Transforming long-term care: a participatory theory of change approach toward community-centered solutions

Long-term care is a priority for public policy in Spain, especially after COVID-19. The InCARE Project (Supporting INclusive development of community-based long-term CARE services through multi-stakeholder participatory approaches) promoted participatory policy and service development, using a Theory of Change (ToC) approach. The Theory of Change describes a causal pathway for making strategic changes in the long-term care system over the next decade, aiming to achieve the desired impacts. A two-day workshop was held with 32 stakeholders, including policymakers, professionals, family carers, and people who use care services. A national ToC and a specific pilot project ToC outlined the steps required to improve the long-term care system to fulfill the needs and preferences of people in situations of dependency. The Theory of Change approach can be highly valuable for policy design, and it provides an integrated action map to guide the changes and inform political and management actions in the coming years.