环境如何促进积极老龄化：来自加拿大魁北克两个城市的案例研究结果。
How environments can promote active aging: results from a case study of two municipalities in Quebec, Canada.
机构信息
Direction Régionale de Santé Publique de La Montérégie, CISSS of Montérégie Centre, Longueuil, QC, Canada.
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
出版信息
Can J Public Health. 2024 Feb;115(1):117-131. doi: 10.17269/s41997-023-00806-0. Epub 2023 Aug 17.
OBJECTIVES
To address global aging, a paradigm shift is needed from disease prevention and treatment towards active aging, i.e., optimizing opportunities for health, participation, and security as people age. Little is known about how age-friendly environments promote active aging. This study thus aimed to explore how (through which mechanisms and in what contexts) environments can promote active aging and, specifically, positive health, social participation, and health equity.
METHODS
Using a realist approach and semi-structured focus groups, a case study was used in two Quebec municipalities known for best fostering active aging. Data also included participants' logbooks, sociodemographic questionnaires, municipalities' sociodemographic profiles, and policy documents. A conceptual framework and thematic content analysis were carried out.
RESULTS
A total of 24 participants (9 older adults, 4 health professionals, 3 community-based actors, 5 municipal employees, and 3 elected officials) took part in 5 focus groups. Regarding contexts, both cases were midsize municipalities having an income and education level higher to Quebec's averages with supportive active aging policies. Two main themes explained how the environments promoted active aging: (1) by ensuring proximity through built (urban planning), social (network structures), services (variety and availability of local and outreach resources), and organizational (active listening to older adults' needs for active aging) environments; and (2) by fostering transversality through built (universal accessibility, intergenerational spaces), social (intergenerational opportunities for social participation), and political/organizational (unified and complementary policies) environments.
CONCLUSION
To better promote active aging through age-friendly environments, practices should focus on fostering proximity and transversality, and act simultaneously on multiple environments.
目的
为应对全球老龄化问题，需要从疾病预防和治疗范式转变为积极老龄化，即优化人们随着年龄增长的健康、参与和安全机会。对于友好的环境如何促进积极老龄化，人们知之甚少。因此，本研究旨在探讨环境如何（通过哪些机制和在哪些背景下）促进积极老龄化，特别是促进积极的健康、社会参与和健康公平。
方法
采用现实主义方法和半结构化焦点小组，对两个以最佳促进积极老龄化而闻名的魁北克市进行了案例研究。数据还包括参与者的日志、社会人口统计问卷、城市的社会人口统计概况和政策文件。进行了概念框架和主题内容分析。
结果
共有 24 名参与者（9 名老年人、4 名卫生专业人员、3 名社区行为者、5 名市政雇员和 3 名民选官员）参加了 5 个焦点小组。在背景方面，两个案例都是中等规模的城市，收入和教育水平高于魁北克省的平均水平，并且有支持积极老龄化的政策。有两个主要主题解释了环境如何促进积极老龄化：（1）通过确保由建筑（城市规划）、社会（网络结构）、服务（本地和外展资源的多样性和可用性）和组织（积极倾听老年人对积极老龄化的需求）环境提供的接近性；以及（2）通过建筑（普遍可达性、代际空间）、社会（代际社会参与机会）和政治/组织（统一和互补政策）环境促进跨领域性。
结论
为了通过友好的环境更好地促进积极老龄化，实践应侧重于促进接近性和跨领域性，并同时对多种环境采取行动。
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