Newbold K Bruce, Valaitis Ruta, Phillips Stuart, Alvarez Elizabeth, Neil-Sztramko Sarah, Sihota Davneet, Tandon Mainka, Nadarajah Abbira, Wang Amy, Moore Caroline, Orr Elizabeth, Ganann Rebecca
School of Earth, Environment & Society, McMaster University, Hamilton, ON.
School of Nursing, McMaster University, Hamilton, ON.
Can Geriatr J. 2023 Mar 1;26(1):23-30. doi: 10.5770/cgj.26.602. eCollection 2023 Mar.
Using the comparatively new environmental scan methodology, a protocol was developed and conducted to inform the co-design and implementation of a novel intervention to promote mobility among older adults in Hamilton, Ontario, Canada. The EMBOLDEN program seeks to promote physical and community mobility in adults 55 years and older who face barriers accessing community programs and who reside in areas of high inequity in Hamilton, and to address the following areas of focus: physical activity, nutrition, social participation, and system navigation supports.
The environmental scan protocol was developed using existing models and drew insights from census data, a review of existing services, organizational representative interviews, windshield surveys of selected high-priority neighbourhoods, and Geographic Information System (GIS) mapping.
A total of 98 programs for older adults from 50 different organizations were identified, with the majority (92) supporting mobility, physical activity, nutrition, social participation, and system navigation. The analysis of census tract data identified eight high-priority neighbourhoods characterized by large shares of older adults, high material deprivation, low income, and high proportion of immigrants. These populations can be hard to reach and face multiple barriers to participation in community-based activities. The scan also revealed the nature and types of services geared toward older adults in each neighbourhood, with each priority neighbourhood having at least one school and park. Most areas had a range of services and supports (i.e., health care, housing, stores, religious options), although there was a lack of diverse ethnic community centres and income-diverse activities specific to older adults in most neighbourhoods. Neighbourhoods also differed in the geographic distribution number of services, along with the number of recreational services specific to older adults. Barriers included financial and physical accessibility, lack of ethnically diverse community centres, and food deserts.
Scan results will inform the co-design and implementation of the Enhancing physical and community MoBility in OLDEr adults with health inequities using commuNity co-design intervention-EMBOLDEN.
采用相对较新的环境扫描方法，制定并实施了一项方案，为加拿大安大略省汉密尔顿市一项促进老年人行动能力的新型干预措施的协同设计和实施提供信息。EMBOLDEN项目旨在促进55岁及以上面临参与社区项目障碍且居住在汉密尔顿高度不平等地区的成年人的身体和社区行动能力，并关注以下重点领域：体育活动、营养、社会参与和系统导航支持。
环境扫描方案是利用现有模型制定的，并从人口普查数据、现有服务回顾、组织代表访谈、对选定高优先级社区的实地考察以及地理信息系统（GIS）绘图中获取见解。
共识别出50个不同组织提供的98个针对老年人的项目，其中大多数（92个）支持行动能力、体育活动、营养、社会参与和系统导航。对普查区数据的分析确定了8个高优先级社区，其特点是老年人比例大、物质匮乏严重、收入低且移民比例高。这些人群可能难以接触到，并且在参与社区活动方面面临多重障碍。扫描还揭示了每个社区针对老年人的服务的性质和类型，每个优先级社区至少有一所学校和一个公园。大多数地区有一系列服务和支持（即医疗保健、住房、商店、宗教场所），尽管大多数社区缺乏多样化的族裔社区中心和针对老年人的收入多样化活动。社区在服务的地理分布数量以及针对老年人的娱乐服务数量方面也存在差异。障碍包括经济和身体可达性差、缺乏族裔多样化的社区中心以及食品荒漠。
扫描结果将为使用社区协同设计干预措施“增强存在健康不平等问题的老年人的身体和社区行动能力（EMBOLDEN）”的协同设计和实施提供信息。
