What Makes Community Inclusion Work for Older Adults With an Intellectual Disability? An Application of the Normalisation Process Theory.

BACKGROUND

Older adults with intellectual disability experience high levels of loneliness and social exclusion. MATILDA is a community-based intervention supporting participation in mainstream community groups through volunteer mentors.

AIM: To use Normalisation Process Theory (NPT) to explore the processes, mechanisms, and barriers influencing implementation and sustainability.

METHODS

A qualitative study (focus groups and interviews with 29 adults with intellectual disability, volunteer mentors, intellectual disability staff, and community-group managers) across two UK sites. Data analysed using an NPT-informed framework.

FINDINGS: Implementation was supported through sense-making, engagement, collective action, and appraisal. Key mechanisms included Volunteer Co-ordinators, mentor support, participant-group matching, adaptable community groups, and strong relationships. Community inclusion emerged as relational work. Staffing pressures, transport difficulties, and resource constraints limited participation for some individuals.

CONCLUSIONS

MATILDA shows potential as a sustainable community inclusion intervention. Successful implementation depends on programme components and the relational and organisational work needed to support participation and belonging.

TRIAL REGISTRATION: ISRCTN, ISRCTN15294181. Registered 20th December 2022, https://doi.org/10.1186/ISRCTN15294181.