Uncovering the Dynamic System Driving Older Adults' Vitality: A Causal Loop Diagram Co-Created With Dutch Older Adults

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-07-09 DOI:10.1111/hex.70344

Djoeke Besselink, Fons van der Lucht, Lisa Barsties, Martine Jansen- van der Vliet, Thomas G. Kuijpers, Lidwien Lemmens, Evelyn J. Finnema, Saskia W. van den Berg

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引用次数: 0

Abstract

Background

Most studies on older adults' vitality focus on linear connections between determinants and outcomes. To design more comprehensive and impactful approaches to support the vitality of older adults, a better understanding of the interplay among elements that shape their vitality is necessary.

Objective

To uncover the underlying dynamic system that drives vitality in older adults, drawing directly from older adults' perspectives.

Methods

During three group model-building sessions with 10–12 older adults (≥ 55 years old), a causal loop diagram with relevant feedback loops was developed through co-creation with older adults. The construction and analysis of the causal loop diagram were facilitated using the online modelling tools Vensim and Kumu. The group model-building sessions were guided by Scriptapedia, an online guide to conducting group model-building practices.

Results

The final CLD consisted of 15 elements contributing to older adults' vitality, organised into three themes: ‘Psychological and emotional elements’, ‘Social connections and support’ and ‘Lifestyle and habits’. A total of 41 reinforcing feedback loops were identified, with 21 involving all three themes, 15 connecting two themes and 5 within a single theme.

Conclusions

This study displays the complex interplay of elements influencing older adults' vitality, highlighting the critical roles of psychological, social and lifestyle-related elements. The participatory-led approach yielded co-produced insights that inform public health strategies, underscoring the need for comprehensive, multidisciplinary approaches to promote older adults' vitality. Such approaches must offer social opportunities and foster individuals' capacity and motivation to engage in meaningful social relationships.

Patient or Public Contribution

The study was conducted in collaboration with a municipal policymaker and a coordinator of local community centres, who provided input on participant recruitment, materials, data interpretation, ethical considerations and result dissemination. During data collection, twelve older adults participated in three group model-building sessions, collaboratively developing a causal loop diagram to explore elements of vitality and their interconnections. Ongoing member checking with participants throughout the process ensured the analysis was refined and the researchers' interpretations were validated.

Abstract Image

查看原文本刊更多论文

揭示驱动老年人活力的动态系统：与荷兰老年人共同创作的因果循环图

大多数关于老年人活力的研究集中在决定因素和结果之间的线性关系上。为了设计更全面和有影响力的方法来支持老年人的活力，有必要更好地了解影响老年人活力的各种因素之间的相互作用。目的直接从老年人的角度出发，揭示驱动老年人活力的潜在动力系统。方法在10-12名老年人（≥55岁）的3次群体模型构建过程中，通过与老年人共同创造，形成具有相关反馈回路的因果循环图。利用在线建模工具Vensim和Kumu促进了因果循环图的构建和分析。小组模型建立会议由Scriptapedia指导，这是一个进行小组模型建立实践的在线指南。最终的CLD包括有助于老年人活力的15个要素，分为三个主题：“心理和情感因素”、“社会关系和支持”和“生活方式和习惯”。共确定了41个强化反馈回路，其中21个涉及所有三个主题，15个连接两个主题，5个在一个主题内。结论本研究揭示了影响老年人活力的因素之间复杂的相互作用，突出了心理、社会和生活方式相关因素的关键作用。参与主导的方法产生了共同产生的见解，为公共卫生战略提供了信息，强调需要采取综合、多学科的方法来促进老年人的活力。这种方法必须提供社会机会，培养个人参与有意义的社会关系的能力和动机。这项研究是与一名市政决策者和一名当地社区中心协调员合作进行的，他们在参与者招募、材料、数据解释、伦理考虑和结果传播方面提供了投入。在数据收集过程中，12名老年人参加了三次小组模型构建会议，共同开发因果循环图，以探索活力的要素及其相互联系。在整个过程中不断与参与者进行成员检查，确保分析得到完善，研究人员的解释得到验证。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.