Evaluation of a community-led, cross sector partnership of housing, and healthcare to optimize aging: the unite care model

An older adult affordable housing community and a Federally Qualified Health Center partnered to improve the health of low-income older adults. The Unite Care Model included establishing onsite primary care, wellness support, and social needs assistance. The RE-AIM framework guided our mixed-methods evaluation. We sought to determine whether the model was associated with change in blood pressure, social or physical environment and understand model reach and implementation. Of the 251 residents, 13.1% had a clinic visit, and of respondents 70% attended at least one wellness event, and 35% received social needs assistance (reach). Clinic utilization was not associated with improved blood pressure or environment change (effectiveness). Residents reported barriers to clinic utilization including an established provider, uncertainty in transferring care, lack of urgent visits, and insurance barriers. Administrators echoed policy, staffing, and patient barriers to utilization (implementation). Expanding appointment options, increasing staffing, and overcoming insurance barriers may increase effectiveness.