reliance • Increased reciprocity • Lower healthcare demand • Fulfilment of needs • Create and start an accessible place for social sessions • Ask residents themselves • Awaken self-organising capacity (give a taste of more and take small steps) • Establish a loneliness contact point • Promote meeting in public spaces (greenery, benches) • Get to know each other • Increase sense of security • Ensure that meetings take place • Use social media • Use digital platforms • Inform about what already exists: e.g., newsletters • Use professional communication channels • Create a social information map • Promote reciprocity by encouraging (e.g., students learn to knit) • Make sure professionals are visible in the neighbourhood to stimulate the connection • Train volunteers to help older people increase their social networks [Insert Table 4 ] Quick Scan In addition, during the online stakeholder sessions, the stakeholders recommended developing a quick scan to map the vitality and development stages of the community. The development of this quick scan was not foreseen in advance, but, according to the participants, a more specific activation plan needed to be drawn up based on the development phase. The quick scan should be part of process step 1, mapping the current situation, and is developed on the basis of Wenger's ( 27 ) growth model for communities of practice. This growth model is in line with the wishes of the stakeholders. According to Wenger et al. ( 27 ), a community needs time and dedication to grow and passes through a number of phases as it does. During these phases, it has different support needs and different energy levels. The development phases of a community are potential, forming, maturing, self-sustaining and transforming ( 27 ). Based on Wenger’s theory and a scoping review concerning the conceptualisation of vital communities (blinded for review), the authors and participants developed and validated a quick scan containing four development phases, ten building blocks and 40 statements to map the vitality of a community (blinded for review). Design Based on the gathered data (see Table 3 ), six prototypes were developed during the design phase. These prototypes represented: 1) the resources for a vital community, 2) the combination of process steps, strategies and interventions, 3) the development phases of a vital community, 4) the community discovery learning circle, 5) the community empowerment wheel and 6) the community assessment tool. These prototypes were designed in several forms: a) a prototype of a website, b) a set of guidelines, c) roadmap, d) an infographic, e) an app, f) a Excel Microsoft file. These prototypes are visually represented in terms of content and design. Selecting Preferred Form During the selection phase, the participants recommended a set of guidelines (b) and an infographic (d) as preferred forms. The set of guidelines is a document in which all steps, strategies and interventions are described. The purpose of the proposed infographic is to provide a quick overview of the entire method and how to activate a community. Testing and Improvement During the first test session, participants rated the four process steps: 1) mapping out the current situation, 2) drawing up a plan, 3) implementing a plan and 4) safeguarding as relevant. Within these steps, however, the participants still missed the evaluation step, the focus on sustainable solutions, an inclusive society and the use of small success stories. These parts have been added to the guidance. In the second step, drawing up a plan, a format for a business plan based on the OGSM model ( 26 ), was proposed. Participants, were more supportive, however, of the use of the Business Model Canvas ( 23 ). According to the participants, this model is more commonly used in practice. The participants rated the proposed strategies as relevant. The user-friendliness of the guidance and infographic were rated as moderate (66%). According to the participants, more support for guiding is needed. The introduction of the method could be improved by means of video animations in an online environment. Table 5 presents an overview of the results of test session 1. Table 5 Results, Test Session 1: Evaluation Cards Evaluation card Results Explanation Improvement 1. Steps: Relevance Highly relevant Not applicable Not applicable Completeness Not complete Evaluation is missing (PDCA) Add focus on sustainable solutions Add focus on an inclusive society Add focus on the use of small success stories Add to step 4 2. Formats: Relevance Relevant Business Model Canvas is more suitable. Include in the guidance instead of the OGSM model Completeness Complete Not applicable Not applicable 3. Strategies: Relevance Highly relevant Not applicable Not applicable Completeness Complete 4. Usability Moderate (66%) More support is needed. Video animations in an online environment. During the second test session, the participants indicated that the points for improvement from session 1 had been properly integrated. They did, however, have two additions: namely, in steps one and three, add a second bullet (“attention to individual customisation” and “meet collectively”, respectively). Final Version The final version, named the Community Activation Compass and the output of this design-oriented study, consists of guidance and an infographic. A tree was chosen as a metaphor for the visualisation of the infographic. Hence, with this metaphor, the tree roots, the growth phases and the proverbial fruits can be visualised. The tree roots or resources of a vital community were defined as social cohesion, member commitment and activity, ownership, participation, leadership, involvement, openness and trust, demographic composition, physical environment and capacity (blinded for review). The tree itself represents the development phases of the community: the sowing phase, germination phase, growth phase and flowering phase. The apples symbolise the proverbial fruits of support for older people, such as quality of life, participation, daily functioning and meaning. The infinite circle around the tree visualises the process steps to be followed with strategies, interventions and formats that can be helpful in taking the community to the next development phase. Figure 1 shows the infographic. Discussion The aim of this study was to develop a method that could help community members—professionals, volunteers, care partners and older people—to select helpful strategies and interventions to activate a community in order to facilitate ageing in place. The findings of this study resulted in the Community Activation Compass. Theoretical and Practical Implications The participants recommended dividing the activation process into four logical steps: 1) mapping out the current situation, 2) drawing up a plan, 3) implementing a plan and 4) evaluating and safeguarding. With this method, the activation of a community could be achieved. Furthermore, the community-development process, according to Vincent ( 28 ) consists of approximately the same but more detailed steps: 1) establishing an organising group, 2) creating a mission statement, 3) identifying community stakeholders, 4) collecting and analysing information, 5) developing an effective communications process, 6) expanding the community organisation, 7) creating a vision statement, 8) creating a comprehensive strategic plan, 9) implementing the plan and reviewing and evaluating the planning outcomes and 10) creating new goals and objectives as needed. According to Vincent and John ( 29 ), the Plan Do, Check and Adjust cycle is a key aspect of community development. It is also important, however, to realise that the activation of a community is a dynamic process—a a set of steps that does not necessarily follow a sequential path. The steps may not follow the exact sequence above, and some can occur concurrently ( 29 ). In addition, once the community is activated, keeping alive its potential (to have a positive effect on people ageing in place) requires application of the Plan, Do, Check and Adjust circle as well. The stakeholder meetings have yielded several strategies that, according to the participants, contribute to activating communities. These strategies were logically divided among the four steps. The suggested strategies could contribute to the activation process but are not yet complete; after all, these strategies were developed from the context of the living lab and put forward by the participants. Nevertheless, the strategies to be applied depend on and vary with the development phase of the community ( 27 , 30 ). In addition to the development phase, the mechanisms of effectiveness and contextual factors of the community may also influence the strategies to be deployed ( 31 ). Therefore, a process evaluation of the set of guidelines in practice is recommended. The Community Activation Compass include two formats: a quick scan and the BMC model ( 32 ). The quick scan is part of the first step and a tool for mapping the vitality of the community. Other measuring instruments, however, are also available to map the vitality of communities or living arrangements, such as the Quality of Life Index ( 33 ). This measuring instrument, however, is based on the five dimensions: housing, physical environment, facilities for residents, safety and, in particular, the residential environment ( 34 ). Therefore, the quick scan has a broader perspective and also indicates the vitality of social (social cohesion and participation) and organisational (capacity and leadership) aspects. This broader perspective and its social and organisational dimensions are important for activating communities. Participants suggested the BMC model ( 32 ) as a format through which to draw an activation plan. According to them, this canvas is a commonly used model in practice. Visually representing an activation plan through this canvas tool supports developing and communicating a more holistic and integrated view of a business model or, in this case, an activation plan. The Triple Layered Business Model Canvas, however, is an interesting tool for exploring sustainable and socially oriented plans. It extends the original business model canvas by adding two layers: an environmental layer based on a life-cycle perspective and a social layer based on a stakeholder perspective. When taken together, the three layers of this canvas make more explicit how vital communities generate multiple types of value: 1) economic, 2) environmental and 3) social ( 35 ). According to the participants in this research, the developed Community Activation Compass has added value for activating communities. The steps, strategies, interventions and formats provided are seen as highly relevant and complete. Its user-friendliness, however, could be improved. Participants recommended a web-based version with short videos to explain the steps, strategies, interventions and formats. The expected effect of the developed Community Activation Compass is the activation of communities, which in turn will contribute to the quality of life of older people ageing in place. The participating older people expressed the importance of vital communities in terms of quality of life, daily functioning, participation and meaning. This is confirmed by the findings of Robertson, Gibson ( 36 ) demonstrating the importance of communities in supporting older people and their experienced individual quality of life; they argue for a movement beyond the concept of quality of life and towards the inclusion of perspectives regarding communal well-being, alongside the role communities play in influencing quality of life. By developing conceptions of quality of life in social relations and community cohesion—in particular how quality of life is influenced by perceptions of solidarity and social justice including across generations—assessing quality of life at community level will help drive cultural change in policy-making and practice. ( 36 ). Furthermore, according to a study by Cleland, Hutchinson ( 37 ), communities contribute to five salient quality of life dimensions: independence, social connections, emotional well-being, mobility and activities. To activate a community could be an intensive, time-limited intervention and is often multi-disciplinary in nature. The activation of communities, supported by the guidelines, is an inclusive approach that seeks to work with all kinds of people and organisations. It requires skilled professionals who are willing to adapt their practice, as well as receptive older people, families and care partners. Still, supporting ageing in place in vital communities may be just the right thing to do. Hence, ( 33 ) the great majority of older people prefer to remain in their own homes and communities as they age ( 3 ), and there is a demand for more efficient health and social care support ( 4 ). Limitations and Recommendations for Future Research Our study has several strengths. First, we used a design-oriented research methodology to involve parties in an iterative and interactive approach ( 9 , 10 ). The approaches in this study followed the principles of co-creation by means of involving stakeholders as full and equal partners in all phases of the research process. Second, to enhance the trustworthiness of the study, the data-analysis process was done independently, by two reviewers. This study may have also been subject to certain limitations, however. First, ten of the twenty participants opted out of the needs assessment with seniors in the neighbourhood due to the Covid-19 pandemic. Online meetings as an alternative to physical meetings with this group of older people, unfortunately, turned out to be impossible. Hence, the data collected during the meetings may not be complete. Secondly, the age of the ten participants was between 75 and 80. This implies that the support needs of those aged > 80 were not taken into account first-hand. Thirdly, when recruiting the professionals, general practitioners, practice nurses and occupational therapists were not available to participate in this design-oriented study. Their vision has therefore not been included in the set of guidelines. The development of this set of guidelines took place in a living lab. How the guidance will work in practice must be researched further. Therefore, it is recommended that a systematic process evaluation of the application of the guidance in practice be carried out in which three components are evaluated: 1) the implementation, 2) the mechanisms through which change or activation occurs and 3) the context in which this takes place ( 38 ). Conclusion The Community Activation Compass, to support the activation of a community in facilitating ageing in place, consists of four process steps (mapping out the current situation, drawing up a plan, implementing a plan, and evaluating and safeguarding). These four steps provide possible strategies, interventions and formats (the quick scan and Business Model Canvas). All steps, strategies, interventions and formats were described in a set of guidelines and an infographic. Based upon the gathered data and feedback in the co-creation sessions, the compass is likely to add value for communities and older people ageing in place. This contribution particularly relates to the perceived quality of life, participation, daily functioning and meaning. Still, well-monitored and documented future implementations and application of the guidance should provide evidence for this claim; this is the next step we intend to take. Declarations Acknowledgments This research was supported by Maastricht University and Zuyd University of Applied Sciences in the form of sponsorship of time and human resources. The authors thank all participants for their participation in this study and Stadslabs Sittard-Geleen for facilitating the living lab. We also thank Chantalle Keulaarts, Anna-Chiara Pani and Claudia Smit for taking minutes during the sessions and helping analyse the data. The lead author (KPH) is a PhD researcher at Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, the Netherlands and the Research Centre for Facility Management, Zuyd University of Applied Sciences, Heerlen, the Netherlands. The funding body had no active role in the design of the study, data collection, data analysis, interpretation of data, or writing of the manuscript. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors Author information Katinka Pani-Harreman 1,2 , Gerrie Bours 1,3 , Joop M.A. van Duren 2 , and Sandra Zwakhalen 1,3 1 Research Centre for Facility Management, Zuyd University of Applied Sciences, Heerlen, the Netherlands 2 Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, AWO-L, Maastricht, the Netherlands 3 Academy for Nursing, Zuyd University of Applied Sciences, Heerlen, the Netherlands Katinka Pani-Harreman https://orcid.org/0000-0002-0112-6970 Gerrie Bours https://orcid.org/0000-0002-4286-1197 Joop van Duren https://orcid.org/0000-0002-4391-3606 Sandra Zwakhalen https://orcid.org/0000-0002-7561-5259 Contributions KH, and GB, JvD and SZ conceptualized and designed the study. KH collected the data. KH and GB analysed the data. GB contributed to the interpretation of results and provided critical revisions. K.H. wrote the main manuscript text .All authors reviewed and approved the final manuscript. Corresponding author Correspondence concerning this article should be addressed to Katinka E. Pani-Harreman, Zuyd University of Applied Sciences, Nieuw Eyckholt 300, 6419 DJ Heerlen, the Netherlands. E-Mail: [email protected] Ethics declarations Ethics approval The study was approved by the regional Medical Ethical Review Board (METC Zuyderland) in the Netherlands (METCZ20210166) and aligned with the principles outlined in the Declaration of Helsinki. This study did not fall under the scope of the Medical Ethical Review because it did not involve subjecting participants to actions or imposing a manner of behaviour on them. It was determined that written informed consent was not required, as per the committee’s exemption. Consent to participate All authors of this manuscript, including KP, GB. 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Co-creatie impact kompas Heerlen: LIME; 2021 [Available from: https://www.limeconnect.nl/wp-content/uploads/2021/03/Co-creatie-Impact-Kompas.pdf Moser A, Korstjens I, Series. Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. Eur J Gen Pract. 2018;24(1):9–18. Muijeen K, Kongvattananon P, Somprasert C. The key success factors in focus group discussions with the elderly for novice researchers: a review. J Health Res. 2020;34(4):359–71. Lyon AR, Coifman J, Cook H, McRee E, Liu FF, Ludwig K, et al. The Cognitive Walkthrough for Implementation Strategies (CWIS): a pragmatic method for assessing implementation strategy usability. Implement Sci Commun. 2021;2:1–16. Terwee CB, Prinsen CA, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, et al. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27(5):1159–70. Maramba I, Chatterjee A, Newman C. Methods of usability testing in the development of eHealth applications: a scoping review. Int J Med Informatics. 2019;126:95–104. Vlachogianni P, Tselios N. Perceived usability evaluation of educational technology using the System Usability Scale (SUS): A systematic review. J Res Technol Educ. 2022;54(3):392–409. Osterwalder A, Euchner J. Business model innovation: An interview with Alex Osterwalder. Research-Technology Manage. 2019;62(4):12–8. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88. Huber M. Towards a new, dynamic concept of health: Its operationalisation and use in public health and healthcare and in evaluating health effects of food [Disertation]. Maastricht: Maastricht University; 2014. van Bohn S. Loghum. Businessplan op 1 A4. HEADline. 2014;31(2):32–3. Wenger E, McDermott RA, Snyder W. Cultivating communities of practice: A guide to managing knowledge. Harvard Business; 2002. Vincent JW. Community development practice. 2014. In: An introduction to community development [Internet]. London: Taylor & Francis Group. 2nd. [125 – 44]. Vincent J, John W. Community development practice. An introduction to community development. Routledge; 2014. pp. 125–44. Webber E, Dunbar R. The fractal structure of communities of practice: Implications for business organization. PLoS ONE. 2020;15(4):e0232204. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ open [Internet]. 2015; 350:[1–6 pp.]. Qastharin AR. Business model canvas for social enterprise. J Bus Econ. 2016;7(4):627–37. Leidelmeijer K, Marlet G, Ponds R, Schulenberg R, van Woerkens C, van Ham M. Leefbaarometer 2.0: instrumentontwikkeling. Rigo Research en Advies & Atlas voor de gemeenten; 2014. Leidelmeijer K, Marlet G, Ponds R, Schulenberg R, Van Woerkens C, Van Ham M. Leefbaarometer 2.0: instrumentontwikkeling. Utrecht: Research en Advies; 2014. Joyce A, Paquin RL. The triple layered business model canvas: A tool to design more sustainable business models. J Clean Prod. 2016;135:1474–86. Robertson JM, Gibson G, Greasley-Adams C, McCall V, Gibson J, Mason-Duff J, et al. It gives you a reason to be in this world’: The interdependency of communities, environments and social justice for quality of life in older people. Ageing Soc. 2022;42(3):539–63. Cleland J, Hutchinson C, McBain C, Walker R, Milte R, Khadka J, et al. Developing dimensions for a new preference-based quality of life instrument for older people receiving aged care services in the community. Qual Life Res. 2021;30:555–65. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 16 Jan, 2026 Read the published version in BMC Geriatrics → Version 1 posted Editorial decision: Revision requested 12 Sep, 2025 Reviews received at journal 12 Sep, 2025 Reviews received at journal 28 Aug, 2025 Reviewers agreed at journal 05 Aug, 2025 Reviews received at journal 01 Aug, 2025 Reviewers agreed at journal 27 Jul, 2025 Reviewers agreed at journal 25 Jul, 2025 Reviewers invited by journal 25 Jul, 2025 Editor invited by journal 23 Jul, 2025 Editor assigned by journal 19 Jul, 2025 Submission checks completed at journal 19 Jul, 2025 First submitted to journal 04 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7046695","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":491558115,"identity":"ca757f4c-71e1-4110-b007-ea32ef1462a6","order_by":0,"name":"Katinka E. Pani-Harreman","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBUlEQVRIiWNgGAWjYBACCSA+AIQMBjARfhDBw8Agg1sLM5oWyQaIFh58WhhQtBgcIKBFsv38wcMFZ+wYzNnPPvvwMccuz/j8GTOJNwx3cGqR5klmODzjRjKDZU+68cyZ25KLzQ6cMZOcw/AMpxY5BqAWng/MQPekMTPzbmNO3Hawx0yaByiIUwv/Y5CWegaD88+Ymf9uq0/c3MyDX4u0BMiWG4cZDG4AbWHcdjhxAxsBLZIzHhsc5jlznMfgxjNmxt5txxNnnGErtpxjgFuLxPnEx595jlXLGZxPY2b4ua06sb//8MYbbyoOy+HSAgMoZrJIIKKJSMD8gUQNo2AUjIJRMLwBAEQJVNQkL7DVAAAAAElFTkSuQmCC","orcid":"","institution":"Zuyd University of Applied Sciences","correspondingAuthor":true,"prefix":"","firstName":"Katinka","middleName":"E.","lastName":"Pani-Harreman","suffix":""},{"id":491558116,"identity":"e298764f-e36d-4222-b74a-31efa313d513","order_by":1,"name":"Gerrie Bours","email":"","orcid":"","institution":"Zuyd University of Applied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Gerrie","middleName":"","lastName":"Bours","suffix":""},{"id":491558118,"identity":"09b5fc1d-2adb-4c90-8c2d-33db33bafad0","order_by":2,"name":"Joop M.A. Duren","email":"","orcid":"","institution":"Zuyd University of Applied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Joop","middleName":"M.A.","lastName":"Duren","suffix":""},{"id":491558119,"identity":"7c1e0bcd-2b3d-443f-99e3-ef2e36d4528c","order_by":3,"name":"Sandra Zwakhalen","email":"","orcid":"","institution":"Maastricht University, AWO-L","correspondingAuthor":false,"prefix":"","firstName":"Sandra","middleName":"","lastName":"Zwakhalen","suffix":""}],"badges":[],"createdAt":"2025-07-04 12:23:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7046695/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7046695/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12877-025-06797-6","type":"published","date":"2026-01-16T16:30:01+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":87784703,"identity":"b33f08ab-9e31-405b-9940-b68592ecfde4","added_by":"auto","created_at":"2025-07-29 03:24:10","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":234997,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eInfographic, Community Activation Compass\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7046695/v1/e4002e38b12128971ebd82a1.png"},{"id":100616218,"identity":"5a3bfbca-eaef-4ec8-b217-3b18c9bcf964","added_by":"auto","created_at":"2026-01-19 17:41:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":911811,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7046695/v1/94972dbf-e2e7-4770-8005-d1c669aa311d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Development of a Method to Activate Vital Communities’ Facilitation of Older People Ageing in Place: A Community-Based Participatory Research Study","fulltext":[{"header":"Background","content":"\u003cp\u003eThe ageing population is emerging as a key policy issue for governments and healthcare organisations. One reason for this is that the number of older people in populations around the world is increasing (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In Europe, the percentage of people aged 65 and over is expected to account for over 30% of the population by 2060 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Within the Europe, approximately nine out of ten older people in Germany, France, Finland and the United Kingdom live independently in their own homes. In the Netherlands, the percentage is even higher (95%) (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). In addition, older people prefer to live independently and to stay in their own homes, a situation known as \u003cem\u003eageing in place\u003c/em\u003e (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Many older people, however, face declining health, limitations in their functioning and/or other complex issues that affect their ability to live independently. As a result, the demand for care and support for older people will continue to increase (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). European welfare states with ageing populations promote the substitution of expensive forms of care, such as residential care, with less expensive forms, such as ageing in place with additional support.\u003c/p\u003e\u003cp\u003eThe Canadian Index of Wellbeing (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) describes \u003cem\u003evital communities\u003c/em\u003e as those that can cultivate and marshal strong, active and inclusive relationships among residents, the private sector, the public sector and civil-society organisations in order to create, adapt to and thrive in the changing world and thus improve the individual and collective well-being of citizens. The aim of vital communities is to meet individual and common needs: “in a vital community people of all generations work together to find the right balance between meeting individual needs and meeting the needs of the community as a whole” (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Vital communities seem to be able to contribute to ageing in place and the quality of life directly as providers of support (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). There is limited evidence on how to activate communities to facilitate ageing in place. Hence, this study aims to develop a method that can be of assistance to community members, professionals, volunteers, care partners and older people to select helpful strategies and interventions to activate a community in order to facilitate ageing in place. We, therefore, formulated the following research question: “What method can activate a community to support older people ageing in place?” This insight is needed to enhance the quality of life of older people who are ageing in place. A more comprehensive understanding of the development phases, the helpful strategies and the interventions for activating communities could be beneficial for community members in activating a vital community and customising the support they give older people.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eContext and Design\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe research was conducted in a living lab specially set up for this study in the south of the Netherlands. The living lab is a physical location as well as a joint approach in which participating parties experiment, co-create and test in a lifelike environment, delimited by geographical and institutional boundaries (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). A design-oriented research methodology was applied to involve parties in an iterative and interactive approach (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eStudy Population and Sampling\u003c/em\u003e\u003c/p\u003e\u003cp\u003eParticipants in this study were older people (n = 20) and other stakeholders involved in practice from the housing, healthcare and welfare sectors, municipalities and local associations (n = 33) living and working in the community setting of the living lab. The older people were recruited by distributing a flyer through the letterboxes in the neighbourhood. The selection of the stakeholders was based on snowball sampling (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The inclusion and exclusion criteria are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eInclusion and Exclusion Criteria Study Population\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudy Population\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInclusion Criteria\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eExclusion Criteria\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eOlder People\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAge ≥ 75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo Dutch speaking ability\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndependent living with some formal and/or informal support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eScore Tilburg Frailty Indicator 0–4 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLiving in the living lab environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eStakeholders from Practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWorking in the housing, healthcare, or welfare sectors or for a municipality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDelivering (in)formal care or activities aimed at older people\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMembers of local associations in the living lab environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eParticipants were informed in writing that their participation in the study was voluntary and that they were free to end their participation whenever they wanted. The study was approved by the regional Medical Ethical Review Board (METC Zuyderland) in the Netherlands (METCZ20210166) and aligned with the principles outlined in the Declaration of Helsinki. This study did not fall under the scope of the Medical Ethical Review because it did not involve subjecting participants to actions or imposing a manner of behaviour on them. The online sessions via Microsoft Teams were recorded with the verbal permission of the participants.\u003c/p\u003e\u003cp\u003e\u003cem\u003eData Collection\u003c/em\u003e\u003c/p\u003e\u003cp\u003e The approaches in this study followed the principles of co-creation by involving stakeholders as full and equal partners in all phases of the research process. Co-creation leads to outcomes that are more likely to be acceptable, valuable and enduring compared to traditional research (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). To develop the activation method, a systematic development process was followed comprising five phases: 1) needs assessment, 2) design, 3) selection, 4) finalising for further evaluation and 5) testing and improvement (Coulter et al., 2013). The phases are detailed in the following section.\u003c/p\u003e\u003cp\u003eNeeds-Assessment Phase. The first phase of the data collection was a needs assessment performed by context mapping (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) and was carried out by older people. Context mapping is a co-creative method to gain insight into the living environment, emotions and needs of participants, who draw a collage or mood board and tell their story. Context mapping goes a layer deeper than the usual interview methods do (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).Twenty older people who were ageing in place signed up for these meetings in small groups and were asked to express their needs for support while ageing in place. The output of these group conversations, mood boards, and minutes taken during the sessions were analysed and translated into a list of support needs. In addition to the meetings with older people, we organised two online sessions (using Microsoft Teams) with other 33 stakeholders involved. We obtained two smaller groups for the online sessions because smaller groups might be more suitable for complex topics, give the participants more time to voice their views and provide more detailed information (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). During these online stakeholder sessions, we presented the results of the needs assessment with older people and asked the stakeholders for additions and comments. In the second part of these online stakeholder sessions, we asked the participants what they thought was necessary to activate a community. In addition, we made an inventory of the preferred design of the method in practice. During this inventory, we used open-ended questions regarding the preferred design without giving any examples.\u003c/p\u003e\u003cp\u003eDesign Phase. Based on the gathered data from phase 1, the second phase aimed to develop prototypes (a valid method that addressed the user requirements) containing a set of steps, strategies and interventions for activating a community to facilitate ageing in place.\u003c/p\u003e\u003cp\u003eSelection Phase. The selection phase aimed to select the most suitable prototype. During an online session, the researcher presented the developed (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) prototypes via a PowerPoint presentation to the participating stakeholders. After the presentation, based on a prepared script (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), the researcher asked the participants to give their first reaction to the developed prototypes, including the content and design of the prototypes. The participants were also asked to choose the most applicable prototype.\u003c/p\u003e\u003cp\u003eFinalising Phase. Phase 4 aimed to determine the final version of the chosen prototype. The researcher processed the received feedback of phase 3 in a final test version for evaluation and dissemination.\u003c/p\u003e\u003cp\u003eTesting and Improvement Phase. Phase 5 aimed to test and improve the final prototype in a maximum of three iterations, involving all participants (older people and stakeholders) by cognitive walkthrough (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). This phase consisted of three physical meetings in the living lab environment. During the first meeting, the researcher presented the final test version and asked participants to evaluate this version on paper for its relevance, comprehensiveness, comprehensibility (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and usability (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The testing took place by the use of the co-creation method of evaluation cards containing pre-established hypotheses (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The participants discussed how they could use the prototype and what steps they should take to activate a community. They noted their feedback on the evaluation cards. During the second meeting, the improved versions were presented, and the participants were asked whether their feedback from the first round had been properly incorporated into this version and whether they had any additions. A third and final meeting took place in which the final version was presented. During this meeting, all participants involved were asked how this guidance could be implemented and developed further in practice.\u003c/p\u003e\u003cp\u003e\u003cem\u003eAnalyses\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe data, consisting of minutes and mood boards from the needs assessment with the older people, were deductively coded (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) by researcher one (KPH). This analysis was compared with the analysis of researcher two (CK) and determined based on consensus. If no consensus could be reached, a third researcher (JvD) was consulted. The categories were based on the six dimensions of the Positive Health approach contributing to people’s ability to deal with the physical, emotional and social challenges in life. The dimensions used were body functions, mental well-being, meaning, quality of life, participation and daily functioning (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). The analysis resulted in an overview of support needs.\u003c/p\u003e\u003cp\u003eThe data, existing minutes and recordings from the stakeholder sessions were deductively coded (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) by researcher one (KPH) by the use of the OGSM (Objective, Goals, Strategies and Measurement) model (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This analysis was compared with that of researcher three (JvD) and determined based on consensus. The used categories were objectives, goals, strategies and measures (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe data, existing minutes and evaluation cards from the testing sessions were deductively coded (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) by researcher one (KPH). This analysis was compared with that of researcher three (JvD) and determined based on consensus. The used categories were the pre-established hypotheses to test the relevance, comprehensiveness, comprehensibility (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and usability of the created method (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eCharacteristics of the Participants\u003c/em\u003e\u003c/p\u003e\u003cp\u003eIn phase 1, the needs assessment, ten out of twenty older people participated in the four meetings in the living lab environment. The other ten participants cancelled their participation due to the Covid-19 pandemic. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the characteristics of the participants.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eCharacteristics of Participants, Needs Assessment: Older People (n\u0026thinsp;=\u0026thinsp;10)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eResults\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage score on the Tilburg Frailty Indicator (TFI)\u003c/p\u003e\u003cp\u003e(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperiencing more than two chronic illnesses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 out of 10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperiencing lack of support of people in their own living environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 out of 10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperiencing feelings of loneliness and sadness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7 out of 10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 out of 10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 out of 10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage age\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75\u0026ndash;80 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn total, 22 out of 33 stakeholders participated in the two online stakeholder and/or test sessions. Five stakeholders worked for the municipal government, two in the healthcare sector, two in the housing sector, six in the welfare sector and seven in voluntary organisations and senior citizens' associations.\u003c/p\u003e\u003cp\u003e\u003cem\u003eNeed Assessments for Older People\u003c/em\u003e\u003c/p\u003e\u003cp\u003eDue to the Covid-19 pandemic, four sessions took place in groups of two or three older people. According to the participants, vital communities can contribute to ageing in place for the categories of: quality of life, participation, daily functioning and meaning (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), especially in the areas of living arrangements, social contacts, the ability to ask for support, taking care of oneself and having a meaningful life. This could be achieved by facilitating services and facilities, suitable housing, senior-friendly design of public space, a pleasant and safe living environment, activities in the neighbourhood, information and communication, (in)formal support, domestic help, mobility and participation. Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e provides an overview of the results.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eResults, Need Assessments: Older People\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAccording to the participants, vital communities can contribute to ageing in place for the categories:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIn the field of support for:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBy facilitating:\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDaily functioning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBeing able to ask for support\u003c/p\u003e\u003cp\u003eTaking care of yourself\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Information and communication\u003c/p\u003e\u003cp\u003e\u0026bull; Services and facilities\u003c/p\u003e\u003cp\u003e\u0026bull; (In)formal support\u003c/p\u003e\u003cp\u003e\u0026bull; Independent living\u003c/p\u003e\u003cp\u003e\u0026bull; Domestic help\u003c/p\u003e\u003cp\u003e\u0026bull; Mobility\u003c/p\u003e\u003cp\u003e\u0026bull; Accessibility of the living environment\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eQuality of life\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFeeling happy\u003c/p\u003e\u003cp\u003eEnjoyment\u003c/p\u003e\u003cp\u003eHousing circumstances\u003c/p\u003e\u003cp\u003eFeeling safe\u003c/p\u003e\u003cp\u003eHaving enough money\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Well-being\u003c/p\u003e\u003cp\u003e\u0026bull; Services and facilities\u003c/p\u003e\u003cp\u003e\u0026bull; Suitability of the property\u003c/p\u003e\u003cp\u003e\u0026bull; Design of the public space\u003c/p\u003e\u003cp\u003e\u0026bull; Pleasant living environment\u003c/p\u003e\u003cp\u003e\u0026bull; Budget friendly\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParticipation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDoing fun things together\u003c/p\u003e\u003cp\u003eBeing taken seriously\u003c/p\u003e\u003cp\u003eSocial contacts\u003c/p\u003e\u003cp\u003eDoing meaningful things\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Interventions and events in the neighbourhood\u003c/p\u003e\u003cp\u003e\u0026bull; Services and facilities\u003c/p\u003e\u003cp\u003e\u0026bull; Information and communication\u003c/p\u003e\u003cp\u003e\u0026bull; Participation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMeaning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHaving a meaningful life\u003c/p\u003e\u003cp\u003eLifelong learning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Participation\u003c/p\u003e\u003cp\u003e\u0026bull; Independent living\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003eOnline Stakeholder Sessions\u003c/em\u003e\u003c/p\u003e\u003cp\u003eTwo online stakeholder sessions took place. The participants recommended dividing the activation process into four logical steps: mapping out the current situation, drawing up a plan, implementing a plan and safeguarding the activation process. In addition to these four process steps, the participants provided an overview of goals, strategies, performance indicators and interventions. The goals are related to: what do we want to achieve by a vital community in specific terms? The strategy: what is the best way to achieve these goals? The measures: what are our critical performance indicators? The interventions: what are we going to do?\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the results of the sessions.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eResults from Online Stakeholder Sessions\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eObjectives (What are we striving for?):\u003c/p\u003e\u003cp\u003e\u003cem\u003eForming a vital community together to facilitate ageing in place\u003c/em\u003e.\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGoals (What do we want to achieve in concrete terms?)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrategy (What is the best way to achieve this?)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMeasures (What are our critical performance indicators?)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eInterventions (What are we going to do?)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Quality of life:\u003c/p\u003e\u003cp\u003eSafe and pleasant living environment\u003c/p\u003e\u003cp\u003eNo loneliness and/or sadness\u003c/p\u003e\u003cp\u003e\u0026bull; Well-being:\u003c/p\u003e\u003cp\u003eHappy older people\u003c/p\u003e\u003cp\u003e\u0026bull; Belonging:\u003c/p\u003e\u003cp\u003eParticipation\u003c/p\u003e\u003cp\u003eEmpowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Increase openness, trust and awareness through information and communication\u003c/p\u003e\u003cp\u003e\u0026bull; Apply co-creation\u003c/p\u003e\u003cp\u003e\u0026bull; Start small and grow autonomously\u003c/p\u003e\u003cp\u003e\u0026bull; Activate people to implement ideas themselves by using a booster to get things going\u003c/p\u003e\u003cp\u003e\u0026bull; Facilitate initiatives by professionals\u003c/p\u003e\u003cp\u003e\u0026bull; Promote collaboration between residents and professionals\u003c/p\u003e\u003cp\u003e\u0026bull; Connect key figures (ambassadors), residents and professionals in the neighbourhood\u003c/p\u003e\u003cp\u003e\u0026bull; Promote intergenerational traffic by diversity in the composition of residents and housing arrangements\u003c/p\u003e\u003cp\u003e\u0026bull; Reinforce the existing initiatives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Fewer feelings of loneliness and sadness\u003c/p\u003e\u003cp\u003e\u0026bull; Happier residents\u003c/p\u003e\u003cp\u003e\u0026bull; Larger social network\u003c/p\u003e\u003cp\u003e\u0026bull; Increased co-reliance\u003c/p\u003e\u003cp\u003e\u0026bull; Increased reciprocity\u003c/p\u003e\u003cp\u003e\u0026bull; Lower healthcare demand\u003c/p\u003e\u003cp\u003e\u0026bull; Fulfilment of needs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026bull; Create and start an accessible place for social sessions\u003c/p\u003e\u003cp\u003e\u0026bull; Ask residents themselves\u003c/p\u003e\u003cp\u003e\u0026bull; Awaken self-organising capacity (give a taste of more and take small steps)\u003c/p\u003e\u003cp\u003e\u0026bull; Establish a loneliness contact point\u003c/p\u003e\u003cp\u003e\u0026bull; Promote meeting in public spaces (greenery, benches)\u003c/p\u003e\u003cp\u003e\u0026bull; Get to know each other\u003c/p\u003e\u003cp\u003e\u0026bull; Increase sense of security\u003c/p\u003e\u003cp\u003e\u0026bull; Ensure that meetings take place\u003c/p\u003e\u003cp\u003e\u0026bull; Use social media\u003c/p\u003e\u003cp\u003e\u0026bull; Use digital platforms\u003c/p\u003e\u003cp\u003e\u0026bull; Inform about what already exists: e.g., newsletters\u003c/p\u003e\u003cp\u003e\u0026bull; Use professional communication channels\u003c/p\u003e\u003cp\u003e\u0026bull; Create a social information map\u003c/p\u003e\u003cp\u003e\u0026bull; Promote reciprocity by encouraging (e.g., students learn to knit)\u003c/p\u003e\u003cp\u003e\u0026bull; Make sure professionals are visible in the neighbourhood to stimulate the connection\u003c/p\u003e\u003cp\u003e\u0026bull; Train volunteers to help older people increase their social networks\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e[Insert Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e\u003cp\u003e\u003cem\u003eQuick Scan\u003c/em\u003e\u003c/p\u003e\u003cp\u003eIn addition, during the online stakeholder sessions, the stakeholders recommended developing a quick scan to map the vitality and development stages of the community. The development of this quick scan was not foreseen in advance, but, according to the participants, a more specific activation plan needed to be drawn up based on the development phase. The quick scan should be part of process step 1, mapping the current situation, and is developed on the basis of Wenger's (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) growth model for communities of practice. This growth model is in line with the wishes of the stakeholders. According to Wenger et al. (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), a community needs time and dedication to grow and passes through a number of phases as it does. During these phases, it has different support needs and different energy levels. The development phases of a community are potential, forming, maturing, self-sustaining and transforming (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Based on Wenger\u0026rsquo;s theory and a scoping review concerning the conceptualisation of vital communities (blinded for review), the authors and participants developed and validated a quick scan containing four development phases, ten building blocks and 40 statements to map the vitality of a community (blinded for review).\u003c/p\u003e\u003cp\u003e\u003cem\u003eDesign\u003c/em\u003e\u003c/p\u003e\u003cp\u003eBased on the gathered data (see Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e), six prototypes were developed during the design phase. These prototypes represented: 1) the resources for a vital community, 2) the combination of process steps, strategies and interventions, 3) the development phases of a vital community, 4) the community discovery learning circle, 5) the community empowerment wheel and 6) the community assessment tool. These prototypes were designed in several forms: a) a prototype of a website, b) a set of guidelines, c) roadmap, d) an infographic, e) an app, f) a Excel Microsoft file. These prototypes are visually represented in terms of content and design.\u003c/p\u003e\u003cp\u003e\u003cem\u003eSelecting Preferred Form\u003c/em\u003e\u003c/p\u003e\u003cp\u003e During the selection phase, the participants recommended a set of guidelines (b) and an infographic (d) as preferred forms. The set of guidelines is a document in which all steps, strategies and interventions are described. The purpose of the proposed infographic is to provide a quick overview of the entire method and how to activate a community.\u003c/p\u003e\u003cp\u003e\u003cem\u003eTesting and Improvement\u003c/em\u003e\u003c/p\u003e\u003cp\u003eDuring the first test session, participants rated the four process steps: 1) mapping out the current situation, 2) drawing up a plan, 3) implementing a plan and 4) safeguarding as relevant. Within these steps, however, the participants still missed the evaluation step, the focus on sustainable solutions, an inclusive society and the use of small success stories. These parts have been added to the guidance. In the second step, drawing up a plan, a format for a business plan based on the OGSM model (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), was proposed. Participants, were more supportive, however, of the use of the Business Model Canvas (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). According to the participants, this model is more commonly used in practice. The participants rated the proposed strategies as relevant. The user-friendliness of the guidance and infographic were rated as moderate (66%). According to the participants, more support for guiding is needed. The introduction of the method could be improved by means of video animations in an online environment. Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e presents an overview of the results of test session 1.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eResults, Test Session 1: Evaluation Cards\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvaluation card\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eResults\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eExplanation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eImprovement\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. Steps:\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelevance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHighly relevant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCompleteness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot complete\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEvaluation is missing (PDCA)\u003c/p\u003e\u003cp\u003eAdd focus on sustainable solutions\u003c/p\u003e\u003cp\u003eAdd focus on an inclusive society\u003c/p\u003e\u003cp\u003eAdd focus on the use of small success stories\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAdd to step 4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. Formats:\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelevance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRelevant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBusiness Model Canvas is more suitable.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eInclude in the guidance instead of the OGSM model\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCompleteness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eComplete\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. Strategies:\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelevance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHighly relevant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCompleteness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eComplete\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. Usability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eModerate (66%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMore support is needed.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eVideo animations in an online environment.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eDuring the second test session, the participants indicated that the points for improvement from session 1 had been properly integrated. They did, however, have two additions: namely, in steps one and three, add a second bullet (\u0026ldquo;attention to individual customisation\u0026rdquo; and \u0026ldquo;meet collectively\u0026rdquo;, respectively).\u003c/p\u003e\u003cp\u003e\u003cem\u003eFinal Version\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe final version, named the Community Activation Compass and the output of this design-oriented study, consists of guidance and an infographic. A tree was chosen as a metaphor for the visualisation of the infographic. Hence, with this metaphor, the tree roots, the growth phases and the proverbial fruits can be visualised. The tree roots or resources of a vital community were defined as social cohesion, member commitment and activity, ownership, participation, leadership, involvement, openness and trust, demographic composition, physical environment and capacity (blinded for review). The tree itself represents the development phases of the community: the sowing phase, germination phase, growth phase and flowering phase. The apples symbolise the proverbial fruits of support for older people, such as quality of life, participation, daily functioning and meaning. The infinite circle around the tree visualises the process steps to be followed with strategies, interventions and formats that can be helpful in taking the community to the next development phase. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the infographic.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this study was to develop a method that could help community members\u0026mdash;professionals, volunteers, care partners and older people\u0026mdash;to select helpful strategies and interventions to activate a community in order to facilitate ageing in place. The findings of this study resulted in the Community Activation Compass.\u003c/p\u003e\u003cp\u003e\u003cem\u003eTheoretical and Practical Implications\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe participants recommended dividing the activation process into four logical steps: 1) mapping out the current situation, 2) drawing up a plan, 3) implementing a plan and 4) evaluating and safeguarding. With this method, the activation of a community could be achieved. Furthermore, the community-development process, according to Vincent (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) consists of approximately the same but more detailed steps: 1) establishing an organising group, 2) creating a mission statement, 3) identifying community stakeholders, 4) collecting and analysing information, 5) developing an effective communications process, 6) expanding the community organisation, 7) creating a vision statement, 8) creating a comprehensive strategic plan, 9) implementing the plan and reviewing and evaluating the planning outcomes and 10) creating new goals and objectives as needed. According to Vincent and John (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), the Plan Do, Check and Adjust cycle is a key aspect of community development. It is also important, however, to realise that the activation of a community is a dynamic process\u0026mdash;a a set of steps that does not necessarily follow a sequential path. The steps may not follow the exact sequence above, and some can occur concurrently (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In addition, once the community is activated, keeping alive its potential (to have a positive effect on people ageing in place) requires application of the Plan, Do, Check and Adjust circle as well.\u003c/p\u003e\u003cp\u003eThe stakeholder meetings have yielded several strategies that, according to the participants, contribute to activating communities. These strategies were logically divided among the four steps. The suggested strategies could contribute to the activation process but are not yet complete; after all, these strategies were developed from the context of the living lab and put forward by the participants. Nevertheless, the strategies to be applied depend on and vary with the development phase of the community (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). In addition to the development phase, the mechanisms of effectiveness and contextual factors of the community may also influence the strategies to be deployed (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Therefore, a process evaluation of the set of guidelines in practice is recommended.\u003c/p\u003e\u003cp\u003eThe Community Activation Compass include two formats: a quick scan and the BMC model (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). The quick scan is part of the first step and a tool for mapping the vitality of the community. Other measuring instruments, however, are also available to map the vitality of communities or living arrangements, such as the Quality of Life Index (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). This measuring instrument, however, is based on the five dimensions: housing, physical environment, facilities for residents, safety and, in particular, the residential environment (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Therefore, the quick scan has a broader perspective and also indicates the vitality of social (social cohesion and participation) and organisational (capacity and leadership) aspects. This broader perspective and its social and organisational dimensions are important for activating communities.\u003c/p\u003e\u003cp\u003eParticipants suggested the BMC model (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) as a format through which to draw an activation plan. According to them, this canvas is a commonly used model in practice. Visually representing an activation plan through this canvas tool supports developing and communicating a more holistic and integrated view of a business model or, in this case, an activation plan. The Triple Layered Business Model Canvas, however, is an interesting tool for exploring sustainable and socially oriented plans. It extends the original business model canvas by adding two layers: an environmental layer based on a life-cycle perspective and a social layer based on a stakeholder perspective. When taken together, the three layers of this canvas make more explicit how vital communities generate multiple types of value: 1) economic, 2) environmental and 3) social (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAccording to the participants in this research, the developed Community Activation Compass has added value for activating communities. The steps, strategies, interventions and formats provided are seen as highly relevant and complete. Its user-friendliness, however, could be improved. Participants recommended a web-based version with short videos to explain the steps, strategies, interventions and formats.\u003c/p\u003e\u003cp\u003eThe expected effect of the developed Community Activation Compass is the activation of communities, which in turn will contribute to the quality of life of older people ageing in place. The participating older people expressed the importance of vital communities in terms of quality of life, daily functioning, participation and meaning. This is confirmed by the findings of Robertson, Gibson (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e) demonstrating the importance of communities in supporting older people and their experienced individual quality of life; they argue for a movement beyond the concept of quality of life and towards the inclusion of perspectives regarding communal well-being, alongside the role communities play in influencing quality of life. By developing conceptions of quality of life in social relations and community cohesion\u0026mdash;in particular how quality of life is influenced by perceptions of solidarity and social justice including across generations\u0026mdash;assessing quality of life at community level will help drive cultural change in policy-making and practice. (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Furthermore, according to a study by Cleland, Hutchinson (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), communities contribute to five salient quality of life dimensions: independence, social connections, emotional well-being, mobility and activities. To activate a community could be an intensive, time-limited intervention and is often multi-disciplinary in nature. The activation of communities, supported by the guidelines, is an inclusive approach that seeks to work with all kinds of people and organisations. It requires skilled professionals who are willing to adapt their practice, as well as receptive older people, families and care partners. Still, supporting ageing in place in vital communities may be just the right thing to do. Hence, (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) the great majority of older people prefer to remain in their own homes and communities as they age (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), and there is a demand for more efficient health and social care support (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eLimitations and Recommendations for Future Research\u003c/em\u003e\u003c/p\u003e\u003cp\u003eOur study has several strengths. First, we used a design-oriented research methodology to involve parties in an iterative and interactive approach (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). The approaches in this study followed the principles of co-creation by means of involving stakeholders as full and equal partners in all phases of the research process. Second, to enhance the trustworthiness of the study, the data-analysis process was done independently, by two reviewers.\u003c/p\u003e\u003cp\u003eThis study may have also been subject to certain limitations, however. First, ten of the twenty participants opted out of the needs assessment with seniors in the neighbourhood due to the Covid-19 pandemic. Online meetings as an alternative to physical meetings with this group of older people, unfortunately, turned out to be impossible. Hence, the data collected during the meetings may not be complete. Secondly, the age of the ten participants was between 75 and 80. This implies that the support needs of those aged\u0026thinsp;\u0026gt;\u0026thinsp;80 were not taken into account first-hand. Thirdly, when recruiting the professionals, general practitioners, practice nurses and occupational therapists were not available to participate in this design-oriented study. Their vision has therefore not been included in the set of guidelines. The development of this set of guidelines took place in a living lab. How the guidance will work in practice must be researched further. Therefore, it is recommended that a systematic process evaluation of the application of the guidance in practice be carried out in which three components are evaluated: 1) the implementation, 2) the mechanisms through which change or activation occurs and 3) the context in which this takes place (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe Community Activation Compass, to support the activation of a community in facilitating ageing in place, consists of four process steps (mapping out the current situation, drawing up a plan, implementing a plan, and evaluating and safeguarding). These four steps provide possible strategies, interventions and formats (the quick scan and Business Model Canvas). All steps, strategies, interventions and formats were described in a set of guidelines and an infographic. Based upon the gathered data and feedback in the co-creation sessions, the compass is likely to add value for communities and older people ageing in place. This contribution particularly relates to the perceived quality of life, participation, daily functioning and meaning. Still, well-monitored and documented future implementations and application of the guidance should provide evidence for this claim; this is the next step we intend to take.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by Maastricht University and Zuyd University of Applied Sciences in the form of sponsorship of time and human resources. The authors thank all participants for their participation in this study and Stadslabs Sittard-Geleen for facilitating the living lab. We also thank Chantalle Keulaarts, Anna-Chiara Pani and Claudia Smit for taking minutes during the sessions and helping analyse the data. The lead author (KPH) is a PhD researcher at Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, the Netherlands and the Research Centre for Facility Management, Zuyd University of Applied Sciences, Heerlen, the Netherlands. The funding body had no active role in the design of the study, data collection, data analysis, interpretation of data, or writing of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKatinka Pani-Harreman\u003csup\u003e1,2\u003c/sup\u003e, Gerrie Bours\u003csup\u003e1,3\u003c/sup\u003e, Joop M.A. van Duren\u003csup\u003e2\u003c/sup\u003e, \u003csup\u003e\u0026nbsp;\u003c/sup\u003eand Sandra Zwakhalen\u003csup\u003e1,3\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003e Research Centre for Facility Management, Zuyd University of Applied Sciences, Heerlen, the Netherlands\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003eMaastricht University, Care and Public Health Research Institute, Department of Health Services Research, AWO-L, Maastricht, the Netherlands\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003e Academy for Nursing, Zuyd University of Applied Sciences, Heerlen, the Netherlands\u003c/p\u003e\n\u003cp\u003eKatinka Pani-Harreman https://orcid.org/0000-0002-0112-6970\u003c/p\u003e\n\u003cp\u003eGerrie Bours https://orcid.org/0000-0002-4286-1197\u003c/p\u003e\n\u003cp\u003eJoop van Duren https://orcid.org/0000-0002-4391-3606\u003c/p\u003e\n\u003cp\u003eSandra Zwakhalen https://orcid.org/0000-0002-7561-5259\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKH, and GB, JvD and SZ conceptualized and designed the study. KH collected the data. KH and GB analysed the data. GB contributed to the interpretation of results and provided critical revisions. K.H. wrote the main manuscript text .All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence concerning this article should be addressed to Katinka E. Pani-Harreman, Zuyd University of Applied Sciences, Nieuw Eyckholt 300, 6419 DJ Heerlen, the Netherlands. E-Mail: [email protected]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval\u003c/p\u003e\n\u003cp\u003eThe study was approved by the regional Medical Ethical Review Board (METC Zuyderland) in the Netherlands (METCZ20210166) and aligned with the principles outlined in the Declaration of Helsinki. This study did not fall under the scope of the Medical Ethical Review because it did not involve subjecting participants to actions or imposing a manner of behaviour on them. It was determined that written informed consent was not required, as per the committee\u0026rsquo;s exemption.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors of this manuscript, including KP, GB. SZ and JvD, have provided their consent to participate in this study. The study was conducted in accordance with ethical guidelines, and informed consent was obtained from all human participants involved.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Key Facts on ageing and health: World Health Organization; 2021 [cited 2022 19-09-2022]. 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Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Ageing in place, vital communities, guidance, activation, support","lastPublishedDoi":"10.21203/rs.3.rs-7046695/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7046695/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe ageing population is emerging as a key policy issue for governments and healthcare organisations. Welfare states with ageing populations promote the substitution of expensive forms of care, such as residential care, with less expensive forms, such as ageing in place with additional support by vital communities. There is limited evidence on how to activate communities to facilitate ageing in place. Hence, this study aims to develop a method that can be of assistance for community members, professionals, volunteers, care partners and older people when selecting helpful strategies and interventions to activate a community to facilitate ageing in place.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA community-based participatory research methodology was applied to involve parties in an iterative and interactive approach to develop the activation method.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003e This study resulted in the creation of the Community Activation Compass, a guide and infographic containing a set of development steps, strategies, interventions and formats that could be of assistance to activate vital communities\u0026rsquo; facilitating ageing in place.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eActivating a community could be an intensive, time-limited intervention and is often multi-disciplinary in nature. An inclusive approach seeks to work with all kinds of people and organisations. Still, supporting ageing in place by vital communities may just seem the right thing to do.\u003c/p\u003e","manuscriptTitle":"The Development of a Method to Activate Vital Communities’ Facilitation of Older People Ageing in Place: A Community-Based Participatory Research Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-29 03:24:05","doi":"10.21203/rs.3.rs-7046695/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-12T20:10:43+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-12T07:27:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-28T07:57:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155869926624941240802237611209594652232","date":"2025-08-05T08:48:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-01T05:10:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"106074053420455458332192611455952619829","date":"2025-07-27T19:03:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"275539831963813954571023944710889248449","date":"2025-07-25T09:25:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-25T07:47:35+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-23T07:31:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-19T04:46:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-19T04:45:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Geriatrics","date":"2025-07-04T12:09:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"45ee31e5-8cbd-434f-89c5-e3b9d81599d7","owner":[],"postedDate":"July 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-19T17:06:06+00:00","versionOfRecord":{"articleIdentity":"rs-7046695","link":"https://doi.org/10.1186/s12877-025-06797-6","journal":{"identity":"bmc-geriatrics","isVorOnly":false,"title":"BMC Geriatrics"},"publishedOn":"2026-01-16 16:30:01","publishedOnDateReadable":"January 16th, 2026"},"versionCreatedAt":"2025-07-29 03:24:05","video":"","vorDoi":"10.1186/s12877-025-06797-6","vorDoiUrl":"https://doi.org/10.1186/s12877-025-06797-6","workflowStages":[]},"version":"v1","identity":"rs-7046695","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7046695","identity":"rs-7046695","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}