Transdisciplinary Centre for Qualitative Methods, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.
Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands.
BMC Public Health. 2022 Aug 5;22(1):1489. doi: 10.1186/s12889-022-13875-6.
Transportation is among the key aspects that influence active ageing. This realist review intends to understand the mechanisms of urban mobility infrastructure interventions and policies in low- and middle-income countries for older adults and to identify factors, which influenced the success or failure of interventions. We followed the steps suggested by Pawson and colleagues for a realist review. Electronic databases were searched from inception until August 2020. Studies were screened based on titles, abstracts and full text. The quality of included studies was assessed based on rigour and relevance. The evidence was obtained from 36 articles with diverse study designs conducted in 36 low- and middle-income countries. Findings were validated through stakeholder consultations from three low- and middle-income countries. Of the various individual factors identified, behaviour change communication interventions were low-cost, had a long-term impact and were efficient in increasing awareness among users to improve safety, social inclusion and about transport schemes for older adults. Improved transport infrastructure resulted in a shift from private to public transportation. For a sustainable urban transport infrastructure, good governance and involvement of stakeholders for planning and implementing transport interventions were considered necessary. Lack of evaluation, experience of transport planners, and inter-sectoral coordination were key challenges to successful interventions. The review highlighted a lack of older adult-specific transportation policies, and gender-targeted interventions for older women, suggesting a need for interventions and policies based on the contextual factors existing in a region.
交通是影响积极老龄化的关键因素之一。本现实主义综述旨在了解城市流动基础设施干预措施和政策在中低收入国家对老年人的作用机制，并确定影响干预措施成败的因素。我们遵循 Pawson 及其同事提出的现实主义综述步骤进行研究。从创建数据库开始，我们对电子数据库进行了搜索，一直搜索到 2020 年 8 月。研究根据标题、摘要和全文进行筛选。根据严谨性和相关性对纳入研究的质量进行评估。证据来自 36 个在 36 个中低收入国家进行的具有不同研究设计的文章。通过来自三个中低收入国家的利益相关者协商对研究结果进行了验证。在确定的各种个体因素中，行为改变沟通干预措施成本低、具有长期影响，并且能够有效地提高用户的意识，以提高老年人的安全性、社会包容性和对交通计划的认识。改善交通基础设施导致从私人交通向公共交通转变。为了实现可持续的城市交通基础设施，需要良好的治理和利益相关者的参与，以便规划和实施交通干预措施。缺乏评估、交通规划者的经验以及部门间协调是成功干预的关键挑战。该综述强调了缺乏针对老年人的特定交通政策以及针对老年妇女的性别针对性干预措施，这表明需要根据所在地区的现有背景因素制定干预措施和政策。
