Public-Facing Communication of Health and Social Services for Older Adults and Their Family or Friend Caregivers: Environmental Scan of 58 Integrated Care Teams' Websites in Ontario, Canada

Abstract

Background: Family or friend caregivers of older adults are critical in helping older adults navigate fragmented health and social systems, but they face significant challenges in doing so. Their needs for support, information, and resources are often unmet or remain largely invisible to health and social systems and public policy. In Ontario, Canada, Ontario Health Teams (OHTs) were established to integrate and streamline health care services. However, emerging evidence suggests that despite the requirement to integrate patient and caregiver advisors in these activities, caregivers still face substantial navigation barriers. Objective: This study aimed to systematically evaluate the amount, nature, and accessibility of information provided on each of the 58 OHT websites. Specifically, we focused on information on services and supports for older adults and their caregivers. Methods: Between November 2024 and May 2025, we conducted an environmental scan of all 58 OHT websites. Using a 5-point Likert scale, 2 team members independently rated how easy or difficult it was to identify services and supports for older adults and their caregivers. They also documented each service and support listed on each website and provided additional details on the experience of navigating the website in an open-text comment. The ratings were discussed in team meetings, and discrepancies were resolved through team consensus. Data analysis included thematic analysis of the services identified and of open-text responses (positive and negative experiences of navigating the websites, rationales for the ratings), as well as descriptive statistics of the ease of access ratings and of the types of services listed on OHT websites. Results: Almost 60% of the websites were rated as difficult or very difficult to navigate, and 33% provided insufficient information on services and supports. However, information quality and accessibility varied significantly between websites. While some featured clear, well-organized resources, others were poorly designed, lacked a well-functioning search function, or provided vague or incomplete descriptions of services and supports. Design features that improved the accessibility and usefulness of websites included user-friendly, simple navigation and direct links to relevant services. In contrast, poorly designed websites often require multiple steps to access essential information, risking exacerbating caregiver burden. Conclusions: Our findings highlight significant barriers for caregivers to access and navigate health and social service information, despite the intended goals of OHTs to improve system navigation. Health care system reforms focusing on integrated care need to include older adults and their caregivers as priority populations. Older adults and caregivers need to be engaged systematically and comprehensively, including in the development, design, and evaluation of health care system websites. Further, standards of public reporting need to be developed, and integrated care networks need to be required to follow these standards. This will help to improve transparency and accountability.