Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review
2.1. Identifying the Research Question
2.2. Theoretical Framework Guiding the Review Process
2.3. Identifying Relevant Studies
2.3.1. Eligibility Criteria
2.3.2. Search Strategies and Databases
2.3.3. Screening and Study Selection
2.3.4. Data Extraction and Charting
2.3.5. Data Analysis and Synthesis
2.4. Stakeholder Event
3. The Analysis
3.1. Context—What Is an Ecosystem and How Does It Function?
3.2. Ecosystem Mechanisms: What Works Well and What Prevents Effective Working?
3.2.1. Existing and Identified Need
3.2.2. Authorization, Knowledge, Planning, Preparation, and Design
3.2.3. Virtual and/or Place-Based Resources and Attributes
3.3. Barriers to Ecosystem Success
3.4. Facilitators of Ecosystem Success
- A community engagement program aimed at promoting healthy relationships and resilience as well as facilitating digital engagement. Specifically, the development of telecentres as a part of the ecosystem was found to be useful for improving digital engagement. This approach recognizes the importance of social connectedness and access to technology for promoting community participation among older people. However, it was noted that a broader multidimensional approach involving other ecosystem levels would be needed to fully promote digital inclusion .
- Active aging across the life-course . This approach recognizes the potential of older people to contribute to their communities and society as a whole and aims to create environments that support their continued participation and inclusion (through lifelong learning, engagement in meaningful activities, and social connectedness).
- A range of key factors to assess ‘successful aging’ among older people aging-in-place, which are organized according to individual, family, and community systems (Jang). These factors may include individual characteristics such as physical and cognitive function, mental health, and social engagement; family-related factors such as social support, caregiving, and intergenerational relationships; and community-related factors such as access to healthcare and social services, neighborhood safety, and social and cultural opportunities.
- Applying ecological principles can facilitate the development of age-friendly communities, as found by . According to DelaTorre and Neal , ensuring that cities maintain age-friendly policies requires ongoing planning initiatives that consider macro-level factors. When an ecological approach is used to develop age-friendly cities, as noted by Marston et al. , there is evidence of increased stability in areas such as education, support, and employment for older people.
- At the policy level, changes that encourage the development of social and built environments promoting belonging and social engagement throughout the life course can facilitate the development of social capital, impacting both community and individual health and wellbeing [47,48,49,50,55,57]. This requires a focus on creating age-friendly environments that support community participation and social connectedness, including access to social and cultural activities, transportation, and public spaces that promote interaction and inclusivity.
3.6. Stakeholder Event
- There exist several community-driven projects and initiatives aimed at building community resilience, which have not been documented in academic literature. The COVID-19 pandemic has further fueled the development of such initiatives, raising discussions on equity, diversity, inclusion, community responsibility, and local democracy. To create places that function across diverse older people and attract intergenerational participation, it is essential to avoid treating older people as a homogeneous group. This requires a focus on empowerment, especially amplifying the voices of those who are often overlooked. However, disempowerment over the years has made it challenging to sustain community-level change, and stronger policy commitment is required to foster community empowerment.
- To avoid tokenistic participation, it is necessary to develop inclusive, intersectional, and cross-sectional ways of working that give more control and assets to the community. This requires collaboration between professionals, practitioners, and residents to ensure that everyone’s voices are heard and considered.
- Initiating a debate around the concept of caring cities and communities would be useful to challenge organizational agendas and shift towards perspectives that prioritize the needs and preferences of both the city and its citizens.
- Consider reframing the perception of older people as a homogenous group of frail individuals, as many of them are active community participants. By doing so, we can avoid the development of age silos and focus on community development for active aging. This will help in creating a better society for all ages and bridging the gap between young and old. Additionally, we need to counter the negative narrative of older people as a financial burden on society and instead highlight them as valuable resources and assets.
- To move forward, community hubs and people’s assemblies are potential solutions, but these require a new community-based narrative that includes communities of interest and regional variations. This new way of thinking also requires political and community commitment as well as funding for social movements and networks—rather than one-off interventions, sustained efforts are necessary.
- ‘Inclusive coffee mornings’ organized by a local church are an example of best practice for supporting older adults’ community participation. The initiative works thanks to its bottom-up approach, with older people helping each other, and its ability to also bring together diverse groups. However, initiating, and sustaining citizen-led initiatives can be challenging; they require dedication, time, and effort from volunteers and organizers alike.
- A common pitfall of many policies is to segregate individuals based on their age groups, rather than recognizing that we are all unique individuals with our own personalities, stories, and experiences. A notable example of best practice is the V&A Dundee’s (the first design museum in Scotland) ‘See Me, Hear My Voice’ initiative, which forms part of the Dundee International Year of Older People. The initiative aims to move beyond viewing older people solely through demographic lenses and instead focuses on recognizing them as individuals with diverse backgrounds, interests, and skills—shifting from a ‘care’ perspective to a ‘community’ perspective, ultimately promoting the idea of caring communities.
- Solutions for enhancing older people’s community participation need to be locally driven. Smaller communities are often better positioned to create innovative and effective approaches that work for their unique needs and circumstances. For instance, in Kirriemuir (a town located in the county of Angus, Scotland), collaboration with the Royal Town Planning Institute has led to the implementation of new traffic calming measures, road crossings, signage, and community garden spaces, which benefit people of all ages in the community. However, it is essential to acknowledge that what works in one area may not necessarily work in another. Therefore, it is crucial to learn from each other by sharing stories and experiences. This is where community champions can play a vital role in facilitating the development of new initiatives and the sharing of knowledge.
4. Discussion and Conclusions
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Older people||Old* people|
|Example Search String for Web of Science|
|Authors||Title||Publication Type||Publication Title||Publication Date||Main Area of Research||Main Author Location||Study Geographical Focus||Study Design|
|Aldwin, C. and Igarashi, H.||An ecological model of resilience in late life.||Journal article||Annual review of gerontology and geriatrics||2012||Aging||USA||Global||Review|
|Baldissera, Thais, and Camarinha-Matos, Luis M||SCoPE: Service Composition and PErsonalization Environment||Journal article||Applied Sciences||2018||Science and Technology||Brazil||Brazil and Portugal||Constructive researchmethod|
|Bettis, J., Kakkar, S. and Chan, C, D.||Taking Access to the Community: An Ecological Systems Framework for In-Home Counselling with Older Adults||Journal article||Adultspan Journal||2020||Mental health care/Counselling||USA||Global||Review|
|Camarinha-Matos, L, M., Rosas, J., Oliveira, A. I. and Ferrada, F.||Care services ecosystem for ambient assisted living,||Journal article||Enterprise Information Systems,||2015||Science and Technology||Portugal||Europe||Conceptual model|
|Carroll, N., Kennedy, C. and Richardson, I.||Challenges towards a Connected Community Healthcare Ecosystem (CCHE) for managing long-term conditions.||Journal article||Gerontechnology||2016||Science and Technology||Ireland||Europe, North America, and Australasia||Systematic mapping study|
|DeLaTorre, A. and Neal, M, B||Ecological Approaches to an AgeFriendly Portland and Multnomah County||Journal article||Journal of Housing for the Elderly||2017||Aging||USA||USA||Reflective account|
|Ferreira, S, M., Sayago, S. and Blat, J.||Going Beyond Telecenters to Foster the Digital Inclusion of Older People in Brazil: Lessons Learned from a Rapid Ethnographical Study||Journal article||Information Technology for Development||2016||Technology||Brazil||Brazil||Rapid ethnographic study|
|Fulmer, T., Patel, P., Levy, N., Mate, K., Berman, A., Pelton, L., Beard, J., Kalache, A., and Auerbach, J.||Moving Toward a Global Age-Friendly Ecosystem||Journal article||J Am Geriatr Soc||2020||Aging||USA||Global||Retrospective account of the global progress made toward age-friendly ecosystem|
|Jang, H. Y.||Factors associated with successful aging among community-dwelling older adults based on ecological system model||Journal article||International Journal of Environmental Research and Public Health||2020||Nursing||Korea||Korea||Descriptive secondary analysis|
|Lak, A., Rashidghalam, P., Myint, P. K., and Baradaran, H. R.||Comprehensive 5P framework for active aging using the ecological approach: an iterative systematic review||Journal article||BMC Public Health||2020||Architecture and Urban Planning||Iran||Global||Narrative review|
|Loos, E., Soubati, M., and Behrendt, F.||The Role of Mobility Digital Ecosystems for Age-Friendly Urban Public Transport: A Narrative Literature Review||Journal article||International Journal of Environmental Research and Public Health||2020||Digital health information||Netherlands||Global||Narrative literature review|
|Marston, H.R., Shore, L., and White, P.J.||How does a (Smart) Age-Friendly Ecosystem Look in a Post-Pandemic Society?||Journal article||International Journal of Environmental Research and Public Health||2020||Digital technology, Wellbeing and Social Care||UK||Global||Review|
|Menec, V.H.||Conceptualizing Social Connectivity in the Context of Age-Friendly Communities.||Journal article||Journal of Housing for the Elderly||2017||Aging, Community health||Canada||Global||Review, Conceptual model|
|Wetle, T.T.||Age-Friendly Ecosystems: An Aspirational Goal||Editorial||Journal of the American Geriatrics Society||2020||Public Health||USA||Global||Editorial comment on another published article|
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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Sixsmith, J.; Makita, M.; Menezes, D.; Cranwell, M.; Chau, I.; Smith, M.; Levy, S.; Scrutton, P.; Fang, M.L. Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review. Geriatrics 2023, 8, 52. https://doi.org/10.3390/geriatrics8030052
Sixsmith J, Makita M, Menezes D, Cranwell M, Chau I, Smith M, Levy S, Scrutton P, Fang ML. Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review. Geriatrics. 2023; 8(3):52. https://doi.org/10.3390/geriatrics8030052Chicago/Turabian Style
Sixsmith, Judith, Meiko Makita, Deborah Menezes, Marianne Cranwell, Isaac Chau, Mark Smith, Susan Levy, Pat Scrutton, and Mei Lan Fang. 2023. "Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review" Geriatrics 8, no. 3: 52. https://doi.org/10.3390/geriatrics8030052