In the context of health care delivery for senior citizens, this research utilizes three studies that examine the development and implementation of health policy and the factors that can directly or indirectly impact the effective delivery of health services to senior citizens. It utilizes three essays employing mixed methods (qualitative and quantitative) methods including semi structured interviews, multiple regression and partial least squares structural equation modelling to examine the extent to which the implementation of health services delivered attributes of primary and integrated care to seniors. The two essays identified methods, approaches and strategies of integrated care relevant to the development of policy that can be successfully implemented when the contextual issues that older people consider to be important in maintaining their functional capabilities and their motivation to improve health as perceived by them are addressed. Consequent upon the results from these studies, the third essay examines the methodological issues on integrated geriatric care implementation when guidelines for effective policy development identified were not followed. By highlighting the relationship between effective policy and patient satisfaction, these three essays' recommended approach enhances the theory of health design that confirms that theoretical models of primary care must incorporate the system, process and service delivery levels of care to optimize seniors health.

Higher education institutions are facing a major challenge in retaining 1st-year college students and engaging them in meaningful activities and programs to promote their sense of belonging (Strayhorn, 2012; Astin, 1993). Though a few belonging intervention practices have been studied (Perrell, 2018; Peck, 2011), there is a lack of understanding on the dynamic mechanisms of developing belongingness through a combination of belonging enhancement practices (Yob, 2014). Moreover, there is an urgent need to examine which belonging enhancement practice has the most impact on students' academic performance (Slaten, Elison, Hughes, Youg, & Shemwell, 2015). This study used convergent, parallel mixed-methods design to make meanings from both qualitative and quantitative data on the effect of the service-learning leadership program (SLLP) for 1st-year students at a large, public university on perceived sense of belonging and related academic performance, and the mechanism of the dynamic process. Quantitative data contained 2 parts: the 1st part is university student record data from 2007 to 2018 with total of 2,762 students, and the 2nd part of the data were collected through pre-and post-surveys from total of 262 students in treatment and control groups. Qualitative data were collected from 9 participants through individual interviews, focus group and weekly journals. Quantitative datasets were analyzed through mixed-design MANOVA, mixed-design ANOVA and hierarchical (logistic) multiple regressions, and qualitative data was analyzed through spiral approach. The findings demonstrated that the studied program protected against the decline of sense of belonging in the 1st semester of college year, and it brought more benefits to male and racial minority students as compared to female and racial majority students. Moreover, the findings indicated mentorship and living-learning community practices had the most impact on students' sense of belonging and academic performance, and suggested further improvement for performance feedback, social media and service-learning practice. The results of the study have implications for future institutional interventions and provide comprehensive practical guidelines for belonging enhancement programs for 1st-year students. The conclusions provide recommendations for designing and implementing belonging intervention programs that bring maximum outcomes on students' sense of belonging, retention and academic performance.

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