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The Creation of a Reliable and Valid Age-friendly Checklist and Guidebook (breakout presentation)
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Abstracts / Journal of Transport & Health 7 (2017) S4–S87
S5:01 Creating Healthy Walkable Environments for Seniors Smart Wellness City - New Healthy Community Movements in Japan (breakout presentation) Hirotaka Koike 1, Teppei Osada 2, Takahiro So 3 1
Utsunomiya Kyowa University, Japan Utsunomiya University, Japan 3 Kokusai Kogyo Co., Ltd., Japan 2
Background: Japan is now heading toward a population decrease and a highly aging society. The elderly population over 65 years old will exceed 40% by 2055. Medical and social welfare cost is skyrocketing. The nationwide automobile dependency established over the past half a century resulted in the low-density sprawl to wide suburban areas and hollowing out of the downtown area. Now, Japan is facing serious mobility problems, especially among the elderly who cannot continue to drive. Although the fatal traffic accidents in Japan decreased to less than a quarter of the peak in 1970, the elderly casualties are increasing to more than half of the total traffic death. Description of Program: A new community revitalization program called "Smart Wellness City" (SWC) was started by a group of mayors and academics in 2009. The main purpose of the program is to build a city where "walkability" is the central theme in order to enable citizens to live healthier and happier. Factors to realize SWC are: Provision of public traffic infrastructures including walkways, natural trails, bikeways and public transit to reduce car dependency; Restructuring of urban form toward compact cities where people can interact to create social capital; Increasing health literacy of all citizens through community fitness programs involving outdoor activities (population approach); and objective evaluation scheme to assess the result based on the data analysis with comprehensive health/medical evidence. Outcomes: Now the member municipalities have increased to 62. Many of these municipalities proved the effectiveness of SWC program especially among elderly citizens. They are enjoying the benefits of delaying frailty in both physical and mental level, and enhancing the restored community spirits. Other important benefits of SWC are the cost savings in health care sectors, and revitalization of downtown activities including commercial sales increase. Implications: The success of SWC influences the formation of a new program called "Smart Wellness Community" in 2015 including national and local governments, private industries and academia to further expand the movement to nationwide level. It will become a model for many countries to cope with problems caused by the increase of aging population. http://dx.doi.org/10.1016/j.jth.2017.11.107
The Creation of a Reliable and Valid Age-friendly Checklist and Guidebook (breakout presentation) Rebecca Lewinson, Spencer Nageleilson, Elizabeth Kristjansson University of Ottawa, Canada
Background: The communities in which we live can have a profound impact on our health and well-being. This may be especially true for older adults. The World Health Organization (WHO) ascribed a central role to features of the physical and social environment in determining the health and wellbeing of older adults in its active aging policy framework. Experts also developed a WHO Guide, which described key aspects of agefriendliness across eight domains. Many Canadian cities and towns have been designated Age-Friendly, However, up until now, there has been little measurement or evaluation of Age-Friendliness.
Abstracts / Journal of Transport & Health 7 (2017) S4–S87
S67
Aim: In order to address these gaps in measurement and evaluation, we developed the Age-Friendly Neighbourhood Checklist (AFNC), based on WHO Guidelines for Age-Friendliness. The AFNC is an observational checklist which focuses specifically on the built features of a neighbourhood including outdoor spaces, buildings, transportation and winter walkability. In this presentation, we will provide information on its development and validation, highlighting ways in which evidence from this checklist might be used to help communities and neighbourhoods as they move towards becoming Age-Friendly. Methods: Development of the AFNC proceeded in three phases. Phase One comprised of initial development, content validation with seven experts, and pilot testing. Inter-rater reliability from the first pilot test was unacceptably low (Cohen’s Kappa – 0.61), therefore, Phase Two included scale refinement and development of a guidebook followed by further pilot testing. Phase Three involved content validation and reliability testing in all urban and suburban neighbourhoods. Results: The Phase Two pilot test revealed that inter-rater reliability using Cohen’s Kappa rose to .76 with use of the Guidebook; the overall ICC was 0.87. Ten experts participated in the latest content validation. The average expert ratings ranged from 2.6 to 4.8 out of 5; the experts also made suggestions on the wording of 4 items. Based on this, we deleted 6 items with scores below 3; we also rewrote 4 items. Conclusions: Providing communities with a reliable and valid means to assess age-friendliness is useful and enables them to plan and adapt to their population’s needs, develop interventions, and monitor progressive change within their community. http://dx.doi.org/10.1016/j.jth.2017.11.108
Age‘n’dem, Age and Dementia Friendly Streetscapes Toolkit, Walking Environments to Support Older People to Walk More and for Longer (breakout presentation) Carmel Boyce 1, Elissa McMillan 2, Kerryn Lockett 2, Sarah Haq 2, Guy Luscombe 3 1
Equity Justice Access City of Moonee Valley, Australia 3 Achitects Johannsen and Associates 2
Background: Age’n’dem was developed as a participatory design process with many older residents of Moonee Valley to: inform streetscape design, ensure access for older people including people with dementia, and be mindful of other special needs of community members ensuring measures were inclusive. Age’n’dem was delivered as a component of the Victorian State Dementia Plan underlying Age’n’dem was a desire to change outcomes for older residents. The existing streetscape palette was tired. The experiential learning process informed redesign of Union Road streetscape in Ascot Vale, Victoria as it: operated as an intact and attractive environment for shopping, was surrounded by the highest density of older people in the municipality, particularly older women, shops played an important role in supporting people to age in place, and offered a complete range: newsagents, small supermarket, hardware, butchers, bakers and the deli, cake and coffee. Shopkeepers played an informal role: looking out for regulars, helping out when and if something happened. Residents knew, understood and relied on it. Walking up to the street, passing the time in a familiar place and dropping in on shopkeepers had become part of a daily ritual for many locals over time. What the shopkeepers did informally, helping older residents age in place was better than any response any community service could offer. Our role became one of supporting a natural and organic response by listening, watching and learning. We wanted to encourage this to happen, more often and for longer. We knew: If we made the street more comfortable we could sustain older residents’ interest as they age; If the environment was increasingly supportive it could continue to provide this function, enabling residents to age in place for as long as possible, and; Walking plays a key role in dementia prevention. Description: Moonee Valley had budget for streetscape redesign and remediation and were funded through the Municipal Association of Victoria (MAV) and Department of Health and Human Services for Age’n’dem development. Lessons Learned: Investing in local’s knowledge was important. Process is everything. Our most articulate supporters are the older residents themselves talking on national radio, and statewide press. http://dx.doi.org/10.1016/j.jth.2017.11.109
Abstracts / Journal of Transport & Health 7 (2017) S4–S87
S5:01 Creating Healthy Walkable Environments for Seniors Smart Wellness City - New Healthy Community Movements in Japan (breakout presentation) Hirotaka Koike 1, Teppei Osada 2, Takahiro So 3 1
Utsunomiya Kyowa University, Japan Utsunomiya University, Japan 3 Kokusai Kogyo Co., Ltd., Japan 2
Background: Japan is now heading toward a population decrease and a highly aging society. The elderly population over 65 years old will exceed 40% by 2055. Medical and social welfare cost is skyrocketing. The nationwide automobile dependency established over the past half a century resulted in the low-density sprawl to wide suburban areas and hollowing out of the downtown area. Now, Japan is facing serious mobility problems, especially among the elderly who cannot continue to drive. Although the fatal traffic accidents in Japan decreased to less than a quarter of the peak in 1970, the elderly casualties are increasing to more than half of the total traffic death. Description of Program: A new community revitalization program called "Smart Wellness City" (SWC) was started by a group of mayors and academics in 2009. The main purpose of the program is to build a city where "walkability" is the central theme in order to enable citizens to live healthier and happier. Factors to realize SWC are: Provision of public traffic infrastructures including walkways, natural trails, bikeways and public transit to reduce car dependency; Restructuring of urban form toward compact cities where people can interact to create social capital; Increasing health literacy of all citizens through community fitness programs involving outdoor activities (population approach); and objective evaluation scheme to assess the result based on the data analysis with comprehensive health/medical evidence. Outcomes: Now the member municipalities have increased to 62. Many of these municipalities proved the effectiveness of SWC program especially among elderly citizens. They are enjoying the benefits of delaying frailty in both physical and mental level, and enhancing the restored community spirits. Other important benefits of SWC are the cost savings in health care sectors, and revitalization of downtown activities including commercial sales increase. Implications: The success of SWC influences the formation of a new program called "Smart Wellness Community" in 2015 including national and local governments, private industries and academia to further expand the movement to nationwide level. It will become a model for many countries to cope with problems caused by the increase of aging population. http://dx.doi.org/10.1016/j.jth.2017.11.107
The Creation of a Reliable and Valid Age-friendly Checklist and Guidebook (breakout presentation) Rebecca Lewinson, Spencer Nageleilson, Elizabeth Kristjansson University of Ottawa, Canada
Background: The communities in which we live can have a profound impact on our health and well-being. This may be especially true for older adults. The World Health Organization (WHO) ascribed a central role to features of the physical and social environment in determining the health and wellbeing of older adults in its active aging policy framework. Experts also developed a WHO Guide, which described key aspects of agefriendliness across eight domains. Many Canadian cities and towns have been designated Age-Friendly, However, up until now, there has been little measurement or evaluation of Age-Friendliness.
Abstracts / Journal of Transport & Health 7 (2017) S4–S87
S67
Aim: In order to address these gaps in measurement and evaluation, we developed the Age-Friendly Neighbourhood Checklist (AFNC), based on WHO Guidelines for Age-Friendliness. The AFNC is an observational checklist which focuses specifically on the built features of a neighbourhood including outdoor spaces, buildings, transportation and winter walkability. In this presentation, we will provide information on its development and validation, highlighting ways in which evidence from this checklist might be used to help communities and neighbourhoods as they move towards becoming Age-Friendly. Methods: Development of the AFNC proceeded in three phases. Phase One comprised of initial development, content validation with seven experts, and pilot testing. Inter-rater reliability from the first pilot test was unacceptably low (Cohen’s Kappa – 0.61), therefore, Phase Two included scale refinement and development of a guidebook followed by further pilot testing. Phase Three involved content validation and reliability testing in all urban and suburban neighbourhoods. Results: The Phase Two pilot test revealed that inter-rater reliability using Cohen’s Kappa rose to .76 with use of the Guidebook; the overall ICC was 0.87. Ten experts participated in the latest content validation. The average expert ratings ranged from 2.6 to 4.8 out of 5; the experts also made suggestions on the wording of 4 items. Based on this, we deleted 6 items with scores below 3; we also rewrote 4 items. Conclusions: Providing communities with a reliable and valid means to assess age-friendliness is useful and enables them to plan and adapt to their population’s needs, develop interventions, and monitor progressive change within their community. http://dx.doi.org/10.1016/j.jth.2017.11.108
Age‘n’dem, Age and Dementia Friendly Streetscapes Toolkit, Walking Environments to Support Older People to Walk More and for Longer (breakout presentation) Carmel Boyce 1, Elissa McMillan 2, Kerryn Lockett 2, Sarah Haq 2, Guy Luscombe 3 1
Equity Justice Access City of Moonee Valley, Australia 3 Achitects Johannsen and Associates 2
Background: Age’n’dem was developed as a participatory design process with many older residents of Moonee Valley to: inform streetscape design, ensure access for older people including people with dementia, and be mindful of other special needs of community members ensuring measures were inclusive. Age’n’dem was delivered as a component of the Victorian State Dementia Plan underlying Age’n’dem was a desire to change outcomes for older residents. The existing streetscape palette was tired. The experiential learning process informed redesign of Union Road streetscape in Ascot Vale, Victoria as it: operated as an intact and attractive environment for shopping, was surrounded by the highest density of older people in the municipality, particularly older women, shops played an important role in supporting people to age in place, and offered a complete range: newsagents, small supermarket, hardware, butchers, bakers and the deli, cake and coffee. Shopkeepers played an informal role: looking out for regulars, helping out when and if something happened. Residents knew, understood and relied on it. Walking up to the street, passing the time in a familiar place and dropping in on shopkeepers had become part of a daily ritual for many locals over time. What the shopkeepers did informally, helping older residents age in place was better than any response any community service could offer. Our role became one of supporting a natural and organic response by listening, watching and learning. We wanted to encourage this to happen, more often and for longer. We knew: If we made the street more comfortable we could sustain older residents’ interest as they age; If the environment was increasingly supportive it could continue to provide this function, enabling residents to age in place for as long as possible, and; Walking plays a key role in dementia prevention. Description: Moonee Valley had budget for streetscape redesign and remediation and were funded through the Municipal Association of Victoria (MAV) and Department of Health and Human Services for Age’n’dem development. Lessons Learned: Investing in local’s knowledge was important. Process is everything. Our most articulate supporters are the older residents themselves talking on national radio, and statewide press. http://dx.doi.org/10.1016/j.jth.2017.11.109