ArticleFrontiers in public health2026
Construction strategies and implementation pathways of resilience governance system for care risks in older adult care institutions from a social-ecological perspective.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Against the backdrop of population ageing, the governance of care risks in older adult care institutions has become a global challenge. This paper aims to construct a resilience governance system for care risks in older adult care institutions based on social-ecological systems theory, exploring its construction strategies and implementation pathways. The article first reviews the development trajectory of resilience governance theory in social sciences, then introduces social-ecological systems theory into the research on risk governance in older adult care institutions, constructing a resilience governance framework encompassing macro, meso, and micro levels. The study proposes a three-dimensional construction strategy of 'concept-element-mechanism', including three core concepts and three operational mechanisms. Regarding implementation pathways, the article demonstrates a trinity implementation strategy of strengthening resilience governance subject coordination, improving resilience governance policy support, and digital technology empowerment of resilience governance. International case analyses of older adult care institutions' responses to the COVID-19 pandemic are presented as illustrative examples demonstrating the framework's relevance and applicability, rather than as formal empirical validation. Research indicates that the resilience governance system from a social-ecological perspective can effectively enhance the capacity of older adult care institutions to respond to care risks, providing theoretical basis and practical guidance for constructing a sustainable older adult care service system. The innovation of this paper lies in combining social-ecological systems theory with resilience theory, constructing a systematic, dynamic, and adaptive governance framework, opening up new theoretical perspectives for research on risk governance in older adult care institutions exploring its construction strategies and implementation pathways. The article first reviews the development trajectory of resilience governance theory in social sciences, then introduces social-ecological systems theory into the research on risk governance in older adult care institutions, constructing a resilience governance framework encompassing macro, meso, and micro levels. The study proposes a three - dimensional construction strategy of "concept-element-mechanism," including three core concepts: development-security co-construction, temporal-spatial integration, and action-governance alignment. These concepts should emerge from co-creation with multiple stakeholders (e.g., older adult residents, caregivers, families) to ensure they reflect diverse values. Beyond risk mitigation, the framework prioritizes wellbeing, dignity, and a sense of meaning-key values for human-centered resilience in older adult care. Additionally, as well as three operational mechanisms: adaptive proactive circulation mechanism, full-element resilience coupling mechanism, and whole-process dynamic response mechanism. Regarding implementation pathways, the article demonstrates a trinity implementation strategy of strengthening resilience governance subject coordination, improving resilience governance policy support, and digital technology empowerment of resilience governance. Through case analysis of global older adult care institutions' responses to the COVID-19 pandemic, this paper validates the effectiveness of the resilience governance system and proposes localization recommendations combined with Chinese practice. Research indicates that the resilience governance system from a social-ecological perspective can effectively enhance the capacity of older adult care institutions to respond to care risks, while acknowledging the necessary trade-offs between resilience and other priorities (e.g., cost, equity) in resource-constrained settings, providing theoretical basis and practical guidance for constructing a sustainable older adult care service system. The innovation of this paper lies in combining social- ecological systems theory with resilience theory, constructing a systematic, dynamic, and adaptive governance framework, opening up new theoretical perspectives for research on risk governance in older adult care institutions.
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