Advancing Age‑Friendly Community Practice Through Global Learning: A Case Study of the Athens County-Slovenia Exchange for Health Equity.

Abstract

Background: As populations age globally, communities are challenged to promote health equity and well-being for older adults. The World Health Organization's (WHO's) Global Network for Age-Friendly Cities and Communities provides a platform for sharing local innovations, while Global Learning for Health Equity (GL4HE) offers a framework for reciprocal, evidence-to-action learning across borders. Objective: This case study examines a bilateral exchange between Athens County, Ohio, USA, and Slovenia to assess how short-term, immersive exchanges can stimulate innovation, clarify contextual factors, and build relationships that support age-friendly practice, following the GL4HE framework. Methods: The project engaged a seven-member delegation from Athens County in Slovenia (January 2025) and a six-member Slovenian delegation in Athens County (May 2025). Delegations included representatives from local government, public health, community organizations, and academia. Itineraries combined structured site visits, informal reflection sessions, and cultural experiences. Documentation included agendas, minutes, reflections, evaluation, and message logs. Data were analyzed using a hybrid coding approach informed by the GL4HE framework and WHO Age-Friendly domains, with inductive coding to identify emergent themes. Results: Five themes emerged: (1) inspiration sparks innovation, (2) comparative learning clarified context, (3) time for focus, (4) group reflection enhances learning, and (5) exchanges build relationships that inspire future collaboration. Participants reported both professional and personal transformation, with recognition that exchanges at the "explore" stage of GL4HE generate inspiration more than direct adoption. Conclusions: Short-term exchanges are valuable vehicles for advancing age-friendly practice through global learning. By prioritizing a concentrated focus on a single issue (e.g., aging), reflection, and relationship building, exchanges provide a foundation for reciprocity and evidence-to-action transfer. Even without immediate adoption, such experiences can catalyze equity-oriented innovation and strengthen the relational infrastructure needed for sustained collaboration.