Scoping study of definitions of social participation: update and co-construction of an interdisciplinary consensual definition.

BACKGROUND: considering the importance of social participation for quality of life and active ageing in older adults, it is an important target of social and health professionals' interventions. A previous review of definitions of social participation in older adults included articles up to 2009; new publications and changes in the social context (e.g. social media and the COVID-19 pandemic) justify continuing this work.
OBJECTIVE: this paper provides an updated inventory and synthesis of definitions of social participation in older adults. Based on a critical review by content experts and knowledge users, a consensual definition is proposed.
METHODS: using a scoping study framework, four databases (MEDLINE, CINAHL, AgeLine, PsycInfo) were searched with relevant keywords. Fifty-four new definitions were identified. Using content analysis, definitions were deconstructed as a function of who, how, what, where, with whom, when, and why dimensions.
RESULTS: social participation definitions mostly focused on people's involvement in activities providing interactions with others in society or the community. According to this new synthesis and input from content experts and knowledge users, social participation can be defined as a person's involvement in activities providing interactions with others in community life and in important shared spaces, evolving according to available time and resources, and based on the societal context and what individuals want and is meaningful to them.
CONCLUSION: a single definition may facilitate the study of active ageing and the contribution of older adults to society, socioeconomic and personal development, benefits for older adults and society, self-actualisation and goal attainment.

Definitions of social participation should not reinforce social norms.

Involvement in meaningful interactions must be facilitated by health policies.

Future studies on definitions include older adults’ perspectives.

Introduction

Around the world, population ageing creates challenges for human and financial resources, individual health and quality of life, as well as equity and well-being in society [1]. Now more than ever, as the COVID-19 pandemic increases isolation and ageism [2], the importance of social interactions and participation is widely recognised (including in public policies) but this presents new challenges in terms of security and roles [3-5], At the beginning of the pandemic, one in three older Canadians (28.9%) reported concerns about maintaining social ties [6]. For most older Canadians (94.1%), opportunities for social interactions were and still are very limited. Based on a scoping review of the definitions of social participation in older adults, which included articles up to 2009, social participation could be defined as a person’s involvement in activities that provide interaction with others in society or the community [7]. As a health determinant, enhanced social participation helps older adults to be active and, in response to concerns about population ageing [8] that inspired public policies (e.g. [9]), is a key proposal of the World Health Organisation (WHO). Following the UK Minister for Loneliness’ appointment, several countries in Europe considered officialising efforts to combat loneliness [10], against which social participation has a known protective effect [11]. Social participation is also associated with a reduced risk of mortality [12-14] and morbidity [15], greater functional independence [16], greater satisfaction with life [17], and shorter hospital stays [18].

When social participation is optimal [19], older adults might have a sense of purpose and contribution, and their engagement benefits society as well as themselves [20]. For example, volunteering encourages values such as altruism and also fosters the feeling of being valued and respected in one’s community, which in turn increases resilience in response to stress [21] and can lead to positive mental health outcomes, including less loneliness [22]. Social participation should be seen as encompassing involvement not only in non-profit and public organisations, including volunteering, but also in many other aspects such as social and leisure activities, and informal support between families and neighbours. By participating in society according to their needs, desires and capacities, older adults reduce their risk of social exclusion, which is a ‘process through which individuals become disengaged from mainstream society, depriving people of the rights, resources and services available to the majority’ [23:681], and increases as they grow older. Lack of access to material resources such as income and housing or to healthcare restricts social participation [24] and increases inequalities, which could be attributable to the combination of population ageing, ongoing economic instability and situations of vulnerability [25]. Many factors, such as being over 80 years of age, having a low income [26], belonging to a racial, ethnic or linguistic minority, presenting one or more disabilities, or identifying as belonging to a sexual or gender minority [27], can interact and increase the risk of marginalisation and social exclusion [25]. It is thus essential to promote older populations’ social participation using processes that enable their inclusion. Such processes include giving them a voice, providing meaningful opportunities and improving access to proximity resources, while respecting their rights [24, 28], fighting systemic ageism [29], and reviewing policies on participation in ageing [30, 31]. Promotion of social participation should consider a variety of life experiences, foster structural and cultural access to participatory settings, and offer spaces supporting new identities, including ageing with disabilities.

To expand the study of social participation and better understand, encourage and value older adults’ contribution to society, it is important to adopt a consensual and current definition of the concept. Although a previous review contained a content analysis of definitions and proposed a synthesis [7], a qualitative study presented results according to dimensions [32], and a concept analysis was carried out [33], many researchers still define this concept in their own way [34], which only exacerbates the confusion surrounding the meaning of social participation. Moreover, a recent study of the current generation of older adults reported a lack of alignment between their aspirations, concerns and participation opportunities, especially for women [35]. As witnesses to or being involved in societal advances in social, civil and political rights, this generation is diversified and generally reaches older age in better health and living active lives, searching for freedom, wishing to start new life projects, and advocating for self-determination and a greater citizen presence [36]. They also report needing spaces to contribute and do their activities, regardless of their health and without worrying about being productive and useful [37, 38]. Today’s ageing generation wants to participate and be recognised and active, not necessarily in roles valued by society or liberal policies based on contributing and volunteering, but in ways that reflect their own interests and capacities. Empowered older adults can describe their own experiences and reality [39]. Moreover, in keeping with approaches involving personalisation [40] and reablement [41], older adults should be involved in revisiting the definition of social participation, i.e. given a voice in the conceptual work. This paper provides an updated inventory and synthesis of definitions of social participation in older adults. Based on a critical review by content experts and knowledge users, a consensual definition is proposed.

Methods

Following PRISMA guidelines [42], including collaboration between researchers and knowledge users [43] and validation by a documentalist (FL), the methodological framework for scoping studies [44, 45] was used to synthesise current knowledge concerning definitions of social participation in older adults. Papers retrieved were published between February 2009 and March 2020 in four databases with relevant keywords (Table 1). Papers were excluded if written in languages other than English or French or if they targeted a narrower concept (such as only participation in a senior centre or volunteering) that potentially did not fully represent the complexity of the concept of social participation. Inclusion criteria were that documents must: (i) report an empirical study, review or conceptual paper, and (ii) provide a definition of social participation. The definition selected must be an original statement (i.e. not refer to another source) of the meaning or description of the target concept. The title and, when available, abstract were reviewed for all papers identified through electronic searches carried out by MLT and ÉL. Reference lists, personal reference files of the principal investigator (ML), and websites were also searched.

Table 1

Synthesis of databases searched, selected keywords and search strategies

Databases	MEDLINE (with Full Text), CINAHL, AgeLine and PsycInfo
Keywords[strategy:	1. elder* OR seniors OR old* adult* OR geriatric OR aged OR ageing OR aging OR older people
1 AND 2]	2. community participation OR social participation OR social involvement OR social engagement OR community involvement OR community engagement OR civic participation OR social isolation OR social integration OR social contact* OR social activity* OR social inclusion* OR social interaction* OR solitude OR loneliness OR lonely OR social exclusion*

*Complete search strategy is available upon request.

Conceptual definitions were extracted from each paper by MLT and ÉL and content-analysed using seven predetermined interrogative pronouns: who, how, what, where, with whom, when and why [7]. These pronouns identified critical dimensions of the concept of social participation [46]. Themes emerging from this condensation were deductively organised and renamed according to the Human Development Model–Disability Creation Process (HDM–DCP), a model of human development and disability [47] similar to the International Classification of Functioning, Disability and Health [48] in terms of approaches, objectives, and elements of the models’ components [49]. The HDM–DCP illustrates interactions between personal and environmental factors, and participation. Three of the researchers (MLT, MLB, KG) independently performed the content analysis with an inter-rater agreement before discussion of 96.9% (number of identical codes/total number of codes); it was then validated by the principal investigator (ML). All discrepancies were resolved through discussion between at least two members of the interdisciplinary research team, with final decisions approved by the principal investigator (ML).

To enrich and validate the results of this first step, as is often done in scoping studies [43], the dimensions identified with the seven interrogative pronouns provided the starting point for a 90-minute workshop conducted by the principal investigator (ML). This workshop aimed to reach a consensus on key elements of the definition of social participation and identify participants’ perceptions of related challenges and concerns. The workshop involved 32 content experts and knowledge users, i.e. 11 researchers, 8 partners, 7 collaborators and 6 students from an interdisciplinary (social work, medicine, occupational therapy, etc.) emerging partnership on older adults’ social participation [50, 51]. While workshop participants were mainly academics who conducted research on social participation, partners and collaborators came from community organisations working directly with or representing older adults (e.g. seniors’ groups, volunteer organisations and roundtables across the province). All dimensions identified were discussed, not just the commonest. The workshop began with testimony concerning social participation from three older adults and, to validate the main ideas, finished with a synthesis of the proposal. The workshop was audiotaped and a research professional took notes, mainly on a clipboard. The workshop also included a 15-minute PowerPoint presentation summarising preliminary results, followed by a 60-minute discussion on which key elements to retain. During this discussion, older adults primarily shared their views while some of the researchers briefly raised points from their own studies to stimulate debate. The notes and audiotape were considered throughout the content analysis of the definitions and when proposing a consensual definition. By revisiting the definitions three times, i.e. synthesis and workshop, and triangulating these perspectives, the authors of the present paper corroborated the analysis and a consensus on the definition was reached. This work was supported by a Social Sciences and Humanities Research Council emerging partnership [#890–2012-0034].

Results

Of the 2,326 papers retrieved through electronic searches, almost half (n = 1,076; 46.3%) were duplicates and 936 did not meet the inclusion criteria based on titles and abstracts (Figure 1). Of the remaining 314, more than two fifths were excluded (n = 132; 42.0%) since they did not provide a definition of social participation; nearly half were eliminated (n = 144; 45.9%) because they referred to another source. Ultimately, 54 original definitions (from 53 papers), 15 of which were added because of extended search strategies (reference lists, suggestions from colleagues, websites; Figure 1), were extracted and content-analysed (Table 2). Year of publication of the papers containing an original definition ranged from 1987 to 2020. Almost three quarters (n = 38; 71.7%) were published after 2010, with the most productive year being 2019 (n = 7; 13.2%). A majority of first authors were from North America (n = 20; 37.7%) and Europe (n = 17; 32.1%), principally working in healthcare and social services (n = 36; 69.2%; medicine, social work, psychology), and especially public health (n = 14; 26.9%). More than one-third of the journals that published the papers were from the fields of public health (n = 20; 37.7%) and gerontology or geriatrics (n = 18; 34.0%), with nearly one-tenth from rehabilitation (n = 5; 9.4%). Only a limited number (<6% each) of the definitions came from the psychology, sociology, education and social work literature. Most papers specifically concerned older adults (n = 36; 66.7%) and used the term social participation (n = 30; 56.6%) or social engagement (n = 16; 30.2%; Table 2). A majority (n = 41; 77.4%) reported empirical results, mostly from quantitative cross-sectional (n = 24; 45.3%) or longitudinal (n = 12; 22.6%) studies. One-fifth (n = 11; 20.8%) of the papers were more conceptual, with the majority from reviews.

Figure 1

Flow chart

Table 2

Definitions of social participation identified through an extensive search of the literature from February 2009 to March 2020 (N = 54)

#Concepts (Author) [ref:page]	Definitions
Social participation (Hanson & Östergren) [52:850]	How actively the individual takes part in activities of formal and informal groups in society
Social engagement (Mor et al.) [53:2, 6]	Ability to take advantage of opportunities for social interaction; nursing home residents’ involvement in the social and recreational life of the facility
Social participation (Baum et al.) [54:415]	Individuals’ levels of participation in both social and civic affairs
Civic engagement (Adler & Goggin) [55:236]	Ways in which citizens participate in the life of a community in order to improve conditions for to others or to help shape the community’s future
Social participation (Lindström & The Malmö Shoulder-Neck Study Group) [56:283]	Person takes part in the activities of formal and informal groups as well as other activities in society
Social engagement (Hartwell & Benson) [57:331]	The extent to which individuals participate in a broad array of social roles, relationships and activities
Social participation (Plug et al.) [58:1811]	Ability to participate in work and education
Social participation (Brodie et al.) [59:5]	Collective activities that individuals may be involved in as part of their everyday lives. This might include: being a member of a community group, a tenant’s association or a trade union; supporting the local hospice by volunteering; and running a study group on behalf of a faith organisation
Social engagement (Dupuis-Blanchard) [60:1189]	A psychological thought process and a conscious behaviour that shapes all forms of social relationships and by which social ties and social networks are derived. This includes both relationships that are a source of social support and those that are less supportive
Social engagement (Park) [61:462]	Making social and emotional connections with people and the community; relationships with family, friends, and persons within the facility, social interactions through activities, reciprocity of relationships
Social engagement (Rubio et al.) [62:2]	Community involvement, for example, in terms of membership of neighbourhood associations, religious groups or nongovernmental organisations; formal social relations
Social participation (Broese van Groenou & Deeg) [63:448]	Social activities outside the home that provide opportunities to meet other people in productive or recreational activities
Social participation (Dalemans et al.) [64:537]	Performance of people in social life domains through interaction with others in the context in which they live
Social engagement (Kamiya et al.) [65:2]	A combination of objective and subjective measures of the salient aspects of people’s ‘social’ existence. The objective measures are defined by [. . .] participation in social groups (affiliation to or membership in religious, voluntary, political, and social associations or activities). The subjective measures comprise of perceptions of available emotional support from spouse, children, relatives and friends
Social participation (Levasseur et al.) [7:2146]	Person’s involvement in activities that provide interaction with others in society or the community
Social participation (Andonian & MacRae) [66:2]	Older adults [. . .] involved and meaningfully engaged within the contexts of their lives, such as community, friends and areas of interest
Social participation (Guillen et al.) [67:333]	Contacts a person has with other individuals•-Informal: interactions that an individual has with relatives, friends and work colleagues in an informal setting•-Formal: interactions resulting from involvement in established organisations in society
Social engagement (Timonen et al.) [68:52]	Participation in leisure activities and volunteering, and connectedness to family and friendship networks
Civic engagement (Ekman & Amnå) [69:291, 296]	Individual or collective actions:•-Individual: activities based on personal interest in and attention to politics and societal issues•-Collective: voluntary work to improve conditions in the local community, for charity, or to help others (outside the own family and circle of friends) Activities within the civil domain
Social participation (Legh-Jones & Moore) [70:1363]	Person’s level of engagement in formal and informal groups
Social engagement (Min et al.) [71:2]	Formal social engagements and social interactions with other friends and relatives
Social engagement (Thomas) [72:549]	Participation in activities that involve interactions between or among people, capturing a broader array of social interactions and intensity of interaction that may contribute to greater social integration
Community participation (Chang et al.) [73:772]	Active involvement in activities that are intrinsically social and either occur outside the home or are part of a nondomestic role
Social participation (Ontario Seniors’ Secretariat et al.) [74:7]	Interaction that older adults have with other members of their community and the extent that the community itself makes this interaction possible
Social participation (Takeuchi et al.) [75:2]	Person’s involvement in social activities
Social engagement (Walker et al.) [76:939]	Contacts or connections between individuals that include some element of socio-emotional exchange, that is, flows of interactive, utilitarian and affective elements
Social participation (Buffel et al.) [77:657]	Formal [. . .] voluntary commitment to community organisations on a regular basis
Social participation (Dong & Simon) [78:82]	Engagement in daily social activities
Social engagement (Jang et al.) [79:642]	Participation in social activities and socialisation with others
Social participation (Kanamori et al.) [80:1]	Participation in civic groups that an individual can join, regardless of occupation or family situation
Social participation (Lewis) [81:274]Social participation (Michielsen et al.) [82:371]	Being actively involved with family and community•-Formal: participation in community organisations•-Informal: participation more based on personal development and well-being
Social engagement (Zhang et al.) [83:334]	Carrying out meaningful social roles through activities embedded within social relationships
Social participation (Niedzwiedz et al.) [11:25]	Attending external activities, such as social clubs or volunteering
Social participation (Provencher et al.) [84:976]	Accomplishing an attempted life habit without difficulty
Social participation (Tomioka et al.) [85:555]	Person’s engagement in social groups
Social participation (Bourassa et al.) [86:133]	People’s involvement in social activities
Community participation (Lin) [87:1161]	Involvement in local economic, political, cultural and voluntary activities
Social participation (Carver et al.) [88:2]	Form of social interaction that includes activities with friends, family and/or other individuals
Social engagement (Shibayama et al.) [89:1062]	Participation in social activities, such as community events, volunteerism or providing support to older people
Social participation (Tomioka et al.) [90:801]	Respondent’s social group involvement
Community integration (Camacho et al.) [91:526]	Community involvement and interaction with social networks (e.g. attended religious services, attended a public meeting or visited friends or relatives)
Social participation (Chanda & Mishra) [92:3]	Involvement in society had occurred [. . .] The aspects were: public meeting, attending a club, participating in society or other meetings, etc.
Social engagement (Gyasi et al.) [93:156]	Interaction with neighbours and participation in social activities including attending religious services, social clubs/organisation meetings, sports/cultural activities and civic/political organisations
Social participation (Hosokawa et al.) [94:317]	Both aggressive participation and passive participation in social interactions (i.e. both time spent in social interaction and time spent in presence of others together)
Social engagement (Kubota et al.) [95:187]	Taking part in events, meetings and activities within a local community
Social participation (Pan et al.) [96:1959]	Two categories•-Formal: participation through membership of an organised association•-Informal: day-to-day activities initiated by older people themselves, without an organisation
Social participation (Zheng et al.) [97:6]	Various activities in which the older adults participate in their neighbourhood, including five styles: volunteer works, self-management and mutual assistance activities, lectures and reports, recreational and sports activities, and interest groups
Social participation (Aroogh & Shahboulaghi) [33:68]	Conscious and active engagement in outdoor social activities leading to interacting and sharing resources with other people in the community, and the person has a personal satisfaction resulting from that engagement
Social participation (Government of Quebec) [98]	Participating in activities of a social nature, i.e. nurturing meaningful relationships, being part of a community, and participating in group, volunteer or paid work activities
Social engagement (Luo et al.) [99:2]	To engage in both individual and society-level activities. Also called social participation or social involvement, forms the basis of social relationships or participation in a community and provides a sense of belonging, social identity, and fulfilment
Social involvement (Schwartz et al.) [100:2]	•-Informal: relationships with people from one’s social network, such as family and friends, and focuses on useful interactions that entail provision of support in which adults are needed and beneficial•-Formal: activity in formal organisations, such as volunteering
Civic engagement (Serrat et al.) [101:39]	Psychological attentiveness to social and political issues
Civic participation (Serrat et al.) [101:39]	Action [on social and political issues]; behavioural in nature; activities conducted individually (termed individual, private or informal participation) or within a group or organisation (termed collective, public or formal participation); civic activities may primarily aim to help others, solve a community problem or produce common good, with no manifest political intention (referred to as social, civil, community, pre-political or latent political participation), or may explicitly seek to influence political outcomes (termed political participation or manifest political participation)

Definitions

According to the content analysis based on the seven interrogative pronouns, dimensions related to how and what were found in most definitions (Table 3). Dimensions concerning who and where and with whom were present in almost half the definitions. Dimensions related to when and why were found less often (Table 3). No definitions specifically targeted instrumental activities or responsibilities (from the subcategories of activities and social roles, respectively; what), current (when) and satisfaction of needs or survival (why), but one definition newly focused on educating (from the contribution subcategories; why). Most definitions focused on people (who) involved (how) in activities providing interactions (what) with others (with whom) in society or the community (where). Following is a detailed description of the dimensions identified in the definitions for each interrogative pronoun.

Table 3

Synthesis of the content analysis of the original definitions of social participation found in the ageing literature

Interrogative pronouns	Dimensions [reference # of definition provided in Table 2 retrieved from February 2009 to March 2020 only]	Frequency (%) Current synthesis (N = 54)			(%) Previous synthesis* (N = 43)
		By dimensions	Total**	By dimensions	Total**
Who	1. People2–4, 6, 8, 13, 14, 16, 24, 37, 47, 48, 52	13 (24.1)	23 (42.6)	(14)	(53.5)
	1.1 Person1, 5, 15, 17, 20, 25, 30, 36, 41, 49	10 (18.5)		(44.2)
How	2. Involvement1–6, 8, 11, 14–18, 22, 23, 25, 29–32, 34, 37, 38, 40–48, 50, 51, 54	35 (64.8)	44 (81.5)	(62.8)	(76.7)
	2.1 Engagement16, 20, 21, 28, 36, 49, 51, 54	8 (14.8)		(9.3)
	3. Performance2, 7, 13, 19, 35, 54	6 (11.1)		(30.2)
What	4. Activities1, 5, 6, 8, 10, 14–16, 19, 22, 23, 30, 33, 34, 35, 39, 46–48, 50, 52, 54	22 (40.7)	50 (92.6)	(13.9)	(88.4)
	4.1 Social activities1, 3, 8, 11, 12, 14, 19, 25, 29, 37, 40, 42, 44, 46, 48–51, 54	19 (35.2)		(46.5)
	4.1.1 Productive activities12	1 (1.2)		(7.0)
	4.1.1.1 Work7, 50	2 (3.7)		(16.3)
	4.1.1.2 Voluntary activities8, 14, 18, 19, 27, 35, 38, 40, 48, 50, 52	11 (20.4)		(16.3)
	4.1.2 Community activities3, 8, 14, 19, 34, 40, 42–44, 46, 48, 53, 54	13 (24.1)		(25.6)
	4.2 Recreational activities12, 18, 44, 48	4 (7.4)		(18.6)
	4.3 Daily activities28, 47, 51	3 (5.6)		(11.6)
	4.4 Instrumental activities	–		(7)
	5. Social roles1, 5, 6, 17, 20, 21, 27, 32, 33, 47, 52	11 (20.4)		(16.3)
	5.1 Responsibilities	–		(4.7)
	6. Social interactions2, 6, 9, 10, 11–15, 17, 18, 21, 22, 24, 26, 29, 33, 39, 42, 44, 45, 50–52	24 (44.4)		(51.1)
Where	7. Environment2, 13, 17	3 (5.6)	23 (42.6)	(2.3)	(60.5)
	7.1 Community or society1, 4, 5, 11–13, 15, 17, 19, 23, 38, 41, 43, 46, 48, 49–52, 54	20 (37.0)		(46.5)
	7.1.1 Organisations11, 17, 30, 32, 43, 47, 52	7 (13.0)		(20.9)
With whom	8. Others10, 13, 14, 16–19, 21, 22, 24, 26, 29, 31, 39, 42, 44, 52	17 (31.5)	26 (48.1)	(32.6)	(48.8)
	8.1 Group1, 5, 10, 11, 14, 16, 20, 27, 31, 36, 41, 50, 54	13 (24.1)		(27.9)
When	9. Regular8, 27	2 (3.7)	2 (3.7)	(16.3)	(23.3)
	10. Current	–	–	(7)
Why	11. Development9, 12, 23, 26, 32, 53, 54	7 (13.0)	15 (27.8)	(9.3)	(44.2)
	12. Meaningfulness14, 16, 19, 22, 49, 51, 52, 54	8 (14.8)		(25.6)
	12.1 Contribution22	1 (1.2)		(9.3)
	12.1.1 Helping4, 19, 49, 54	4 (7.4)		(16.3)
	12.1.2 Receiving52	1 (1.2)		(9.3)
	12.1.3 Educating7	1 (1.2)		–
	13. Satisfaction of needs or survival	–	–	(16.3)

*Retrieved from January 1980 to February 2009 [7]

* *The same definition can appear under more than one dimension but only once for the total of each interrogative pronoun.

Who—Although one paper in five defined social participation from an individual perspective (person; Table 3), most definitions took a population perspective (people).

How—Social participation was mostly defined as involvement, i.e. taking part, and included participation, connection, contribution or integration of the person. While engagement referred to a stronger commitment and was mostly emphasised by public health, performance focused on actions and ability to take advantage of opportunities or participate.

What—Social interactions and activities were mainly found in the definitions, and generally came from the field of gerontology and geriatrics. Papers referred to life situations or different kind of activities: other, external, individual, collective, various, formal, informal, paid or voluntary. For one definition [62], social engagement specifically involves formal social relations, as opposed to informal ones that include ties to family and friends.

Where—Social participation was more commonly defined as happening in the community or society, especially in the public health literature, but also occurred in organisations, mostly related to gerontology and geriatrics. No definition specifically mentioned virtual participation.

With whom—Definitions mentioned that social participation involves family, friends, neighbours or other individuals, especially in gerontology and geriatrics, and also groups or associations, mostly in the public health field. Five definitions described how others or groups are involved, namely by offering social and emotional support, having a reciprocal relationship, or making the interaction possible.

When—According to two definitions, social participation takes place regularly.

Why—Finally, and mainly from the gerontology literature, approximately one definition in four mentioned that social participation involves development, mainly personal but also social (e.g. opportunities), or meaningfulness, such as helping others. Meaningfulness is based on older adults’ interests and what gives them a sense of belonging or fulfilment or contributes to their identity. Only one definition considered social participation as including support from others or being educated.

Co-construction of an interdisciplinary consensual definition

According to content experts and knowledge users and based on previous results and testimony from three older adults, social participation can be defined as the action of being involved in community life, socially or politically and structured by the environment, which places can be shared, and which are significant. Participating socially is a conscious, free choice, not an obligation, and it takes various evolving but significant forms (leisure, volunteering, or social and community activities) according to available time. Social participation is highly personalised, i.e. based on individual priorities, motivations, and interests, and involves social interactions and relationships with others. While it can be achieved for oneself and simultaneously for community well-being and development, social participation gives life meaning. Based on the literature review and to better represent older adults, social participation can be defined as a person’s (who) involvement (how) in activities providing interactions (what) with others (with whom) in community life and in important shared spaces (where), evolving according to available time and resources (when), and based on the societal context and what individuals want and is meaningful to them (why).

Discussion

This paper provides an updated inventory and synthesis of 55 definitions of social participation in older adults, enriched by a discussion with content experts and knowledge users. Based on these findings, social participation can be defined as a person’s involvement in activities providing interactions with others in community life and in important shared spaces, evolving according to available time and resources, and based on the societal context and what individuals want and is meaningful to them. A consensual definition is important in order to better communicate, develop or select measuring instruments, intervene, develop policy or analyse research results [7]. Although it shares similarities with the previous synthesis [7], this new definition emphasises the where, when and why. One conceptual analysis of social participation also emphasised the importance of community-based activities, interpersonal interactions, sharing of resources, active participation and individual satisfaction [33]. The why of the current definition is also globally related to all dimensions of social participation identified by Raymond and colleagues [32], which were developing significant relationships, enjoying pleasant group activities, engaging in a collective project, assisting and supporting each other, sharing knowledge, and being empowered in decisions concerning themselves. These dimensions provide clear examples of what older adults want and what contributes to their development and is meaningful to some of them. However, this does not constitute a norm and may differ from societal expectations, an important point that cannot be overemphasised. Linked to the key elements of the mobilisation process (sense of belonging and attachment, learning and stimulation, self-accomplishment, health and well-being, reciprocity, community development and social change) [32], the dimensions also highlight the involvement and even the engagement of older adults. Compared to involvement, engagement indicates a contribution that can be more demanding and sustained [7]; this appeared more often in recent definitions. Finally, the number of original definitions increased compared to the previous synthesis. This may be attributable, not just to the longer period, but also to the greater importance of this concept in the last decade or to the persistent lack of agreement.

Given the importance of active ageing and the contribution of older adults to society, socioeconomic and personal development, benefits for older adults and society, self-actualisation and goal attainment. Also emphasising the why, the influence of some international health policies must not reinforce normative standards or society’s expectations and stigmatise older adults who choose not to be or cannot be involved in some social activities. Older adults can participate socially without being involved in an organisation, such as by doing activities with their grandchildren or helping neighbours, family, friends or others, or even during everyday activities such as shopping or going to the hairdresser. While ageing, personal (e.g. capacities) and environmental (e.g. architectural barriers) resources that are mobilised to participate socially can change [47] and might necessitate assistance from community organisations and health and social professionals [102]. To encompass a broader perspective of social participation, professionals who work with older adults might also help them to use relevant resources, and promote their autonomy and connectedness with the community [98]. Social participation must be recognised as a personal choice and human right, and health policies should include actions to facilitate involvement in activities or interactions meaningful to people, especially older adults with disabilities or insufficient personal or environmental resources.

Compared to the previous synthesis [7], recent definitions referred less often to where social participation takes place. Based on the workshop, community is important, as is community life, which highlights the importance of social interactions and activities that take place in the neighbourhood and other public spaces. During the COVID-19 pandemic and despite sanitary measures, using public spaces generated anxiety in older adults and most people worried about infecting family members or friends through social interactions [103], which greatly increased the risk of being socially isolated [104]. To foster physical distancing and restrict propagation of the virus, the size and ventilation of these public spaces and building materials used must be rethought. Friendliness and safety of neighbourhoods are also important factors associated with social participation that have been emphasised not only in policies (e.g. [28] or [8]) but also in empirical studies synthesised in a review [105]. Sometimes the environment itself can cause social exclusion [25], like stairs for people with limited mobility. With advancing age, life space can be even more restricted and the neighbourhood becomes a central element in the social participation of older adults [106, 107], including interactions between neighbours [108].

Time was also mentioned less often in this new synthesis, yet evolution of the concept over time is an important dimension, which was reported in this study’s workshop and documented in previous studies [109-115]. For instance, when interviewed about their neighbourhood participation, New Zealanders aged 85 and over reported holding onto everyday life as participating and being concerned about maintaining their capacities while ageing [116]. Evolution can occur not just in individuals but also between generations [35], justifying the need to revisit the concept over time, especially when important societal changes occur, such as increased use of social media or a pandemic. The workshop also raised the issue of the time available to participate socially, a dimension linked to ‘optimal’ participation, being the fit between an individual’s reality governing how (and how often; when) social activities are done and expectations about them [19].

Although the why and, more specifically, reference to meaningfulness were added after the workshop, fewer definitions in the recent literature included this dimension compared to the previous synthesis [7], a finding that may concern the baby boomer generation which values freedom, new life projects, self-determination and greater citizen presence [36]. In addition, older adults may feel they contribute to society and fulfil a role when they help others, such as by volunteering, babysitting or caring for family members [117]. The importance of meaningful activities and purposeful life has been highlighted, especially in the occupational sciences [118], and there are emerging interventions that empower older adults to develop their own routines fostering their health and making life more fulfilling. For example, Lifestyle Redesign® [119], a preventive occupational therapy intervention has been shown to improve health, be cost-effective [120] and has been adapted to many contexts, including Quebec, Canada [121, 122]. While it is important to prevent loneliness and isolation, social participation should not only be a way for older adults to stay active, it should also increase their well-being, feeling of being valued and sense of purpose. Finally, rather than being an obligatory contribution to society, including economic activities, meaningfulness should have a more central place in health policies, according to the content experts and knowledge users in this study. Thus, to improve health promotion, these policies should increase their scope to specifically include informal and meaningful participation, which would encompass a broader spectrum of the ageing population.

Strengths and limitations

Expanding upon a previous synthesis and using a rigorous, innovative procedure, a methodological framework for scoping studies and content analysis using interrogative pronouns, this study presents an in-depth review of many original definitions of social participation found in various multidisciplinary databases. This procedure involved at least two people analysing the content of definitions and a workshop with content experts and knowledge users from an emerging interdisciplinary partnership on social participation. Among its limitations, this study did not include the concepts of participation, societal participation, handicap, disability, meaningful activities and occupation, which generated too many unrelated results, although some papers using these concepts might have been relevant. Moreover, retrieving original definitions was occasionally challenging as papers sometimes define the concept implicitly or mainly for operationalisation purposes. Finally, although they might reflect an evolution in the definitions or different perspectives in the group, opinions from two groups of authors [85, 90, 101] might be overrepresented in the analysis as two original definitions were extracted for each group.

Conclusion

This scoping study provides an updated inventory and synthesis of definitions of social participation in older adults enriched by a critical review involving content experts and knowledge users. Although the literature mostly defined social participation as people’s involvement in activities providing interactions with others in society or the community, content experts and knowledge users emphasised the importance of community life and shared spaces. Moreover, social participation should be seen as evolving with available time and resources and based on what individuals want and is meaningful to them [123] and the societal context. As the pandemic clearly showed, social participation and interactions are essential for people’s well-being. To enable community organisations, healthcare providers and decision-makers to encourage social participation, on the ground and in policies, a deep understanding of its conceptualisation is needed as it evolves with virtual communications and respect for social distancing. In their studies, researchers must provide a definition of social participation and choose a measuring instrument accordingly. Future studies should involve older adults, family members and professionals working with them and examine how social participation is operationalised and measured. To make it easier to compare research results, the aim should be to achieve a consensus regarding a single definition and a measuring instrument.