Aims: Participation in health programs supports healthy aging. This study described older adults’ reported reasons for non-participation in health center programs using the predisposing, enabling, and reinforcing domains of the PRECEDE-PROCEED model.
Materials & Methods: This cross-sectional study included 473 older adults (response rate: 94.6%) from 10 urban and rural health centers in Rafsanjan, Iran, in 2023. Multistage stratified random sampling was used. Data were collected using an interviewer-administered, researcher-developed 37-item questionnaire (12 predisposing, 18 enabling, 7 reinforcing items). Reasons were rated from 0 (very low) to 4 (very high). Content validity and reliability were established (Cronbach’s alpha: 0.75–0.86). Only descriptive analyses were performed; actual participation was not measured.
Findings: Mean domain scores were 10.52 ± 6.60/48 (predisposing), 10.52 ± 8.23/72 (enabling), and 4.21 ± 3.30/28 (reinforcing), representing 21.9%, 14.6%, and 15.0% of maximum scores, respectively. Mean item scores were 0.88, 0.58, and 0.60/4. The highest-rated reasons were multiple physical health problems (1.65 ± 1.45; 32.1% rated high/very high), lack of a companion (1.23 ± 1.33; 19.0%), and lack of family support (0.88 ± 1.06; 8.7%).
Conclusion: Physical health problems, lack of a companion, long distance, and lack of family support were the highest-rated reasons within their domains. These perceptions do not establish causes of non-participation but highlight potential needs regarding physical accessibility, service awareness, transportation, accompaniment, and family support. Further studies should assess actual participation.
Keywords: Aging, Geriatrics, PRECEDE-PROCEED model, Program Evaluation, Community Participation