Improving Wayfinding for Older Users With Selective Attention Deficits

Provider and facility readiness for age-friendly health services for older adults in primary health care centres in southwest, Nigeria

There is a growing focus on interventions at the health system level to promote healthy aging and provide age-friendly health services (AFHS) in low- and middle-income countries where populations are aging. This study aimed to determine the provider and facility readiness for AFHS. We developed and implemented surveys to collect PHC facility capacity and readiness to deliver AFHS and a KAP survey for facility healthcare workers based on guidelines from the WHO age-friendly tool kit and questionnaires from other studies. Direct observation and structured interviews of facility heads were conducted in a stratified random sample of 15 out of the 57 comprehensive PHC facilities in Lagos, Nigeria. One hundred and twenty providers were conveniently sampled for the KAP survey. Statistical analysis was conducted using STATA version 15 (StataCorp, College Station, Texas, USA). For facility readiness, only 13.3% of PHCs sometimes offered hearing assessment and none of the PHCs offered colorectal cancer assessment. Few (20.0%) facilities offered home services and only 1 (0.7%) had dedicated funding for care of older people. Ramps were at the entrance in 60.0% of facilities and almost half (43.3%) of the PHCs had wheelchair accessible entrances to the public toilets. The majority of HCWs (81.7%) had heard about healthy aging but only 5.0% about AFHS, only 10.8% reported formal training. Around a third knew about specific conditions which affect people as they age, including; depression (37.5%), urinary incontinence (35.0%), and falls/immobility (33.3%). Over half of the providers (54.2%) screened for malnutrition in older patients, 25.8% screened for suspected elder abuse and much less (19.2%) for delirium. This study found some areas of strength but also gaps in facility readiness as well as knowledge and training needed to support AFHS care. We recommend identifying interventions to improve the availability and delivery of care for older adults.

Adults' Visual Cue Preferences and Wayfinding Abilities in Healthcare Centers

OBJECTIVES

Physical and visual elements that help people find their way around an environment are called visual cues (VCs). The current study aims to evaluate adults' wayfinding abilities (navigation, orientation, spatial anxiety, and distance estimation) and VC (navigational color coding) preferences in terms of color and position; additionally, investigates their differences in adults' life span phases (young adults, early middle-aged adults, and late middle-aged adults).

BACKGROUND

Wayfinding in complex environments such as healthcare centers has been challenging for most people. Although VCs are being used increasingly to facilitate wayfinding, considering people's preferences regarding VCs, especially navigational color coding, are neglected.

METHODS

Obtained data from a survey of 375 healthcare center visitors with textual and photo questionnaires were analyzed by descriptive statics and one-way analysis of variance.

RESULTS

Young adults preferred VCs with "mixed colors and positioned in the middle of the floor," early middle-aged adults preferred "warm color VCs in the middle of the wall," and late middle-aged adults preferred "warm color VCs at the bottom of the wall." Additionally, the results demonstrated that with aging, navigation and distance estimation abilities deteriorate, and spatial anxiety increases.

CONCLUSIONS

The outcomes of the present study increase our knowledge regarding the impact of adults' life span phases on their wayfinding abilities and VC preferences and offer suggestions for architects and healthcare center stakeholders to provide environments that improve adults' wayfinding.

Color Coding the "Labyrinth": How Staff Perceived a Two-Part Intervention to Improve Wayfinding in an Adult Emergency Department

OBJECTIVES, PURPOSE, OR AIM

We report a two-part wayfinding intervention, considering four quality criteria (visibility, usability, efficiency and overall effectiveness) from staff perspectives.

BACKGROUND

Few studies to date have explored wayfinding in the Emergency Department (ED). Yet, as ED usage continues to grow, effective wayfinding in these high-stress, fast-paced environments is likely to become increasingly important. At an adult ED located in the U.S. Southeast, wayfinding has been a persistent problem. We subsequently developed a two-part wayfinding intervention: colored routes to key destinations in the ED and corresponding visitor badges.

METHODS

Quality criteria were formulated using the Donabedian model: visibility (structure), usability (process), efficiency (process), and overall effectiveness (outcome). Assessments consisted of staff surveys, which were distributed from March to early April 2019.

RESULTS

The strong ratings across quality criteria, added to affirmative comments from staff, provide evidence that the color coding system made a positive impact on wayfinding.

CONCLUSIONS

While the results should be generalized with caution, the two-part intervention may be highly portable to other contexts. Future studies might examine the effect of colored routes alone. They might illuminate relations between structure, process, and outcomes as they relate to the assessment of wayfinding. They might also expand wayfinding quality criteria. Ultimately, such studies should improve not only the productivity but also the accessibility and user experience of the ED.

Walking for Transport among Older Adults: A Cross-Sectional Study on the Role of the Built Environment in Less Densely Populated Areas in Northern Germany

In the last decades, there has been rising interest in public health research in the importance of the built environment for a healthy and active life in old age, but little attention has been paid to less densely populated areas. This study aimed to explore the impact of the built environment on walking for transport in the context of an older population living in communities of <100,000 inhabitants. Within the project AFOOT–Securing urban mobility of an aging population, a cross-sectional postal survey was carried out from May to September 2019 in older adults (≥65 years) in the Metropolitan Region Northwest, Germany. Self-reported data from 2189 study participants were analyzed. Logistic and linear regression models were used to examine the associations between the built environment and walking for transport. Any walking and frequent walking were positively associated with nearly all built environment attributes, even after adjustment for demographic and health covariates. The amount of walking in minutes per week was associated only with residential density. Moderating effects of gender, age, and use of walking aids were identified. Improving the built environment appears to be a promising opportunity to motivate and enable older adults to walk for transport.