Age-friendly Community Initiatives Research Articles

'It Made Me Change the Way I Do Business': Outcomes from Age-Friendly Community Initiatives as Systems Change.

Since the early 2000s, a global age-friendly communities (AFC) movement has called for improving the built, social, and service environments of localities for aging. Yet research on the outcomes of AFC initiatives, as programmatic efforts toward AFC progress, remains in its nascence. Drawing on "The Water of Systems Change" framework, our study aimed to address this gap by exploring the extent to which accomplishments of AFC initiatives are indicative of altering six conditions for systems change: policies, organizational practices, resource allocations, power dynamics, relationships, and mental models. We analyzed qualitative data from 26 key informant interviews across eight mature AFC initiatives in the northeastern United States. We engaged in iterative phases of thematic analysis to explore how the initiatives' accomplishments, as described by the participants, align with each of six focal conditions for systems change. We found especially robust and consistent evidence for outcomes in terms of enhanced organizational practices on aging; resource flows; connections within and across communities; and mental models about older adults. Evidence for outcomes concerning changes in power dynamics and policy was more limited. Conceptualizing AFC initiatives as systems-change interventions can bolster research, evaluation, and program development as the movement proliferates and diversifies into the 21st century. Insights can help to advance praxis that empowers AFC leaders as changemakers for "successful aging" at the level of society.

Assessing Age-Friendly Community Initiatives: Developing a Novel Survey Tool for Assessment and Evaluation.

Age-Friendly Community Initiatives (AFCIs) have gained recognition as essential responses to the needs of aging populations. Despite their growing significance, there is a notable lack of effective measurement tools to assess the planning, implementation, and sustainability of AFCIs. The purpose of this study was to develop and validate a survey tool for evaluating AFCIs. A sequential exploratory mixed-method design was used in two phases. First, we identified key themes from interviews with AFCI leads to generate AFCI survey items and regional workshops. Then, we conducted a pilot of the survey and assessed its measurement properties. Thematic analysis of interviews with 68 key informants from 58 AFCIs revealed four main themes: AFCI priorities, enablers, challenges, and benefits. These themes, combined with feedback from AFCI stakeholders at the regional workshops and a AFCI conference, informed the development and refinement of a reliable and valid AFCI survey in 2019, supported by a high Cronbach's Alpha value (α = 0.881). Steps were identified to maintain and sustain the AFCI survey over time. The survey accommodates AFCIs' diverse demographics, governance structures, and priorities with a standardized and flexible approach for effective measurement. This research contributes to the academic understanding of AFCIs and aids community leaders and policymakers in planning, implementing, and evaluating AFCIs.

A qualitative study of healthy ageing and co-production

Europe’s ageing population increases the demand for housing solutions targeting older citizens’ needs and preferences. Establishing age-friendly communities fostering social participation is essential for healthy ageing and various housing options with shared facilities prioritizing social contact have emerged. While involving older people in public service delivery is emphasized, studies on co-production with older people in building age-friendly communities remain limited. This study explores a co-production initiative between older citizens, a municipality and a real estate company in a newly established senior village focusing on organizational settings and physical facilities. A qualitative study inspired by the BIKVA methodology was conducted using focus group interviews with citizens, frontline staff, and management. Through reflexive thematic analysis, the physical environment, organizational setting and other factors influencing the co-production process were analysed. Citizens expressed satisfaction with the unique physical environment, the different activities and being involved in the co-production process on development and building up the senior village. However, the co-production initiative was influenced by the lack of frontline staff involvement, how the physical facilities were organized for building inclusive communities as well as the level of information provided to align expectations among stakeholders. Involving older citizens in the co-production of age-friendly community initiatives has the potential to take the identified challenges into account. To understand what constitutes an optimal environment for healthy ageing further research in collaboration with older citizens is needed.

A Review of Public Sector Engagement in Age-Friendly Community Initiatives

ABSTRACT The global age-friendly cities and communities (AFCC) movement has centered on the involvement of the public sector, calling on high-ranking authorities to commit to improving the built, social, and service environments of their localities. This interpretive review aimed to advance understanding of the ways in which the public sector is involved in AFCC efforts. Based on emergent themes from peer-reviewed articles from the United States and Canada published since 2010, we derived a two-dimensional framework for conceptualizing variability in public sector involvement, encompassing the internal/external (a) locus of responsibility for cross-sector change and (b) target for cross-sector change. We discuss implications for research, policy, practice, and further knowledge development in AFCC implementation.

“I’m Part of Something That Matters”: Exploring What Older Adults Value Through Their Engagement in Age-Friendly Community Initiatives

ABSTRACT Older adults’ engagement in age-friendly community (AFC) initiatives is considered an essential element of community transformation. However, research on older adults’ experiences of engaging in AFC initiatives remains nascent. Based on qualitative interviews with 23 older adult participants from 15 AFC initiatives across four states in the United States (U.S.), our reflexive thematic analysisidentified three themes regarding what participants value from their engagement: (a) social contribution; (b) social connectedness and integration; and (c) staying active and personal growth. Exploring older adults’ interest in contributing to, connecting with, and growing in their community can inform recruitment and retention in AFC initiatives.

Statewide Age-Friendly Virtual Fair as a Tactic for Social Change Across the Aging Ecosystem

ABSTRACT Prior research has demonstrated ways in which community events help to establish age-friendly community initiatives and strengthen their impact. We extend these insights by discussing how the design and implementation of a statewide event – the New Jersey Age-Friendly Virtual Fair – exemplifies this practice theory and extends its applicability beyond local community development toward broader state-level age-friendly ecosystems. We describe how events that are deliberately multi-organizational, multi-sectoral, and multi-level can help to further propel the Age-Friendly Movement toward systems change for aging in community.

Making Communities Age-Friendly: Lessons From Implemented Programs

A growing number of programs promoted by planners and others have aimed to foster communities that support older people. Do such programs make a substantial difference? Through a scoping review of research evaluating WHO-style age-friendly community initiatives (AFCIs), we investigate what kind of outcomes such initiatives have achieved and factors facilitating or hindering them. Elements affecting implementation varied by geographies. They included external resources (e.g., government support, funding, consultants), local resources (e.g., community size, demographics, staff, infrastructure), engaged local participants (e.g., partnerships, champions, older people), and effective strategies to build support (e.g., quick wins, awareness building, cultural sensitivity).

OLDER ADULT ENGAGEMENT IN AGE-FRIENDLY COMMUNITY WORK

Abstract Drawing on 22 interviews with older adults across four states, this qualitative study explores how older adults perceive their age-friendly community work and the personal meaning they derive from participation. Based on iterative coding, findings indicate ways in which geographic differences in the structure and framing of local age-friendly community initiatives set the boundaries, scope, and potential customization of older adult engagement. Across geographies, motivations for starting and sustaining engagement included: perceived personal growth; social connectivity; outlets for advancing skills and passions; and satisfaction from making a difference in the lives of older adults and their broader community. These findings highlight the importance of conceptualizing older adult engagement in age-friendly community work as a dynamic process embedded within intrapersonal, interpersonal, organizational, and community contexts. Demonstrating multiple ways older adults contribute to placemaking, the findings have implications for older adult engagement at various levels and stages of age-friendly community initiatives.

TOWARD STRUCTURAL CHANGE: ADVANCING PRAXIS ON AGE-FRIENDLY CITIES AND COMMUNITIES

Abstract The global age-friendly cities and communities (AFCC) movement has inspired leaders across the public, private, and academic sectors to re-imagine how environments can better support long and healthy lives. There is growing recognition, however, of structural and other constraints that impede the translation of AFCC aspirations into systematic, comprehensive, impactful, and sustainable action. This paper will describe the importance of researchers’ engagement in AFCC praxis to better support the movement toward structural change for aging equity and healthy aging. The paper will present a case example of academic researchers’ long-standing involvement in collaborative efforts toward the development and sustainability of age-friendly community initiatives in New Jersey. The case will emphasize the importance of creating synergies across research, teaching, and service activities; cultivating coordinated AFCC efforts across the mico, meso, and macro levels; and developing sustainable structures for deliberate inter-organizational and multi-sectoral partnerships toward short- and long-term goals.

Age-Friendly Communities and Older Adults' Health in the United States.

As age-friendly community (AFC) initiatives grow, it will be essential to determine whether older adults who live in an AFC have better health than those who live in other environments. This study uses data from the 2017 AARP AFC Surveys and the AARP Livability Index to assess whether AFCs promote the health of older adults. We analyze data for 3027 adults aged 65 and older who reside in 262 zip code areas. Following AARP guidelines, we allocated the sample into two groups: an AFC group (livability score of 51+; n = 2364) and a non-AFC (score ≤ 50, n = 663). The outcome variable was self-rated health (M = 3.5; SD = 1.1; range: 1–5). We used an inverse probability weighting approach to evaluate whether older adults who live in an AFC reported better self-rated health than those who live in a non-AFC. Findings showed that older adults who lived in an AFC had better self-rated health than those in a non-AFC (b = 0.08, p = 0.027). Compared to non-Hispanic Whites, Black and Hispanic older adults reported worse self-rated health. Inasmuch as living in an AFC can promote the well-being of older adults, policymakers and practitioners should continue to develop and sustain high-quality, accessible built and social environments.

Community events as part of age-friendly community practice

ABSTRACT As the number of localities committing to age-friendly progress increases worldwide, there is growing interest in the processes and contexts that lead to systemic and long-term age-friendly community (AFC) impact. Our study aimed to advance research in this area by exploring community events as a mechanism through which practitioners work toward AFC goals. We used semi-structured interview data with core teams that participated in a multi-year developmental evaluation of eight grant-funded AFC initiatives in New Jersey. We employed a constructivist grounded theory approach to analyze the data, focusing on how AFC leaders facilitate events and what they perceive as the value of events. Findings highlighted the centrality of an inter-organizational context for event planning and implementation, as well as the unique positioning of AFC leaders relative to other community actors. Results further indicated that AFC leaders view events as immediately benefiting older adults and local organizational partners, while also having longer-term strategic value, including by deepening older adults’ engagement with the AFC initiative, providing opportunities for core teams to learn about aging in community, and expanding the AFC initiative’s community presence. We interpret these findings within a community-building framework, theorizing that events can strategically build relational capacity to sustain age-friendly progress within broader community systems.

Responding to Local Needs by Mobilizing Community Assets: Age-Friendly Community Initiatives During the COVID-19 Pandemic.

Background and ObjectivesAge-friendly community initiatives (AFCIs) strive to make localities better for long and healthy lives by fostering improvements across social, physical, and service environments. Despite the heightened need for community supports during the coronavirus disease 2019 pandemic, very little research has addressed the work of AFCIs in the context of this crisis. We aimed to develop theory on how AFCI core teams have contributed to community responses during the pandemic, as well as what contexts have influenced the initiatives’ ability to contribute.Research Design and MethodsAs part of a multiyear, community-partnered study on the development of philanthropically supported initiatives in northern New Jersey, we conducted qualitative interviews with 8 AFCI core teams during the winter of 2020–2021. The interviews focused on the leaders’ efforts at that time, with probing questions concerning enabling factors for their community responses. We analyzed the data using an inductive coding process encompassing open, axial, and subcoding.ResultsThe analysis indicated four distinct roles of AFC core groups: good community partner, creator, advocate, and communications broker. We further found that AFC leaders primarily drew on three types of capital—human, social, and tangible—to enact these roles, oftentimes in cumulative ways.Discussion and ImplicationsWe interpret our study’s findings and their implications by integrating insights from theories of social impact. We further highlight the importance of continued research on community-centered approaches to promote aging in community during times of societal crisis, and otherwise.

Giving, Receiving, and Doing Together: Interorganizational Interactions in Age-Friendly Community Initiatives

ABSTRACT Multi-sectoral collaboration is widely considered essential for age-friendly community change; however, there has been little empirical research to describe the ways in which organizations interact as part of age-friendly community initiatives (AFCIs). We conducted a qualitative descriptive study using data from multiple waves of semi-structured interviews with core teams of eight grant-funded AFCIs in the north-eastern U.S. We employed iterative, inductive coding to systematically describe ways in which AFCI core teams described working with other organizational entities. Findings indicated two overarching themes: (a) helping each other (giving and receiving linking, informational, and instrumental assistance), and (b) doing something together (organizing community events, planning collaborative projects, participating in meetings). We discuss the implications of this characterization for guiding research, evaluation, and policy to optimize AFCI implementation and impact across diverse settings.

Age-Friendly Community Practice: Understanding the Role of Community Events

To advance an emerging empirical knowledge base for age-friendly community initiatives (AFCIs), we conducted a qualitative descriptive study to explore one manifestation of age-friendly practice: community events (CEs). We aimed to illuminate how AFCI core teams describe CEs as part of their practice and how they perceive the value of CEs for age-friendly progress. Using inductive coding, we analyzed data from semi-structured interviews (n=24) with eight core teams across three time points spanning the early to mid-implementation phases of the AFCIs. Two predominant themes emerged. First, CEs were described as important for working toward age-friendly goals concerning older residents’ social participation and inclusion. Second, core teams described the longer-term strategic value of CEs, such as building interorganizational partnerships; providing deeper insight on aging in community; and fostering older adults’ leadership as part of the initiative. We discuss implications for advancing transdisciplinary program theory to guide more sustainable and effective AFCIs.

Peer Mentoring to Foster Resilient Age-Friendly Rural Communities in Maine

Maine has a growing number of age-friendly community initiatives (AFCIs); 116 communities are actively working to adapt the social, service, and built environments for aging and 71 have formally joined the AARP Network of Age-Friendly States and Communities. During COVID, rural municipalities were faced with dynamic changes that limited older resident’s access to services and social engagement. To overcome these limitations, it is critical for emergent AFCIs to have tools and strategies to maintain and further enhance healthy environments and resilient communities. This study uses group interviews with 6 leaders of established AFCIs and 6 leaders of emergent AFCIs to explore how the Lifelong Fellows Program, a peer mentoring model that matches experienced leaders with newly formed initiatives, was able to spur development of new strategies to build community resilience. Prominent themes were (1) engaging new local and regional partners; (2) intergenerational volunteerism; (3) fun and flexibility; and (4) relationship-building.

Enhancing Collaborations between our Age-Friendly Community and University Initiatives

Community involvement and synergistic partnerships are key to fostering a holistic approach to programming and outreach that assess and meet the needs of the older adults in our communities. The University of Illinois Urbana-Champaign has created an Age-Friendly network to facilitate these partnerships featuring our designation of Age-Friendly City and Age-Friendly University as well as partnerships with our state and local governments, community aging services providers, and continuing care retirement communities. Through these partnerships, we have identified the landscape of the community, assessed the unique needs older adults, and identified novel solutions. We will discuss our plans for activities that will empower older adults in our community and at our university by promotion connection, collaboration, and inclusion.

Measurement Indicators of Age-Friendly Communities: Findings From the AARP Age-Friendly Community Survey.

Background and ObjectivesCities and counties worldwide have adopted the concept of “age-friendly communities.” These communities aspire to promote older adults’ well-being by providing a safe, affordable built environment and a social environment that encourages their participation. A major limitation in this field is the lack of valid and reliable measures that capture the complex dimensionality and dynamic nature of the aging–environment interface.Research Design and MethodsThis study uses data from the AARP 2016 Age-Friendly Community Surveys (N = 3,652 adults aged 65 and older). The survey includes 62 indicators of age-friendliness, for example, outdoor spaces, transportation, housing, social participation, and community and health services. We randomly split the sample into 2 equal subsamples for confirmatory factor analysis (CFA) and structural equation modeling (SEM).ResultsCFA results indicated that both the 5-factor model and the second-order factor model adequately fit the data. In the SEM 5-factor model, outdoor space (β = 0.134; p = .017), social participation (β = 0.307; p < .001), and community and health services (β = −0.149; p = .008) were associated with self-rated health, the outcome of interest. The path coefficients of housing and transportation were not significant. In the second-order factor model, people who lived in more age-friendly communities reported better self-rated health (β = 0.295; p < .001).Discussion and ImplicationsOur findings show that the Age-Friendly Community Survey measures demonstrate reliability and concurrent validity. To promote older adults’ well-being, practitioners, policymakers, and researchers should focus on improving their built and social environments. They can use these measures for short- and long-term planning, monitoring, and evaluating age-friendly community initiatives.

Do Age-Friendly Community Initiatives Form a Biopolitical Paradigm?

Biopolitical paradigms are frameworks that specify how concerns about health and the body are made the simultaneous focus of biomedicine and state policy (Foucault 1984; Rose 2007). As aging and urbanization trends converge, developing “age-friendly community initiatives” (AFCIs) has become a global movement and important policy area. To prompt critical questioning, situational analysis was used as a theory-methods package to compare AFCI conceptual frames with perspectives of thirteen AFCI experts and seventeen older San Franciscans. Preliminary analysis suggests AFCIs form a biopolitical paradigm because they not only seek to rework boundaries between bodies and environments, they operate as modes of individual and population governance for the sake of health; yet, struggle to find ways to preserve the inclusion of older people in the ongoing social system. Understanding how AFCIs place social and physical environments squarely in view within the biomedical arena of the gerontological gaze has theoretical and policy implications.

Developing Age-Friendly Communities: Comparative Research on the Role of Social Infrastructure and Inclusion

Aging experiences are often framed by the forms in which communities take shape. In turn, the material forms of communities provide the conditions in which aging experiences and processes are produced. These multidirectional pathways of influence between micro-macro contexts comprise an assemblage of networks that usually go unnoticed, except on breakdown. Applying Leigh-Star’s (1999) charge to study these networks as infrastructure, we examine their “invisible work” in the ecological analysis of aging in community. This symposium presents research using community-embedded methods to illuminate how paradoxical forms of transparent and opaque infrastructure facilitate and mediate interactions between people, things, and the environmental shapes that hold these interactions. Yarker’s comparative case analysis of two Manchester neighborhoods highlight the critical importance of social infrastructure in supporting the diversity of relations needed to develop age-friendly communities and new forms of community action amongst older people. Grove’s qualitative and geo-spatial approaches demonstrate how planned and unplanned social interactions, and variety of social infrastructural forms, contribute positively and negatively to ageing well for older people in Dublin. Simon-Rusinowitz’s three-part intervention addresses unmet needs of older Baltimore residents in a low-income community; finding, in part-one, that housing is a platform for providing health and social services needed to age successfully. Yeh compares the conceptual frames undergirding age-friendly community initiatives with expert knowledges and lay perspectives of older San Franciscans, revealing tension between the rational dreams and material realities of aging in the community. These presentations contribute to gerontological discourse, providing new insights for policy and practice considerations.

Which Seat at the Table? The Ways That Senior Service Organizations Are Engaged in Age-Friendly Community Efforts

Senior centers across the nation continue to serve as important access and focal points for older adults to voice their desires, get basic needs met, and to engage in opportunities that support many of the key concepts of Age-Friendliness (i.e. social participation, respect and social inclusion, civic engagement, transportation, and community supports and health services). Senior centers are the front line of aging services and thus in a position to implement programs and raise public awareness about age-friendly initiatives. The purpose of this presentation is to present and discuss the involvement of senior centers or other senior service agencies, as well as to characterize the mobilization of a community after joining the movement. We will present 5 case studies of age-friendly communities who are in the implementation phase of their initiative, to illustrate the challenges, opportunities, and outcomes associated with placing a senior center at the forefront of the movement. Based on the results of this work, we will present a typology of age-friendly community initiatives as a mechanism for supporting other communities make this transition. We conclude with a discussion of how age-friendly communities are part of the paradigm shift of aging in community and the ways in which this work intersects with other health policy initiatives with which cities and towns engage.