Technological Health Intervention in Population Aging to Assist People to Work Smarter not Harder: Qualitative Study.
Chen Sonia Chien-I
Journal of medical Internet research
BACKGROUND:Technology-based health care has been promoted as an effective tool to enable clinicians to work smarter. However, some health stakeholders believe technology will compel users to work harder by creating extra work. OBJECTIVE:The objective of this study was to investigate how and why electronic health (eHealth) has been applied in Taiwan and to suggest implications that may inspire other countries facing similar challenges. METHODS:A qualitative methodology was adopted to obtain insightful inputs from deeper probing. Taiwan was selected as a typical case study, given its aging population, advanced technology, and comprehensive health care system. This study investigated 38 stakeholders in the health care ecosystem through in-depth interviews and focus groups, which provides an open, flexible, and enlightening way to study complex, dynamic, and interactive situations through informal conversation or a more structured, directed discussion. RESULTS:First, respondents indicated that the use of technology can enable seamless patient care and clinical benefits such as flexibility in time management. Second, the results suggested that a leader's vision, authority, and management skills might influence success in health care innovation. Finally, the results implied that both internal and external organizational governance are highly relevant for implementing technology-based innovation in health care. CONCLUSIONS:This study provided Taiwanese perspectives on how to intelligently use technology to benefit health care and debated the perception that technology prevents human interaction between clinicians and patients.
10.2196/jmir.8977
Civic Engagement of Older Adults in Mainland China.
Chen Haiping,Adamek Margaret
International journal of aging & human development
Due to great challenges resulting from China's rapid population aging, Chinese elders are mobilized to address problems caused by this demographic trend through civic engagement. Based on an integrative review of policy, research, and practice, this article reveals that today's Chinese elders have a higher level and wider scope of civic engagement than previous cohorts. A set of factors contributing to such improvement are further identified, including the reform of the national economy, transformation of governmental functions, and the use of effective strategies applied to concrete programs. However, several constraints limiting Chinese elders' equal, active engagement in civic life remain, including the social stratification of older adults, preferential selection of participants due to the nation's socioeconomic development strategy, and family care work competing with other types of civic activities. Finally, future directions for policy, research, and practice are proposed in order to increase Chinese elders' civic engagement.
10.1177/0091415016685326
The Participation of Senior Citizens in Policy-Making: Patterning Initiatives in Europe.
Falanga Roberto,Cebulla Andreas,Principi Andrea,Socci Marco
International journal of environmental research and public health
Worldwide, active aging policy calls for greater participation of senior citizens in the social, economic, and political realms. Despite emerging evidence of initiatives engaging senior citizens in social activities, little is known about the use of participatory approaches in the design and/or implementation of policies that matter to older citizens. This article identifies initiatives facilitating the civic participation of older people in policy-making in European Union member and associate states, drawing on a review of the literature, consultation of national policy experts, and exemplary case studies. Four main patterns of senior civic participation are identified: adopting consultative or co-decisional participatory approaches in policy design or policy implementation. The four are represented to varying degrees at different geographical levels (national, regional, local), with different actor configurations (appointed, elected/nominated, corporate representation), and with varying degree of institutionalization (temporary/permanent). Case studies illustrate approaches taken to enhance the quality and effectiveness of public services for senior citizens. Future research should strengthen this line of enquiry to cast further light on conditions facilitating the civic participation of senior citizens.
10.3390/ijerph18010034
Identification of the Best Societal Measurement of Healthy Aging.
Annals of geriatric medicine and research
Almost six decades after the first proposals to define and evaluate the quality of individual aging, the first indexes for assessing the aging process at the societal level have appeared. Moreover, in five years, three different scores for measuring societal aging have been developed and tested in different areas. The Global Age Watch Index focused on 96 countries from around the world, while the Active Ageing index is limited to the European Union countries and the Ageing Society Index targets Organization for Economic Co-operation and Development countries. This paper analyzed and compared the results of these three indexes. The rankings vary little at the bottom end of the scale, with the same countries consistently ranked among the lowest scores (for example, Poland ranked last among the European countries in the three indexes). The same is true at the top of the rankings, with Sweden, the Netherlands, and Ireland consistently among the high-scoring countries. However, the three indices tend to differently rank the countries in the middle. The United States, for example, is ranked ninth in the Global Age Watch 2015 and third in the Ageing Societal Index 2018. In cases in which the results are not consistent, it is difficult for politicians and policymakers to adequately identify needs and orient the policy to promote active and healthy aging. There is clearly a compelling need for wide-scale debate to reach a consensus on a comprehensive score or index at the societal level.
10.4235/agmr.19.0017
From Intervention to Co-constitution: New Directions in Theorizing about Aging and Technology.
Peine Alexander,Neven Louis
The Gerontologist
We propose directions for future research on aging and technology to address fundamental changes in the experience of later life that come with the "digitization" of societies. Our argument is contextualized by the massive investments of policy makers and companies in gerontechnologies and their failure to create scale and impact. Partly this failure is due to an interventionist logic that positions new technologies as interventions or solutions to the problems of aging. What has been overlooked - at least theoretically - is how aging is already co-constituted by gerontechnology design, the socio-material practices it enacts, and the policy discourse around them. Goals are (a) reviewing elements of the current aging and technology agenda, (b) demonstrating how the interventionist logic has hampered theory development (and practical impact), (c) pulling together key insights from the emerging body of empirical literature at the intersection of social gerontology and Science and Technology Studies (STS), with the objective of (d) providing directions for future research on aging and technology. Our argument presents the theoretical gains that can be made by combining insights from STS and social gerontology to research the co-constitution of aging and technology.
10.1093/geront/gny050
The WHO active ageing pillars and its association with survival: Findings from a population-based study in Spain.
Hijas-Gómez A I,Ayala A,Rodríguez-García M P,Rodríguez-Blázquez C,Rodríguez-Rodríguez V,Rojo-Pérez F,Fernández-Mayoralas G,Rodríguez-Laso A,Calderón-Larrañaga A,Forjaz M J
Archives of gerontology and geriatrics
BACKGROUND:The World Health Organization's active ageing model is based on the optimisation of four key "pillars": health, lifelong learning, participation and security. It provides older people with a policy framework to develop their potential for well-being, which in turn, may facilitate longevity. We sought to assess the effect of active ageing on longer life expectancy by: i) operationalising the WHO active ageing framework, ii) testing the validity of the factors obtained by analysing the relationships between the pillars, and iii) exploring the impact of active ageing on survival through the health pillar. METHODS:Based on data from a sample of 801 community-dwelling older adults, we operationalised the active ageing model by taking each pillar as an individual construct using principal component analysis. The interrelationship between components and their association with survival was analysed using multiple regression models. RESULTS:A three-factor structure was obtained for each pillar, except for lifelong learning with a single component. After adjustment for age, gender and marital status, survival was only significantly associated with the physical component of health (HR = 0.66; 95% CI = 0.47-0.93; p = 0.018). In turn, this component was loaded with representative variables of comorbidity and functionality, cognitive status and lifestyles, and correlated with components of lifelong learning, social activities and institutional support. CONCLUSION:According to how the variables clustered into the components and how the components intertwined, results suggest that the variables loading on the biomedical component of the health pillar (e.g. cognitive function, health conditions or pain), may play a part on survival chances.
10.1016/j.archger.2020.104114
Aging at Work: A Review of Recent Trends and Future Directions.
Barakovic Husic Jasmina,Melero Francisco José,Barakovic Sabina,Lameski Petre,Zdravevski Eftim,Maresova Petra,Krejcar Ondrej,Chorbev Ivan,Garcia Nuno M,Trajkovik Vladimir
International journal of environmental research and public health
Demographic data suggest a rapid aging trend in the active workforce. The concept of aging at work comes from the urgent requirement to help the aging workforce of the contemporary industries to maintain productivity while achieving a work and private life balance. While there is plenty of research focusing on the aging population, current research activities on policies covering the concept of aging at work are limited and conceptually different. This paper aims to review publications on aging at work, which could lead to the creation of a framework that targets governmental decision-makers, the non-governmental sector, the private sector, and all of those who are responsible for the formulation of policies on aging at work. In August 2019 we searched for peer-reviewed articles in English that were indexed in PubMed, IEEE Xplore, and Springer and published between 2008 and 2019. The keywords included the following phrases: "successful aging at work", "active aging at work", "healthy aging at work", "productive aging at work", and "older adults at work". A total of 47,330 publications were found through database searching, and 25,187 publications were screened. Afterwards, 7756 screened publications were excluded from the further analysis, and a total of 17,431 article abstracts were evaluated for inclusion. Finally, further qualitative analysis included 1375 articles, of which about 24 are discussed in this article. The most prominent works suggest policies that encourage life-long learning, and a workforce that comprises both younger and older workers, as well as gradual retirement.
10.3390/ijerph17207659
An Ecological Framework for Active Aging in China.
Ko Pei-Chun,Yeung Wei-Jun Jean
Journal of aging and health
OBJECTIVES:Against the background of emerging research interest in integrating Active Aging in long-term care policies, the study investigates the relationships between community environment and engagement in social activities (paid work, domestic care, participation in community and leisure activities) by older Chinese adults. Six indicators are derived from the economic, institutional, and sociodemographic environments of the communities under analysis. METHOD:The first wave of the China Health and Retirement Longitudinal Study (CHARLS) is used for empirical examinations. The sample includes respondents aged 50 years and above ( n = 6,290) from 307 communities. Random-intercept multilevel logistic models are employed. RESULTS:Economic environment is positively linked to engagement in paid work and grandparental childcare, community activities, and leisure activities. However, the effects decreased after including the indicators for the institutional and sociodemographic environments. We found that older adults are more likely to engage in community activities and leisure activities in communities and with a higher percentage of migrant population. DISCUSSION:To integrate Active Aging in the current long-term care policies in China, the study points out that residential community environment is crucial for older Chinese to enhance and sustain their involvement in family and communities before older adults rely on long-term care facilities. In particular, the relevance of institutional and sociodemographic environment provides policy makers to rethink about how to provide community-based long-term care.
10.1177/0898264318795564
An Empirical Comparison of Different Models of Active Aging in Canada: The International Mobility in Aging Study.
Bélanger Emmanuelle,Ahmed Tamer,Filiatrault Johanne,Yu Hsiu-Ting,Zunzunegui Maria Victoria
The Gerontologist
Purpose:Active aging is a concept that lacks consensus. The WHO defines it as a holistic concept that encompasses the overall health, participation, and security of older adults. Fernández-Ballesteros and colleagues propose a similar concept but omit security and include mood and cognitive function. To date, researchers attempting to validate conceptual models of active aging have obtained mixed results. The goal of this study was to examine the validity of existing models of active aging with epidemiological data from Canada. Methods:The WHO model of active aging and the psychological model of active aging developed by Fernández-Ballesteros and colleagues were tested with confirmatory factor analysis. The data used included 799 community-dwelling older adults between 65 and 74 years old, recruited from the patient lists of family physicians in Saint-Hyacinthe, Quebec and Kingston, Ontario. Results:Neither model could be validated in the sample of Canadian older adults. Although a concept of healthy aging can be modeled adequately, social participation and security did not fit a latent factor model. A simple binary index indicated that 27% of older adults in the sample did not meet the active aging criteria proposed by the WHO. Implications:Our results suggest that active aging might represent a human rights policy orientation rather than an empirical measurement tool to guide research among older adult populations. Binary indexes of active aging may serve to highlight what remains to be improved about the health, participation, and security of growing populations of older adults.
10.1093/geront/gnv126
Social Determinants and Disparities in Active Aging Among Older Taiwanese.
Hsu Hui-Chuan,Liang Jersey,Luh Dih-Ling,Chen Chen-Fen,Wang Ying-Wei
International journal of environmental research and public health
This study assesses equity in active aging across social determinants among older Taiwanese. The data were collected from face-to-face interviews with adults aged 55 years or more in Taiwan in 2017 ( = 738). A total of 30 individual-level Taiwan active aging indicators were chosen, and the relationship between social determinants and active aging indicators were analyzed by logistic regression models. Women were more likely to participate in volunteering and other social groups and in lifelong learning activities, whereas men were more likely to be employed, to engage in physical activity, to feel safe from violence, and to use preventive care. Higher education was related to higher employment, social participation, independent living, lifelong learning, and a lower likelihood of poverty and severe cognitive impairment. Those living in rural areas were more likely to be employed, perform physical activity, feel physically safe, have better mental well-being, and have higher social respect and social integration ratings, whereas living in urban areas was related to greater access to medical care, owning assets, less severe cognitive impairment, greater likelihood of using information and communications technology, higher level of education, and higher access to convenient transportation. The significant disparities that exist in active aging may suggest inequality.
10.3390/ijerph16163005
[The WHO Concept of Active Aging from the Local Perspective: A Qualitative Survey in the District of Constance].
Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))
BACKGROUND:The WHO strategy for active aging comprises maintenance of health, participation in social life as well as integration and social security for the aged. As a political framework for action, the strategy supports the future aging policy of municipalities. This survey examines how local actors assess the WHO strategy of active aging. METHODS:The study consists of 5 guided interviews of experts from the rural district of Constance. The interview was based on a previously coordinated list of indicators that summarize 102 recommendations for action. The awareness of the WHO strategy as well as a brief introduction to the 3 main areas provided the start of the interviews, followed by the comparison of municipal activities with the list of indicators, the identification of the need for action and of previous unrecognized aspects. In the sense of a data triangulation, we conducted a quantitative survey in further districts. The data of the interviews were analyzed by using the method of Gläser and Laudel, referred to as qualitative content analysis. RESULTS:None of the interviewed experts knew the WHO strategy of active aging. However, after a short explanation of the WHO strategy and indicator list, they classified the strategy as practicable. All of them rated the recommendations for action from the sub-areas of participation in society (e.g. creation of advisory councils for seniors) and security in public space and transport (e.g. protection measures for older pedestrians) as feasible. In some areas, such as medical care and formal care, they missed indicators. Hence, we recommend adding new recommendations for action. DISCUSSION:The awareness of local authorities regarding the WHO strategy of active aging should be improved. Taking into account the specified further development needs, active aging is a viable orientation aid and offers several opportunities for aging policy for municipalities.
10.1055/a-1010-6248
What Is Meaningful Participation for Older People? An Analysis of Aging Policies.
Dizon Lovely,Wiles Janine,Peiris-John Roshini
The Gerontologist
BACKGROUND AND OBJECTIVES:The language used to construct policy problems influences the solutions created. Recent aging policies emphasize participation as essential to aging well, encouraging independence and active involvement in all aspects of life. However, it is less clear whether participation in the creation of policies or in policy goals and aspirations is meaningful. This article addresses the question: "How is meaningful participation reflected and enabled in policy?" RESEARCH DESIGN AND METHODS:Eleven global, national, and local policies were purposively selected and analyzed using thematic and discourse analysis. RESULTS:Policies framed population aging as a challenge and active aging as a value as or part of the policy-making process, participation is enabled (or not) through the types of participation encouraged by policy makers and the kinds of participation used to engage with older people. DISCUSSION AND IMPLICATIONS:Our analysis identifies a strong pattern of discourses regarding individual responsibility to age well; underlying tensions between productive and passive participation; and tensions inherent to the concept of consultation. Implications include the need for those in the consultative phase of policy making to engage with diverse older people and to use participatory methods to explore what meaningful participation means for older people themselves.
10.1093/geront/gnz060
The Institutional Active Aging Paradigm in Europe (2002-2015).
López-López Raúl,Sánchez Mariano
The Gerontologist
BACKGROUND AND OBJECTIVES:The paradigm of active aging has been slowly gaining ground in Europe as the ideal framework for public policy and for responding to the population's aging. Taking the work by Rune Ervik as its point of departure, this article updates his conclusions on conceptualizations and policies of active aging by performing a study of the institutional discourses in the matter produced by the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), and the European Union (EU). METHODS:A corpus of 15 WHO, OECD, and EU documents published in the period 2002-2015 and tackling active aging were analyzed qualitatively through a combination of content and thematic analysis, based on a scheme integrated by deductive and inductive iterative manual and computerized codification. RESULTS:The institutional discourses on active aging analyzed have not changed dramatically in the period considered. However, a divergent path has emerged regarding the accent placed on participation and contribution in the construction of the paradigm: the more socially productive and health-oriented WHO discourse is slowly separating from the more economically productive and labor-oriented discourses of the EU and OECD. DISCUSSION AND IMPLICATIONS:The institutional paradigm on active aging is evolving into a reductive treatment of a phenomenon that is multidimensional. International institutions and researchers should pay closer attention and forge a path toward an honest and critical examination of the real conditions and expectations of older people concerning the discursive and practical proposals of active aging, in all its different forms.
10.1093/geront/gnz094