Associations between individual and environmental factors and habitual physical activity among older Chinese adults:A social–ecological perspective

Purpose: To examine, within a social–ecological framework, associations between multifaceted individual and environmental factors and habitual physical activity(HPA) among older Chinese adults.Methods: Through a mix of qualitative and quantitative methods, a survey instrument assessing various factors underlying 3 social–ecological dimensions of intrapersonal, interpersonal, and community and environmental resources was developed. Using a cross-sectional design, older adults(n = 1580, aged 67 ± 7 years) recruited from 10 communities in Shandong province completed the social–ecological survey of HPA. Data were analyzed using Partial Least Squares Path Modeling.Results: Factors related to intrapersonal(medical knowledge, motivation, physical function, sport skills, socioeconomic status, and education),interpersonal(social support, social activity, and social norms), and community and physical environmental resources(safety, capacity, availability of and access to physical activity facilities) were found to be significantly associated with older adults' participation in HPA.Conclusion: The findings provide an initial validation of a social–ecological approach to the study of HPA in China, suggesting that strategies aimed at promoting physical activity in older adults should address multiple levels of factors that may contribute to the likelihood of older Chinese adults being physically active.

Relationship between Self-Perceived Age and Social Activity in Older Japanese Adults: The KAGUYA Study

Youthful feelings were shown to have a positive effect on the mental and physical conditions of the elderly. On the contrary, elderly people whose self-perceived age is older than their chronological age were shown to experience negative health outcomes. This study investigated whether the self-perceived age (younger or older) relative to chronological age promotes social activity. The baseline data acquired from 3094 older adults as part of the Keeping Active across Generations Uniting the Youth and the Aged study was used in the current study. The participants completed a questionnaire that solicits information pertaining to sociodemographic factors, felt age, self-rated health, physical activity, depression, disease burden, fall history, fear of falling, level of instrumental activities of daily living (IADLs) and social activity. The discrepancy between felt age and chronological age was defined as the self-perceived age. Self-perceived age was calculated by subtracting the participant’s chronological age from the felt age, and the score for the difference was divided by the chronological age. The Japan Science and Technology Agency Index of Competence was used to evaluate social activity. Regression analysis results revealed that a younger self-perceived age was associated with higher social activity after controlling for sociodemographic factors, self-rated health, depression, physical activity, disease burden, level of IADL, fall history and fear of falling. Fall history was significantly associated with higher social activity in young-old participants (65 - 74 years) (p = 0.014) but not in old-old participants (>75 years). This study suggests that a younger self-perceived age in older adults would lead to a high-level living function. This finding may provide useful information for interventions aimed at the promotion of health and/or the prevention of frailty.

Insights into the Social Determinants of Health in Older Adults

In this paper, we review the social determinants of health in older adults and their complex interrelationship with medical diseases. Also, we provide recommendations to address these determinants in the integrated healthcare plan. The social determinants in older adults and its influence in health outcomes have been studied for decades. There is solid evidence for the interrelationship between social factors and the health of individuals and populations;however, these studies are unable to define their complex interrelatedness. Health is quite variable and depends on multiple biological and social factors such as genetics, country of origin, migrant status, etc. On the other hand, health status can affect social factors such as job or education. Addressing social determinants of health in the integrated healthcare plan is important for improving health outcomes and decreasing existing disparities in older adult health. We recommend a person-centered approach in which individualized interventions should be adopted by organizations to improve the health status of older adults at the national and global level. Some of our practical recommendations to better address the social determinants of health in clinical practice are EHR documentation strategies, screening tools, and the development of linkages to the world outside of the clinic and health system, including social services, community activities, collaborative work, and roles for insurance companies.

Review Paper: Association between Social Network and Obesity among Adult Population

Objectives: Our main objective is to establish an association between obesity and social networks among the adult population as well as understanding the underlying mechanisms. We aim to provide suggestions for the development of future interventions to treat obesity. Methods: We carried out a literature search from 4 databases: PubMed, Embase, Scopus and Web of Science. We conducted a systematic search targeting on 3 main concept terms—“social network”, “obesity” and “adult”. A final pool of 11 articles best fitted for our topic was included. Results: We have established a clear association between obesity and social networks. Single women with the co-living arrangement have a higher waist circumference (WC), consistent with a higher predisposition to obesity seen among single individuals but lone living divorced men had lower WC compared to those with partners. Women with high incomes are less likely to be obese in comparison to highly social men with low income. The degree of the effect on social networks and obesity was inconclusive due to differences in the study population. Generally, women with low social participation tend to be obese. However, non-partnered women consistently showed a higher WC in comparison to their partnered counterparts regardless of participation rates except for divorced women. Living in a neighborhood with access to active transportation, high socioeconomic status, increased levels of social trust and social support reduces the prevalence of obesity. Mechanisms of cultural ideals, nature of employment, stress, gender, self-selection, network influence, social contagion and shared built environment may have contributed to the variation in results obtained. Conclusion: Association between social network and obesity exists. However, its overall effect on body weight is affected by a variety of factors. Sociodemographic factors and network characteristics of the population may influence the impacts on body weight. Therefore, a good understanding of the mechanisms associated will assist the development of effective network-based interventions.

Use of Social Cognitive Theory to Assess Salient Clinical Research in Chronic Disease Self-Management for Older Adults: An Integrative Review

The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. The focus is application of the SCT domains to self-management programs. The exploration of the current chronic disease self-management research provides an understanding of the Social Cognitive Theory concepts studied in interventional self-management research. The integrative review explicated two areas related to the theory in need of further research. First, social support has not been thoroughly explored as a mechanism for enhancing self-management interventions. Second, moral disengagement was not identified as a focus within chronic disease research raising the question about the impact of moral disengagement on long-term adherence and behavior change.

Impact of social isolation on behavioral health in elderly: Systematic review

AIM: To examine and compare the effects of subjective and objective social isolation on behavioral health in elderly adults.METHODS: A systematic search of Pub Med was performed for original research articles from peerreviewed journals examining one of the following topics: "Social isolation and sleep disturbance", "social isolation and depression", or "social isolation and fatigue in older adults". Studies were selected following the criteria established based on the aim of this review. Data were extracted from the articles by two independent reviewers. Due to the heterogeneity in study designs and outcome measures of the included studies, qualitative and narrative analyses were conducted.RESULTS: The set criteria were used to select a total of 16 studies for the review. Of the 16, 13 were crosssectional studies. The characteristics of study populations were identified as follows. A total of 12 studies randomly selected subjects irrespective of pre-existing health conditions. Consequently, an unspecified number of the study subjects had chronic diseases in the studies compared. In addition, cultural and ethnic backgrounds of studies in this review were diverse, and included subjects living in North America, South America, Asia, Europe, and Oceania. Both subjective and objective types of social isolation increased behavioral symptoms, such as sleep disturbance, depressive symptoms, and fatigue in older adults. Furthermore, a few recent studies reported stronger effects of subjective social isolation than objective social isolation on sleep disturbance and depressive symptoms.CONCLUSION: Social isolation affects behavioral health in older adults. Compared to the objective social isolation, subjective social isolation contributes more significantly to sleep disturbance and depression.

积极社会心态量表的修订及其在老年群体中的验证

基于早期编制的社会心态量表,参考其他相关测量和专家意见,确定积极社会心态量表的维度结构,在原量表基础上修改或重新编写条目,形成初始量表。对309名老年人进行初测,经过探索性因子分析和项目分析形成正式量表。然后选取512名老年人进行正式施策,评估内部一致性信度、结构效度,以及效标关联效度。结果显示,积极社会心态包括生活满意感、社会公平感、社会安全感、社会信任感和社会认同感五个分量表,总量表和各分量表的内部一致性信度及分半信度系数较高,验证性因素分析表明测量模型拟合良好,具有良好的聚合效度与区分效度,以及效标关联效度,可用于开展相关研究。

Social integration: How is it related to self-rated health?

Social integration has well-established health benefits among older adults in observational studies. However, interventions designed to increase social integration have not improved health suggesting important knowledge gaps on how social integration influences health outcomes. This study developed a new measure of social integration, daily social contact, capturing the interpersonal nature of social integration and mobility of individuals, and providing a direct assessment of individuals’ real-time access to companionship and social support. The data used is the 2006-2007 American Time Use Survey (ATUS), which surveyed 25,191 individuals aged 15 years and older (n = 4378 aged 65 years and older). Generalized ordinal logistic regression analyses revealed positive, but non-parallel relationships between daily social contacts and the ordinal categories of self-rated health among older adults. This study may be used to identify populations that experience social exclusion, such that future research can determine more precisely how to intervene to improve health outcomes.

可行能力视角下福利机构成年孤儿的社会安置研究

可行能力是促进人发展的重要且不可或缺的要素。公共政策是促进人的可行能力和实质自由的保障。接受院舍照顾(福利院照顾)长大的成年孤儿,他们的可行能力比不上正常家庭养育成年的孩子。提升成年孤儿的可行能力,是成功安置成年孤儿的关键。可行能力建设要点在于:一是激发成年孤儿的决策参与意识,完善成年孤儿的利益诉求机制,拓展他们的决策参与空间;二是确立政府在社会安置资金投入中的主体地位,拓展成年孤儿社会安置资金来源,改善他们的经济条件;三是推动社会基本公共服务均等化,拓宽信息获取渠道,促进就业,增加他们的社会机会;四是提高社会安置信息与监管的透明度,拓宽与成年孤儿相关的社会政策信息的获取渠道,加强他们的透明性保证;五是完善成年孤儿社会安置的法律法规,健全成年孤儿社会安置体系,完善他们的防护性保障。如此,才能最终实现成年孤儿的科学合理安置。

数智化时代老年人社会参与的挑战与应对策略——基于MOA理论的实证研究

随着积极应对人口老龄化国家战略的实施,养老观念正发生转变,从传统单纯地为老年人生活提供支持,逐步转向鼓励老年人继续参与社会活动,即进行积极的社会参与。数智化技术既给老年人积极社会参与带来更多的机遇,也是未来老年人社会参与的必由之路。基于MOA理论对20位老年人开展为期14天的日记研究,结果表明,数智化技术确实为老年人带来了更多社会参与的机会,但也造成老年人在社会参与时面临“想参与但无从参与”“有机会但参与困难”与“参与但获得感不强”三大挑战。要改善这一现状,首先,要完善制度设计,通过出台老年人社会参与统一平台建设、技术赋能老年社会参与的相关政策,保障参与环境;其次,要建设统一平台,构建包含老年人、养老服务机构(企业)和医疗(健康)服务机构等不同主体共同聚合的生态系统,保障老年人的社会参与机会;再次,推动技术赋能,在做好高频应用适老化改造的基础上,加强对智能化功能的建设,对技术使用的门槛做减法,为技术应用形式做加法;最后,要积极鼓励和推广以志愿服务、银发网红、再就业等为代表形式的“老有所为”活动,支持老年人继续发挥余热,使晚年生活更充实、更有意义。

老年数字健康服务的发展、应用与挑战

数字技术在老年健康服务中的应用日益成为焦点。针对中国人口老龄化背景,探讨数字技术在老年健康服务中的应用、挑战及创新方向。通过回顾自21世纪初以来老年人在数字化健康服务中的角色演变,指出老年人群在数字社会中的边缘化问题。进而聚焦现有研究中关于老年人使用数字技术时面临的主要挑战,包括技术可及性、用户适应性、伦理与安全、人性化服务等问题,提出提高老年人的数字素养和社会参与度的解决策略和研究焦点,从理论和实践层面为老年健康服务的数字化转型提供全面见解。

不同社会支持类型和老年人心理健康的关系

社会支持是指个人从社会网络中获得他人的关心与帮助,包括客观的物质支持和主观的情感支持。老年人的社会支持类型主要包括家人、亲属、朋友、社区组织等给予个体精神和物质上的帮助和支持^([1-4])。前人研究^([5])表明,社会支持与老年人的心理健康有密切联系。老年人心理健康定义为一种个体内部心理和谐一致,与外部适应良好的稳定的心理状态,具体可体现在五个方面,即认知功能正常、情绪积极稳定、自我评价恰当、人际交往和谐、适应能力良好^([6])。

休闲活动对城市老年慢病患者生命质量的影响——基于社会支持、慢病数量的中介与调节作用分析

老年人患慢性病比例的上升使得我国人均预期寿命与老年人口平均健康寿命的差距不断扩大。利用2021年西安市老年慢病患者文化活动参与调查数据,通过有调节的中介效应模型,分析了社会支持及慢病数量在不同类型休闲活动对城市老年慢病患者生命质量影响中的作用机制。结果表明,个体休闲活动、团体休闲活动和社会支持对城市老年慢病患者生命质量具有显著提升作用。社会支持在团体休闲活动与生命质量之间起完全中介作用,同时,慢病数量在城市老年慢病患者“团体休闲活动-社会支持”和“社会支持-生命质量”影响路径中起调节作用。研究结果强调了改善社区休闲活动参与环境和构建多层次老年慢病患者社会支持网络对提升城市居民健康寿命的重要性。

老年人社会衰弱筛查工具的研究现状

综述国内外社会衰弱筛查工具的应用现状,为国内学者开展社会衰弱的筛查提供可借鉴的工具,继而为我国老年人针对性地进行科学、全面的综合护理,提高其生存质量,切实做好健康管理提供支持,以推动我国社会衰弱研究的发展。

我国老年人社会参与政策文本量化研究

目的:分析我国老年人社会参与政策分布特点,探究可优化之处,为我国老年人社会参与政策的制定提供科学参考。方法:采用内容分析法,对我国国家层面老年人社会参与政策开展文本量化研究,构建政策工具和增能理论二维分析框架以探索政策分布特点并提出对策建议。结果:政策工具维度中,需求型、供给型和环境型工具占比分别为8.93%、47.02%、44.05%;增能维度中,主体、环境和服务增能占比分别为14.29%、48.81%、36.90%。结论:我国老年人社会参与政策已成体系,但存在统筹性、协调性和持续性不够、对老年人主体增能回应不足等问题。从“健全体制机制”“以赋能赋权为核心多样化社会参与”等方面提出完善老年人社会参与政策体系的对策建议,以期助推政策的有效执行。

社区老年人社会隔离的潜在剖面分析及影响因素研究

目的分析社区老年人社会隔离特征及影响因素,为制定干预措施以促进积极老龄化提供参考。方法采取便利抽样法,随机选取渭南市3所社区卫生服务中心接受健康体检的老年人308人为调查对象。采用一般资料调查表、Lubben社交网络量表-6、老年人社会参与能力评估标准、日常生活活动能力量表进行调查。结果社区老年人社会隔离得分为(11.26±4.74)分,老年人中51.62%存在社会隔离。社区老年人社会隔离可划分为高朋友隔离组(52.92%)和低朋友隔离组(47.08%)2个潜在剖面。logistic回归分析显示,日常生活自理能力、社会参与能力、退休前职业、患病年限、年均住院次数是老年人社会隔离潜在剖面类别的影响因素(均P<0.05)。结论社区老年人社会隔离现象严重,且存在明显的分类特征,可针对不同类型特征老年人实施个体化干预,改善老年人社会隔离情况。

考虑建成环境和社会-心理因素的老年人休闲散步意向研究

我国刚刚正式迈入深度老龄化,老年友好型社会仍处于探索建设阶段,为弥补建成环境、心理状态、社会交往交互作用下对老年人休闲散步意向影响研究不足,本文选取60岁及以上老年人为研究对象,通过问卷调查获取数据,构建包含建成环境要素(可达性、道路质量、安全性)、心理状态因素(态度、主观规范、感知行为控制)及社会交往的结构方程模型,探究三者交互作用下对老年人休闲散步意向的影响研究,包括建成环境要素、心理状态因素及社会交往对老年人休闲散步意向的直接影响,以及建成环境要素通过心理状态因素和社会交往对老年人休闲散步意向的间接影响。基于路径假设结果中的标准化路径系数发现:可达性(0.099)、道路质量(0.079)、态度(0.318)、主观规范(0.089)、感知行为控制(0.312)及社会交往(0.150)对老年人休闲散步意向有直接显著影响,安全性未产生直接影响;可达性通过态度(0.075)、主观规范(0.016)、感知行为控制(0.055)及社会交往(0.029)对老年人休闲散步意向有间接显著影响,道路质量通过态度(0.039)、主观规范(0.015)、感知行为控制(0.028)及社会交往(0.020)对老年人休闲散步意向有间接显著影响,安全性未通过心理状态因素和社会交往产生间接影响。研究结果可为建成环境和社会-心理因素干预下老年人休闲散步方面研究提供理论依据,在保障老年人休闲散步出行顺畅和老年友好型社会建设方面具有指导意义。

基于LASSO回归的失能老年人社会隔离影响因素分析

目的分析失能老年人社会隔离现状及影响因素,为制订失能老年人社会隔离干预方案提供依据。方法采用多阶段分层整群抽样法,抽取六安市2个社区483名失能老年人,使用Barthel指数评定量表、工具性日常生活能力量表、精简版社会网络量表进行调查,同时收集老年人的个体资料、行为因素及环境因素相关资料。使用LASSO回归筛选变量,对筛选出的变量进行多因素logistic回归分析。结果失能老年人社会隔离发生率为48.86%。多因素logistic回归分析显示,性别、文化程度、睡眠效率、体力活动水平、居住地是失能老年人社会隔离的影响因素(均P<0.05)。结论失能老年人社会隔离水平较高,社区护理人员应关注社会隔离风险较高的失能老年人,针对影响因素对失能老年人进行干预,以降低其社会隔离发生率。

老年人社会网络类型与主观幸福感相关性研究

目的分析老年人的社会网络特征,探讨老年人社会网络类型与主观幸福感之间的关系。方法在浙江、四川、吉林、湖南四地采用二阶段抽样,对老年人的社会人口学资料、主观幸福感、健康状况、社会联系等情况进行问卷调查。采用二阶聚类法将老年人的社会网络分为不同类型。采用Kruskal-Wallis检验和广义线性模型分析社会网络类型与主观幸福感之间的关联。结果调查地区老年人的社会网络类型以家庭型(37.0%)为主。不同年龄、性别、文化程度和月收入情况的老年人的社会网络类型不同;不同年龄、性别、文化程度、月收入、自评健康、衰弱程度、心理健康、抑郁、认知障碍、社会网络类型的老年人幸福感得分不同,工作人员型老年人幸福感低于其他所有类型,多元型和家庭型老年人幸福感高于其他所有类型,差异均有统计学意义(P<0.05)。广义线性模型显示,控制了年龄、性别、文化程度、月收入、自评健康、衰弱程度、心理健康及抑郁因素后,与家庭型社会网络的老年人相比,多元型(B=1.082,P=0.014)老年人的主观幸福感更高,工作人员型(B=-3.961,P<0.001)和子女型(B=-1.141,P=0.005)老年人的主观幸福感更低。结论调查地区老年人的社会网络以配偶和子女为中心,可以通过鼓励老年人多结交朋友、多与亲属交流等方式优化老年人的社会网络结构,从而提高老年人的主观幸福感。