Patient-Centered Care in Healthcare Services: Feedback from Older Adults Engaging in Primary Care-Based Behavioral Health Programs.

Abstract

This study examines older adults' perspectives on patient-centered care and engagement in a short-term behavioral health intervention, addressing persistent barriers to mental health access in aging populations. Guided by the NIH Stage Model (Stage 1), the goal was to refine the intervention by integrating participant feedback to enhance recruitment, retention, and overall program acceptability. Data were drawn from focus groups with residents of The Villages® community, alongside program participation and survey records. The 12-week intervention enrolled 183 participants; 115 (62.8%) completed all 10 sessions and both intake and exit surveys. Most completers were female (75.7%) and white (92.2%), with anxiety (60.9%) and depression (54.8%) as the most common treatment reasons. While completion rates were moderate, 37.2% dropped out, and only 33.8% of non-completers responded to follow-up inquiries, underscoring ongoing retention challenges. Findings highlight the potential of embedding behavioral health services within primary care to reduce stigma, improve accessibility, and leverage trust in existing provider relationships. Older adults valued clear communication, early demonstration of benefits, and interventions tailored to their preferences and cultural context. However, early discontinuation-often after perceived improvement-suggests a need for strategies that encourage sustained engagement, such as rapport-building, booster sessions, or follow-up reminders. From a systems perspective, integrating behavioral health into primary care can promote equity, reduce logistical barriers, and support more holistic care delivery. These insights can guide providers, policymakers, and researchers in designing responsive, patient-centered interventions that improve both engagement and outcomes for older adults.