Abstract
BackgroundMobility, one of the basic daily activities, helps in carrying out routine work, which contributes to people’s well-being. A lack of friendly and accessible infrastructure may act as a barrier, which limits older adults’ contributions and participation in society. Hence, it is important to have an enabling environment for older adults to carry out their activities independently at ease. There is ample research evidence about effective interventions on urban mobility infrastructures, but there is a lack of evidence regarding what works, for whom, and in what circumstances. Hence, there is a need to identify the contextual factors for different regions to design region-specific interventions. The aim of this realist synthesis is to develop an evidence-informed framework for safe and accessible urban mobility infrastructures for older adults in low- and middle-income countries.MethodsA realist review will be undertaken using the following process: (1) development of a program theory, (2) search strategy and information sources, (3) study selection and appraisal, (4) data extraction, and (5) data synthesis. In addition to searching grey literature and contacting authors, we will search (since inception) multiple electronic databases such as PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library. Studies will be included based on their ability to provide data that evaluates some aspect of the program theory. Two independent reviewers will screen and extract data from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome that explains how safe and accessible urban mobility infrastructures for older adults implemented in low- and middle-income countries translate to better health outcomes. The findings will be reported according to Realist and MEta-narrative Evidence Syntheses: Evolving Standards guidelines.DiscussionThis realist review will help to develop a framework for safe and accessible urban mobility infrastructures for older adults in low- and middle-income countries. The results of this study will support evidence-based decision-making on urban mobility systems and will be of interest to various stakeholders. Dissemination will be done through conference presentations, policy briefs, media, and peer-reviewed journals. Implications for future research will be discussed.Systematic review registrationPROSPERO CRD42020168020
Highlights
Mobility, one of the basic daily activities, helps in carrying out routine work, which contributes to people’s well-being
The World Health Organization (WHO) estimates that by 2050, 80% of the older adults (OAs) will be living in low- and middle-income countries (LMICs) [2]
While LMICs are speeding up the infrastructure development project, there is a lack of clear and context-specific evidencebased decision-making framework on urban mobility systems focusing on older adults
Summary
The review protocol has been registered within the PROSPERO database with registration number CRD42 020168020 and is being reported in accordance with the reporting guidelines provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement [18, 19] (see checklist in Additional file 1). The steps involved in a realist synthesis include (1) developing the program theory; (2) search strategy and information sources; (3) screening, study selection, and appraisal; (4) data extraction; (5) data synthesis; and (6) stakeholder consultation and refinement of program theory. Study selection, and appraisal Articles will be included in the review based on their relevance to provide information for the program theory. The data extraction sheet will include study characteristics (title, author, publication year, publication status, country, participants, study objective), intervention-related details (relevance to program theory and implementation strategies), program theory (context, mechanism, and outcome aspects), and quality appraisal of the study. Data synthesis The analysis process in a realist review involves refining the already existing program theory to formulate an evidence-informed framework for effective intervention to improve the mobility and safety of OAs in urban mobility infrastructure. The research focuses on co-designing an inclusive urban mobility evaluative framework that can provide guidelines for making urban transport infrastructures and services more inclusive towards marginalized and vulnerable groups
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