Hong, A., Welch-Stockton, J., Kim, J. Y., Canham, S. L., Greer, V., Sorweid, M. (2023) Age-friendly community interventions for health and social outcomes: A scoping review. International Journal of Environmental Research and Public Health.
To address the numerous challenges associated with aging, increased attention has been given to the development of age-friendly cities and communities (AFCC) to promote healthy aging and social participation. However, limited evidence exists for addressing both health and social needs through the AFCC framework. We address this gap by conducting a scoping review of the interventions that target both health and social outcomes within the purview of the AFCC framework. The results showed that many of the successful interventions used a partnership model and behavioral change theories to inform the program design and implementation. The results also indicated that social participation and engagement played a key role in making the interventions successful. However, the results revealed that the literature is dominated by person-focused approaches. Future research should focus more on evaluating environmental-focused interventions and develop a holistic framework that combines both person- and environment-based approaches to healthy aging.
Hong, Andy, Sallis, James F., King, Abby C., Conway, Terry, Saelens, Brian, Cain, Kelli, Fox, Eric, Frank, Lawrence. 2018. Linking green space to neighborhood social capital in older adults: The role of perceived safety. Social Science & Medicine, 207: 38-45.
This study examines the moderating effect of perceived safety on the association of green space with neighborhood social capital in older adults. Green space may play an important role for promoting neighborhood social capital and health for older adults; however, safety remains a significant challenge in maximizing the benefits of green space. Data were drawn from 647 independent-living seniors who participated in the Senior Neighborhood Quality of Life Study in the Seattle/King County and Baltimore/Washington DC region. The results suggest that certain green space elements, such as natural sights, may be beneficial to neighborhood social capital of older adults. However, other types of green space, such as parks and street trees, may be less advantageous to older adults who perceive their neighborhoods as unsafe for pedestrians. Findings highlight the importance of pedestrian safety in examining associations of green space with neighborhood social capital in older adults. Further studies using a longitudinal design are warranted to confirm the causality of the findings.
Fang, Mei Lan, Woolrych, Ryan, Sixsmith, Judith, Canham, Sarah, Battersby, Lupin, & Sixsmith, Andrew (2016). Place-making with older persons: Establishing sense-of-place through participatory community mapping workshops. Social Science & Medicine, 168, 223–229.
Principles of aging-in-place emphasize the importance of creating sustainable environments that enable older people to maintain a sense of belonging, autonomy, independence, safety and security. Simply altering the built environment is insufficient for creating more inclusive environments for older persons, as creating ‘meaningful’ places for aging involves consideration of psychosocial and cultural issues that go beyond issues of physical space. This paper illustrates how applications of community-based participatory research methods, in particular, participatory community mapping workshops (PCMWs), can be used to access experiences of place, identify facilitators and barriers to accessing the built environment and co-create place-based solutions among older people and service providers in a new affordable housing development in Western Canada.
Increasing attention has been given to the role of green space in reducing health disparities. However, robust evidence to support decision making is lacking in the global South. We investigate the relationship between green space and health as well as its underlying mechanism in Cali, Colombia. Results indicate that neighbourhood greenness is associated with enhanced self-rated ‘good’ health and reduced physical and mental distress. The health benefits of green space appear to be stronger for people living in wealthier neighbourhoods than those in poor neighbourhoods. Results highlight the importance of considering health disparities for future green infrastructure planning in the global South context.
Frank, Lawrence D., Hong, A., and Ngo, V.D. (2019). Causal evaluation of urban greenway retrofit: A longitudinal study on physical activity and sedentary behavior. Preventive Medicine, 123, 109-116.
Studies of the built environment and physical activity (PA) have primarily been cross-sectional. Evidence on the causal impacts of transportation improvements on PA and sedentary behavior (SB) is lacking. This study assessed the effect of retrofitting an urban greenway on PA and SB in Vancouver, Canada. A sample of 524 participants (median age of 44; 57% female) were divided into experimental and control groups, and the effect of exposure to the greenway was examined by using different distance thresholds. Self-report measures of moderate-to-vigorous PA (MVPA) and SB were collected using the International Physical Activity Questionnaire (IPAQSF) before (baseline; 2012-2013) and after (follow-up; 2014-2015) construction of the ComoxHelmcken Greenway in 2013. Mixed-effects models estimated the impacts of greenway on MVPA and SB. For participants living near the greenway (≤ 300m), the odds of achieving an average of 20 minutes of daily MVPA doubled (OR=2.00; 95% CI=1.00, 3.98) after the greenway’s opening. The odds of being sedentary for more than 9 hours declined by 54% (OR=0.46; 95% CI=0.25, 0.85; p < 0.01) after opening. PA benefits from the greenway declined with distance from 100 meters to 500 meters. Reduction in SB was lowest at 100 meters and greatest at 300 meters. Retrofitting an urban residential neighborhood through greenway intervention can be successful in promoting physical activity while reducing sedentary behavior. Recommendations for future longitudinal research include the use of objective PA measures, studying different neighborhood contexts, collecting more representative samples, and minimizing attrition.
Canham, Sarah L., Walsh, Christine A., Sussman, Tamara, Humphries, Joe, Nixon, Lara, & Burns, Victoria F. (2021). Identifying shelter and housing models for older people experiencing homelessness. Journal of Aging and Environment, 1–22.
Limited research has identified the types of shelter/housing and supports for the growing population of older people experiencing homelessness (OPEH) and the extent to which existing models align with their needs. To redress this gap, we conducted an environmental scan and three World Café workshops to identify and characterize shelter/housing models for OPEH in Montreal, Calgary, and Vancouver (Canada). Fifty-two models were identified and categorized into six shelter/housing types based on the program length of stay and level of health and social supports provided onsite: (1) Emergency, transitional, or temporary shelter/housing with supports; (2) Independent housing with offsite community-based supports; (3) Supported independent housing with onsite, non-medical supports; (4) Permanent supportive housing with onsite medical support and/or specialized services; (5) Long-term care for individuals with complex health needs and; (6) Palliative care/hospice, offering end-of-life services. Models that met the unique needs of OPEH had coordinated supports, social and recreational programming, assistance with daily tasks, and had a person-centered, harm-reduction approach to care. This typology of shelter/housing models offers a basis from which local and regional governments can audit their existing shelter/housing options and determine where there may be gaps in supporting OPEH.