Age-Friendly Environment and Community-Based Social Innovation in Japan: A Mixed-Method Study.

BACKGROUND AND OBJECTIVES: While governments are building age-friendly environments, community-based social innovation (CBSI) provides opportunities for older community residents to interact. Common CBSIs in Japan are in the form of group exercise activities or social-cultural activities, such as reading, writing, poetry, chorus, calligraphy, card game, knitting, planting trees, and cooking. In this study, an age-friendly environment in Japan was assessed quantitatively and qualitatively through the perceptions of community residents and their interaction with the environment. RESEARCH DESIGN AND METHODS: A cross-sectional survey of 243 participants and multiple in-depth interviews were carried out. A quantitative study applied the World Health Organization (WHO) framework of 20 age-friendly environmental factors with analysis applying a structural equation model. A qualitative study applied focus group meetings and in-depth interviews to conduct a thematic analysis of Japanese community residents' activities according to the WHO scope of CBSI for healthy aging. RESULTS: This age-friendly environment in Japan has provided pathways for the older people to sustain their social network, which promotes civic participation and engagement in peer group activities leading to active aging. CBSIs are the factors that lead to an age-friendly environment resulting in a sustainable quality of life. DISCUSSION AND IMPLICATIONS: It is important to sustain CBSIs in the era of coronavirus disease 2019 pandemic as those are the paths leading to healthy aging communities and quality of older residents' life. The lessons learned about how physical environment and social participation result in healthy, active quality of life for older adults in Japan may be applicable to other contexts around the world.

Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar.

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients' willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant's socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.