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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Rantanen T. What mobility factors are critical to include in a comprehensive mobility discharge assessment framework for older adults transitioning from hospital-to-home in the community? An international e-Delphi study. Disabil Rehabil 2024; 46:2808-2820. [PMID: 37409876 DOI: 10.1080/09638288.2023.2232293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE To prioritize and achieve consensus on mobility determinant factors [cognitive, financial, environmental, personal, physical, psychological, social] considered critical to include in the COmprehensive Mobility Discharge Assessment Framework (COMDAF) for older adults transitioning from hospital-to-home. MATERIALS AND METHODS We conducted a three-round modified e-Delphi process with 60 international experts (seven older adults, nine family caregivers, 24 clinicians, and 20 researchers) from nine countries with universal or near-universal health coverage. Expert members rated 91 factors identified from scoping reviews using a 9-point scale: not important (1-3), important (4-6), and critical (7-9). RESULT A total of 41 of 91 factors (45.1%) met the a-priori consensus criterion after three rounds: five cognitive, five environmental, two personal, 19 physical, six psychological, and six social factors. No financial factors reached a consensus. The older adult steering committee member recommended the addition of two environmental factors, resulting in 43 mobility factors included in the COMDAF. CONCLUSIONS We advanced a comprehensive mobility framework by developing, through consensus, 43 mobility factors to be assessed as part of a COMDAF. However, its use in hospital-to-home may not be feasible. Therefore, future research will determine the core mobility factors for COMDAF and which measurement instruments best measure these factors. RELEVANCE An interdisciplinary discharge rehabilitation team can utilize the COMDAF during hospital-to-home transition.Implications for rehabilitationMobility assessment following a hospital discharge is a complex process requiring an interdisciplinary discharge rehabilitation team.This study provided a comprehensive list of 91 factors across all seven mobility determinants (cognitive, environmental, financial, personal, physical, psychological, and social) for clinicians in other care settings to use as a starting point to determine which mobility factor should be assessed during older adults' hospital-to-home transition.This international e-Delphi study identified 43 factors within mobility determinants (cognitive, environmental, personal, physical, psychological, and social) to be included in a Comprehensive Mobility Discharge Assessment Framework to assess older adults' mobility during the hospital to home transition.Using these 43 factors, clinicians can identify which assessment tool is best suited to assess the factors while reflecting on the logistics and feasibility; this is the next phase of this project.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Science, University of Jyvaskyla, Jyvaskyla, Finland
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Gripko M, Joseph A. The Role of the Built Environment in Supporting Older Adults' Engagement: A Narrative Literature Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024:19375867241250320. [PMID: 38738947 DOI: 10.1177/19375867241250320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVE This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods. BACKGROUND Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts. METHODS A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being. RESULTS Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security. CONCLUSIONS Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.
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Affiliation(s)
- Monica Gripko
- Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
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Chan DYL, Chong CY, Teh PL, Lee SWH. What drives low-income older adults' intention to use mobility applications? Geriatr Gerontol Int 2024; 24 Suppl 1:342-350. [PMID: 38169136 DOI: 10.1111/ggi.14790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
AIM Mobility applications have the potential to support low-income older adults in facing mobility challenges. However, there is a generally lower uptake of technology in this segment. To understand factors affecting the intention to use a mobility app, we drew upon the Protection Motivation Theory, and tested a model of low-income older adults' technology adoption. METHODS A cross-sectional survey was conducted across seven states in Malaysia among community-dwelling low-income older adults aged ≥60 years old (n = 282). Measurement items were adapted from pre-validated scales and 7-point Likert Scales were used. Partial least squares structural equation modeling was utilized to assess the hypothesized model. RESULTS Mobility technology awareness was found to shape an individual's threat and coping appraisals associated with their intention to use a mobility app. The decision of a low-income older adult to adopt a mobility app as a protective action is not a direct function of threat and coping appraisals but is indirect, and mediated by the underlying cost-benefit perceptions of non-adoption and adoption of the mobility app. In terms of technology perceptions, perceived usefulness is a significant predictor, but not perceived ease of use. CONCLUSIONS This study entails a new model by uncovering the psychological factors encompassing mobility technology awareness, threat-coping appraisals, and cost-benefit perceptions on Technology Acceptance Model studies. These insights have important implications for the development and implementation of a mobility app among low-income older adults. Geriatr Gerontol Int 2024; 24: 342-350.
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Affiliation(s)
| | - Chun Yong Chong
- School of Information Technology, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Pei-Lee Teh
- School of Business, Monash University Malaysia, Bandar Sunway, Malaysia
- Gerontechnology Laboratory, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Shaun Wen Huey Lee
- Gerontechnology Laboratory, Monash University Malaysia, Bandar Sunway, Malaysia
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes. DATA SOURCES PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021. STUDY SECTION Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted. DATA EXTRACTION The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted. DATA SYNTHESIS Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors. CONCLUSIONS Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
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D'Hooghe S, Inaç Y, Deforche B, Van Dyck D, de Ridder K, Vandevijvere S, Van de Weghe N, Dury S. The role of the perceived environment for recreational walking among adults in socioeconomically disadvantaged situations: A study using walk-along interviews. SSM Popul Health 2023; 23:101456. [PMID: 37501782 PMCID: PMC10368917 DOI: 10.1016/j.ssmph.2023.101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Background Persons in socioeconomically disadvantaged situations (PSEDS) are generally less likely to engage in recreational walking (RW) compared to higher socioeconomic groups and are often more dependent on their local environment. Studies on RW have primarily focused on the role of the built environment for the general adult population and the older population in urban areas. The aim of this study is to qualitatively identify the perceived environmental factors affecting RW among PSEDS in peri-urban areas. Methods In two peri-urban municipalities in Belgium, walk-along interviews were conducted until data saturation with a purposeful convenience sampling of 38 PSEDS (25-65y/o) to identify local environmental factors affecting RW. A subsample of 22 participants joined a focus group (n = 4) to categorize the identified factors into environmental types (physical, sociocultural, political, and economic) of the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The interviews were transcribed and analyzed thematically using Maxqda 2022.0. Results The information environment (dissemination, retrieving and understanding of information) was added to the ANGELO framework, highlighting the importance of digital literacy. Availability and accessibility of well-maintained walking surfaces, toilets, street lighting and seating options (physical environment), social support, dog-ownership, stigmatization, social isolation, and a sense of belonging (sociocultural environment) and indirect costs (economic environment) were identified as important environmental factors in RW among PSEDS. The identified political and economic factors are intertwined with the other environments. Conclusions Perceived environmental factors affect RW among PSEDS and peri-urban settings offer specific challenges. Local governments should incorporate citizen perception into decision-making processes to create supportive environments that have the potential to promote RW among PSEDS in a peri-urban setting.
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Affiliation(s)
- Suzannah D'Hooghe
- Sciensano, Department of Epidemiology and Public Health, Belgium
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Yasemin Inaç
- Sciensano, Department of Epidemiology and Public Health, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium
- Ghent University, Faculty of Sciences, Department of Geography, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Benedicte Deforche
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Belgium
| | - Delfien Van Dyck
- Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Belgium
| | - Karin de Ridder
- Sciensano, Department of Epidemiology and Public Health, Belgium
| | | | - Nico Van de Weghe
- Ghent University, Faculty of Sciences, Department of Geography, Belgium
| | - Sarah Dury
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Lättman K, Olsson LE, Waygood EOD, Friman M. Nowhere to go - Effects on elderly's travel during Covid-19. TRAVEL BEHAVIOUR & SOCIETY 2023; 32:100574. [PMID: 36911425 PMCID: PMC9986143 DOI: 10.1016/j.tbs.2023.100574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 12/14/2022] [Accepted: 02/16/2023] [Indexed: 06/03/2023]
Abstract
The COVID-19 pandemic has presented numerous, significant challenges for elderly in their daily life. In order to reach a deeper understanding of the feelings and thoughts of the elderly related to their possibilities to travel and engage in activities during the pandemic, this study takes a qualitative approach to exploring the views of the elderly themselves. The study focuses on experiences during the COVID-19 pandemic. A number of in-depth semi-structured interviews with elderly aged 70 and above, were conducted in June 2020. Applied Thematic Analysis (ATA) was applied, as a first stage, to investigate meaningful segments of data. In a second stage these identified segments were combined into a number of themes. This study reports the outcome of the ATA analysis. More specifically we report experiences, motivations and barriers for travel and activity participation, and discuss how these relate to the health and well-being of elderly, and vice versa. These findings highlight the strong need to develop a transport system that to a higher extent addresses the physical as well as the mental health of old people, with a particular focus on facilitating social interactions.
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Affiliation(s)
- Katrin Lättman
- Karlstad University, CTF - Service Research Center and Department of Social and Psychological Studies, SE-65188 Karlstad, Sweden
- Department of Occupational Health Science and Psychology, University of Gävle, SE-80176 Gävle, Sweden
| | - Lars E Olsson
- Karlstad University, CTF - Service Research Center and Department of Social and Psychological Studies, SE-65188 Karlstad, Sweden
| | - E Owen D Waygood
- Polytechnique Montreal, Department of Civil Geological and Mining Engineering, PO Box 6079, Montréal, QC H3C 3A7, Canada
| | - Margareta Friman
- Karlstad University, CTF - Service Research Center and Department of Social and Psychological Studies, SE-65188 Karlstad, Sweden
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Herrmann-Lunecke MG, Figueroa-Martínez C, Olivares Espinoza B. Making Chile More Pedestrian-Friendly for Older Persons: Expert Perspectives. J Aging Soc Policy 2023; 35:486-508. [PMID: 37011133 DOI: 10.1080/08959420.2023.2196908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Walking provides numerous benefits to older persons, but its practice is hindered by social factors and the built environment. This article aims to understand the factors that encourage or discourage older people's walking behaviors, as well as the policies influencing those factors in Chile. It does so by reporting the analysis of twenty-five semi-structured interviews with Chilean policymakers and local leaders. The experts consistently represented walking as a beneficial activity for older persons that, nonetheless, occurs in adverse built environments. They asserted that the absence of older people in the public discussion and a top-down policy-making structure hamper its promotion.
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Affiliation(s)
| | - C Figueroa-Martínez
- Centro de Desarrollo Urbano Sustentable (CEDEUS), Pontificia Universidad Católica de Chile. Santiago, Chile
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Rambaldini‐Gooding D, Molloy L, Parrish A, Strahilevitz M, Clarke R, Perez P. Free public transport and older people: An ethnographic study of an Australian bus service. Australas J Ageing 2022. [DOI: 10.1111/ajag.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/04/2022] [Accepted: 11/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Luke Molloy
- School of Nursing University of Wollongong Wollongong New South Wales Australia
| | - Anne‐Maree Parrish
- School of Health and Society University of Wollongong Wollongong New South Wales Australia
| | - Michal Strahilevitz
- School of Economics and Business Administration St. Mary's College of California Moraga California USA
| | - Rodney Clarke
- School of Management, Operations and Marketing University of Wollongong Wollongong New South Wales Australia
| | - Pascal Perez
- SMART Infrastructure Facility University of Wollongong Wollongong New South Wales Australia
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Suzuki R, Blackwood J, Webster NJ, Shah S. Functional Limitations and Perceived Neighborhood Walkability Among Urban Dwelling Older Adults. Front Public Health 2021; 9:675799. [PMID: 34277543 PMCID: PMC8277958 DOI: 10.3389/fpubh.2021.675799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Abstract
Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p < 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p < 0.05) and more walking hazards (b = −0.26, p < 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.
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Affiliation(s)
- Rie Suzuki
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, Flint, MI, United States
| | - Jennifer Blackwood
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, United States
| | - Noah J Webster
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Shailee Shah
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, Flint, MI, United States
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A Space-Time Analysis of Rural Older People's Outdoor Mobility and Its Impact on Self-Rated Health: Evidence from a Taiwanese Rural Village. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115902. [PMID: 34072884 PMCID: PMC8198793 DOI: 10.3390/ijerph18115902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
With the aggravation of rural aging, the well-being and self-rated health level of older people in rural communities are significantly lower than those in urban communities. Past studies hold that mobility is essential to the quality of life of the elderly, and well-being depends on their own adaptation strategies in the built environment. Therefore, this study combines three key factors related to active aging: environment, health and mobility, and assumes that the elderly with good health status will have environmental proactivity and a wider range of daily mobility in a poor rural built environment. This study attempts to track daily mobility by using a space-time path method in time geography and then to explore the relationship between outdoor mobility and older people's self-rated health. A 1-week mobility path survey for 20 senior citizens of Xishi Village, a typical rural village in Taiwan, was conducted by wearing a GPS sports watch. A questionnaire survey and in-depth interviews were done to provide more information about the seniors' personal backgrounds and lifestyles. The results show that when the built environment is unfit to the needs of daily activities, half of the participants can make adjustment strategies to go beyond the neighborhoods defined by administrative units. Correlation analysis demonstrated that mental health is associated with daily moving time and distance. In addition, men have higher self-rated health scores than women, and there are significant statistical differences between married and widowed seniors in daily outing time and distance. This exploratory study suggests that in future research on rural health and active aging in rural areas, understanding the daily outdoor mobility of the elderly can help to assess their health status and living demands and quickly find out whether there is a lack of rural living services or environmental planning.
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Sturge J, Meijering L, Jones CA, Garvelink M, Caron D, Nordin S, Elf M, Légaré F. Technology to Improve Autonomy and Inform Housing Decisions for Older Adults With Memory Problems Who Live at Home in Canada, Sweden, and the Netherlands: Protocol for a Multipronged Mixed Methods Study. JMIR Res Protoc 2021; 10:e19244. [PMID: 33475512 PMCID: PMC7861998 DOI: 10.2196/19244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/20/2020] [Accepted: 12/08/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Understanding the mobility patterns and experiences of older adults with memory problems living at home has the potential to improve autonomy and inform shared decision making (SDM) about their housing options. OBJECTIVE We aim to (1) assess the mobility patterns and experiences of older adults with memory problems, (2) co-design an electronic decision support intervention (e-DSI) that integrates users' mobility patterns and experiences, (3) explore their intention to use an e-DSI to support autonomy at home, and (4) inform future SDM processes about housing options. METHODS Informed by the Good Reporting of A Mixed Methods Study (GRAMMS) reporting guidelines, we will conduct a 3-year, multipronged mixed methods study in Canada, Sweden, and the Netherlands. For Phase 1, we will recruit a convenience sample of 20 older adults living at home with memory problems from clinical and community settings in each country, for a total of 60 participants. We will ask participants to record their mobility patterns outside their home for 14 days using a GPS tracker and a travel diary; in addition, we will conduct a walking interview and a final debrief interview after 14 days. For Phase 2, referring to results from the first phase, we will conduct one user-centered co-design process per country with older adults with memory issues, caregivers, health care professionals, and information technology representatives informed by the Double Diamond method. We will ask participants how personalized information about mobility patterns and experiences could be added to an existing e-DSI and how this information could inform SDM about housing options. For Phase 3, using online web-based surveys, we will invite 210 older adults with memory problems and/or their caregivers, split equally across the three countries, to use the e-DSI and provide feedback on its strengths and limitations. Finally, in Phase 4, we will triangulate and compare data from all phases and countries to inform a stakeholder meeting where an action plan will be developed. RESULTS The study opened for recruitment in the Netherlands in November 2018 and in Canada and Sweden in December 2019. Data collection will be completed by April 2021. CONCLUSIONS This project will explore how e-DSIs can integrate the mobility patterns and mobility experiences of older adults with memory problems in three countries, improve older adults' autonomy, and, ultimately, inform SDM about housing options. TRIAL REGISTRATION ClinicalTrials.gov NCT04267484; https://clinicaltrials.gov/ct2/show/NCT04267484. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19244.
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Affiliation(s)
- Jodi Sturge
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - C Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Mirjam Garvelink
- VITAM - Centre de recherche en santé durable, Quebec, QC, Canada
| | - Danielle Caron
- VITAM - Centre de recherche en santé durable, Quebec, QC, Canada
| | - Susanna Nordin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Marie Elf
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - France Légaré
- VITAM - Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
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Independent living with mobility restrictions: older people's perceptions of their out-of-home mobility. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractWe studied older people's perceptions of how they organise their out-of-home mobility and independent living when they face mobility restrictions, based on seven focus groups with older people (N = 28) from a suburb in Finland. This article provides an everyday life view of how the ability to move outside the home evolves through interdependencies between older people and their neighbourhoods, social relations and societal arrangements. Our findings show that supportive socio-material surroundings can provide older people with new ways to move outside their home despite mobility restrictions and new ways to organise their daily life with decreased mobility. In contrast, restrictive socio-material surroundings can lead to situations in which older people forgo certain out-of-home journeys and activities. The findings contribute to an understanding that organising one's daily life and out-of-home mobility is an act of interdependence. Policies promoting independent living in old age should recognise these fundamental interdependencies and support versatile ways of living rather than overemphasise activity and self-reliance. Based on older people's everyday life perspectives, both sides of the coin need to be considered: how to enable the out-of-home mobility of older people facing mobility restrictions and how to support them in managing and enjoying daily life with decreased mobility.
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Franke T, Sims-Gould J, Chaudhury H, Winters M, McKay H. Re-framing mobility in older adults: an adapted comprehensive conceptual framework. QUALITATIVE RESEARCH IN SPORT, EXERCISE AND HEALTH 2020; 12:336-349. [DOI: 10.1080/2159676x.2019.1575269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 01/02/2019] [Indexed: 07/19/2023]
Affiliation(s)
- Thea Franke
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
| | - Joanie Sims-Gould
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Heather McKay
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
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The mobilities of care in later life: exploring the relationship between caring and mobility in the lives of older people. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThere has been a renewed call for a revaluing of informal caring in order to counter the way that caring is undervalued, taken for granted and invisible. Travel is one area where a detailed critique of this issue has emerged with the concept of ‘mobility of care’, however, this concept has only been applied in relation to younger age groups, and our understanding of mobilities of care in later life remains underdeveloped. By ‘mobilities of care’ we mean journeys made for the purpose of giving and receiving informal care and support. This paper draws on the mobility narratives of 99 older people (aged 55 and above) living in three locations in the North of England who participated in a two-year qualitative longitudinal study that explored the inter-play between mobility, wellbeing and life transitions. We focused on the experience of managing life transitions rather than assume that chronology per se determines wellbeing. Narratives of ageing emphasise the importance of getting out and about, and being socially connected active citizens. Our study demonstrates that for many older people getting out and about is not for leisure or utility purposes but to give support and care. As such, these journeys have a particular significance in the lives of older people and in the construction of roles, meaning and identity in later life.
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Towards meaningful mobility: a research agenda for movement within and between places in later life. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19001296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AbstractMobility or physical movement contributes to health and wellbeing in later life. Most studies have focused on the contribution of outdoor mobility to active ageing, but physical and cognitive impairments restrict the mobility of many older adults. This article aims to explore the gaps in the current literature on mobility in later life, and identify required innovations in the field through laying out key areas for future research. It discusses two, largely separate, areas of research, namely on mobility patterns and mobility experiences. The first focuses on quantitative and spatial research on outdoor mobility patterns in terms of routes, timing and transport modes. The second mainly concerns qualitative research on how older adults perceive mobility in their everyday lives. This article identifies three areas for future research on mobility in later life: (a) beyond outdoor movement; (b) diversity in mobility; and (c) the role of time in mobility. To conclude, addressing these areas jointly will contribute to further unpacking the concept of mobility as meaningful practice and to integrating quantitative and qualitative methods when studying mobility in later life. This will result in policy inputs on the mobility and wellbeing of our ageing population.
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