Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"How Housing Stress Affect Health Care Costs: A Panel Data Study.","authors":"Gai Liu, Jianchao Zhou, Yuxiang Wang","doi":"10.1177/00469580241290145","DOIUrl":"10.1177/00469580241290145","url":null,"abstract":"<p><p>As housing prices in China continue to escalate and the limitations of the \"personal unlimited liability system\" for housing loans become more evident, the financial stress on families has significantly increased. This stress not only impacts the physical and mental health of family members but also results in rising health care costs. This paper presents empirical research examining how housing stress influences changes in household health care costs through a panel data analysis. The study is based on the China Family Panel Study (CFPS) database and employs a panel two-way fixed effect model alongside a mediating effect model to examine the impact of housing stress, family income, and health status on health care costs. The findings reveal a significant positive correlation between housing stress and health care costs; specifically, for every 1% point increase in housing stress, health care costs rise by 0.141. Robustness tests and propensity score matching (PSM) further validate these findings, even after addressing endogeneity issues. Mediation effect analysis indicates that for every 1% point increase in housing stress, household disposable income decreases by 1.749, and health status declines by 0.468, thereby increasing household health care costs. Heterogeneity analysis demonstrates that housing stress has a more pronounced impact on health care costs among western, eastern, urban, and rental households. The government should implement various measures, such as promoting a \"personal limited liability system\" mortgage policy, reducing housing prices, and ensuring equal rights to rent and purchase, to alleviate housing stress, enhance family income, and improve residents' health status. These actions would contribute to the promotion of both the housing market and medical care, supporting the sustainable development of the health care sector and ultimately improving long-term social welfare.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241290145"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ownership Matters: Not-for-Profit Chain Nursing Homes Have Higher Utilization of Agency Nursing Staff.","authors":"Rohit Pradhan, Akbar Ghiasi, Gregory Orewa, Shivani Gupta, Ganisher Davlyatov, Bradley Beauvais, Robert Weech-Maldonado","doi":"10.1177/00469580241292170","DOIUrl":"10.1177/00469580241292170","url":null,"abstract":"<p><p>Nursing homes (NHs) have long struggled with nurse shortages, leading to a greater reliance on agency nurses. The purpose of this study was to examine the impact of NH ownership on agency nurse utilization. Data were derived from multiple sources, including the Payroll-Based Journal and NH Five-Star Facility Quality Reporting System (n: 38,550 years: 2020-2022). A 2-part logistic regression model with 2-way fixed effects (state and year) was used to assess the association of ownership and agency nurse utilization. Model 1 compared facilities with and without agency nurse use, while Model 2 focused on NHs using agency nurses, examining high utilization (top 10%). The dependent variables were agency nurse utilization ratios for registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). The primary independent variable was ownership/chain affiliation: for-profit chain (FPC), for-profit independent (FPI), not-for-profit chain (NFPC), and not-for-profit independent (NFPI). Model 1 showed that NFPC facilities had higher odds of using agency RNs (OR = 1.65), LPNs (OR = 1.53), and CNAs (OR = 1.38) compared to NFPI facilities (all <i>P</i> < .001), while FPC facilities also had increased odds for RNs (OR = 1.43), LPNs (OR = 1.30), and CNAs (OR = 1.15) (all <i>P</i> < .001). Model 2 indicated that NFPC, FPC, and FPI facilities were more likely to be high utilizers (top 10%) of agency nurses, with NFPC facilities having the highest odds across all categories. Pairwise comparisons showed that NFPC had the highest utilization of agency RNs and LPNs compared to other ownership groups. These results highlight the significant impact of NH ownership on staffing practices, suggesting that ownership type influences agency nurse utilization.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241292170"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Covid-19 on Women's Mental Health and Wellbeing During Pregnancy and the Perinatal Period: A Mixed-Methods Systematic Review.","authors":"Kanamon Pankaew, Diane Carpenter, Nalinee Kerdprasong, Juntina Nawamawat, Nisa Krutchan, Samantha Brown, Jill Shawe, Jane March-McDonald","doi":"10.1177/00469580241301521","DOIUrl":"10.1177/00469580241301521","url":null,"abstract":"<p><strong>Review question: </strong>What is the impact of Covid-19 upon the mental health and well-being of women during pregnancy and during the perinatal period?</p><p><strong>Inclusion criteria: </strong>empirical primary research; maternal mental health and wellbeing; perinatal period; Covid-19; English or Thai language; studies from December 2019-September 2021, updated March 2024.</p><p><strong>Exclusion criteria: </strong>secondary research, commentary, grey literature. Databases searched: CINAHL, Cochrane, JBI, Medline, PsycINFO, Clinical Key and Web of Science. Studies were assessed for bias using tools aligned with study design. A convergent integrated approach was taken whereby quantitative data was combined with qualitative data, synthesised simultaneously using Braun and Clarke Six Steps to Thematical Analysis and presented as narrative. Forty-two studies were included. Overall level of methodological quality of studies was 14 rated good, 28 fair. Overarching themes: \"Impact\" and \"Emotional Impact.\" Themes: demographic impact; mental health and socio-economic factors; obstetric factors; pre-morbidity; maternity service delivery; relationships; fear and worry, grief and loss. Commonality suggested some evidence for increased risk and prevalence for perinatal mental illness to pre-pandemic levels.</p><p><strong>Risk factors: </strong>lack/perceived lack of social support; high-risk pregnancy, complex obstetric history; prior mental illness; maternity service delivery, quality and safety; fear and worry. Results confer perinatal mental illness prominent during the pandemic though many did not suggest prevalence higher than pre-pandemic levels, or directly associated. Several factors compound risk. A small number of protective factors are identified. The dynamic processes of risk and protection need to be understood within the specific context in which they operate. The authors received no financial support for the research, authorship, and/or publication of this article. The study was not registered.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241301521"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Digital Supervision of China Basic Medical Insurance on Out-of-pocket Expenditure: Evidence from Quasi-natural Experiment.","authors":"Chuncheng Wang, Chen Song, Jing Wu, Yanpeng Ning, Shuai Wang","doi":"10.1177/00469580241301528","DOIUrl":"10.1177/00469580241301528","url":null,"abstract":"<p><p>Scientific research has shown that the sustainability of public health insurance is crucial for governments to effectively manage the risks associated with populations aging. In response, the Chinese government has initiated efforts to ensure the long-term viability of its medical insurance funds. This study utilizes data from 24 484 respondents in the 2013, 2015, 2018, and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS), treating the digital supervision of medical insurance funds as a quasi-natural experiment. The study employs a difference-in-differences (DID) model to evaluate the policy effects and uses heterogeneity analysis to explore variations in impact. The objective is to assess the effectiveness of digital supervision and understand how it achieves its policy goals. The findings indicate that digital supervision of medical insurance funds has a significant positive impact on residents' out-of-pocket medical expenditure. Heterogeneity analysis reveals that the policy's effect is particularly strong in urban samples, especially among younger and elderly urban residents, while showing no significant impact on rural populations. This suggests that the policy has a greater influence on groups with higher moral hazard. By implementing digital supervision of medical insurance funds, the Chinese government has ensured the sustainability of these funds, laying a foundation for mitigating the risks associated with population aging. Additionally, the policy has contributed to promoting healthcare equity and reducing the waste of medical resources.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241301528"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity Enforces Well-being or Shame in Children and Adolescents With Asthma: A Meta-ethnography.","authors":"Thomas Westergren, Hanne Aagaard, Elisabeth O C Hall, Mette Spliid Ludvigsen, Liv Fegran, Nastasja Robstad, Åsa Audulv","doi":"10.1177/00469580241290086","DOIUrl":"10.1177/00469580241290086","url":null,"abstract":"<p><p>Asthma symptoms and experiences of dyspnea challenge participation in physical activity (PA). Therefore, in-depth understanding of experiences with PA is essential. In this meta-ethnography, we synthesized published qualitative studies of experiences of children and adolescents with asthma that influenced, or limited, participation in PA. We followed Noblit and Hare's 7 phases of meta-ethnography. We searched relevant databases by December 18, 2023 for published peer-reviewed studies (Medline (OVID), Embase (OVID), PsycINFO (OVID), CINAHL (EBSCHOhost), SPORTDiscus (EBSCHOhost), SocINDEX (EBSCHOhost), and Social Science Citation Index (WoS)) and theses (ProQuest Nursing & Allied Health Source, ProQuest Healthcare Administration Database, and ProQuest Public Health Database). We conducted study selection and assessment of methodological quality and data extraction using Joanna Briggs Institute's methodology. Sixteen reciprocally related qualitative studies, representing experiences of 238 children and adolescents aged 4 to 18 years were included. We translated primary study concepts and findings into 3 themes covering relationships with others, emotions, and behaviors related to PA participation: (1) feeling related to and connected with friends and family in PA; (2) acquiring and managing new PA and asthma skills; and (3) enjoying PA and experiencing well-being. We also defined 3 themes covering aspects related to PA limitations: (4) feeling misunderstood and penalized in relation to PA; (5) experiencing nervousness, embarrassment, shame, and sadness during PA; and (6) withdrawing from PA due to asthma, environment, and/or socially imposed attitudes. The themes were synthesized into the following lines of argument: children and adolescents with asthma experience that PA enforces empathic/non-empathic relationships, vulnerability, and awareness; PA enhances resilient participation and well-being, or reinforces resignment to isolation and shame. From the outset of either relatedness or being penalized, youngsters with asthma either manage well and experience well-being, or experience shame and withdrawal.<b>Registration:</b> PROSPERO No. 164797.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241290086"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Literacy and Wellbeing Among Medical Students, Residents, and Attending Physicians in Lebanon: Results From a Nationwide Multi-Centered Survey.","authors":"MohammadAli Jardaly, Jumana Antoun, Rania Sakr, Hassan Doumiati, Issam Shaarani","doi":"10.1177/00469580241294135","DOIUrl":"10.1177/00469580241294135","url":null,"abstract":"<p><p>Financial wellbeing and financial literacy are crucial aspects of personal and professional lives, particularly in graduate medical education. Low financial literacy among healthcare professionals, including physicians, has been identified as a concern, impacting job satisfaction, productivity, and burnout. Few studies have used validated methods, assessed financial wellbeing, or compared financial outcomes across the continuum of medical education and practice. This study aims to measure the financial wellbeing of healthcare professionals and trainees and its predictors using validated instruments on a nationwide scale in Lebanon. This is a multi-institutional cross-sectional study using an online survey using validated instruments, including the CFPB Financial Well-Being Scale and Lusardi and Mitchell's \"Big Five\" financial literacy questions. The data was collected in April and May 2020. The population includes medical students, residents, and practicing physicians in all six private medical schools and their affiliated medical centers in Lebanon. A total of 330 responded, with a response rate of 20.7%. The financial wellbeing score (out of 10 was 57.2 ± 9.7 before the financial crisis and dropped to 45.2 ± 10.1 during the country's financial crisis. With a passing grade of 60%, 75.3% (195/259) failed the financial knowledge questions. Attending physicians outperformed students and residents/fellows regarding knowledge scores. Financial wellbeing was positively associated with age, family socioeconomic status, and household income. It was negatively associated with the crowding index and agreement with the attitude of living for today and letting tomorrow take care of itself. Medical students, residents, and physicians in Lebanon had low financial literacy. Attending physicians have high financial wellbeing despite low financial literacy and lack of formal education. The COVID-19 pandemic and economic crisis adversely affected the financial wellbeing of all three groups.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241294135"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional-level Indicators for Chronic Diseases of People with Disabilities: Findings from a Modified Delphi Study.","authors":"Seungeun Park, Boyoung Jeon, Young-Il Jung, Juhyeon Moon, So-Youn Park","doi":"10.1177/00469580241305993","DOIUrl":"10.1177/00469580241305993","url":null,"abstract":"<p><p>Maintaining health cannot be achieved individually; it is influenced by social, legal, and institutional factors surrounding the individuals. This study aimed to identify regional-level factors that may influence the occurrence of chronic diseases among people with disabilities. To achieve this, we conducted a Delphi survey with experts to identify a set of regional indicators required for studying the health status of people with disabilities, particularly for predicting the occurrence of chronic diseases. Through the process of the Delphi survey, 24 indicators were finally selected. The major categories of the indicators were demographic factors (4 indicators), health behaviors (6 indicators), healthcare resources and utilization (11 indicators), and local community policies (3 indicators). Each category and subcategory of indicators plays a crucial role in understanding and improving the health and well-being of people with disabilities at the regional level. By addressing these factors comprehensively, policymakers and healthcare providers can develop more effective and targeted interventions, ultimately fostering a more inclusive and supportive environment for people with disabilities. The findings underscore the importance of a holistic approach to health assessment and the need for continued monitoring and evaluation to inform policy and practice.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241305993"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonoscopy Screening Behavior in First-Degree Relatives of Colorectal Cancer Patients: A Qualitative Study Based on the Theory of Planned Behavior.","authors":"Ruihuan Zhang, Cong Fu Ms, Jing Yuan, Wenwen Li, Chang Du, Shuang Chen, Kaihua Liu, Xiaoping Yin","doi":"10.1177/00469580241305344","DOIUrl":"10.1177/00469580241305344","url":null,"abstract":"<p><p>To investigate the factors influencing the colonoscopy screening behavior of first-degree relatives of colorectal cancer patients and to provide a basis for formulating screening intervention strategies. In this study, 15 first-degree relatives of colorectal cancer patients in the Department of Medical Oncology of a tertiary hospital in Baoding City from May to July 2024 were selected as the research subjects, and face-to-face semi-structured interviews were conducted. The theme was analyzed and summarized based on the theory of planned behavior and Colaizzi's 7-step analysis method. Results of this study identified 12 themes from 3 aspects. For behavioral attitudes, 4 themes emerged: (1) Negative screening emotions caused by psychological stress, (2) Lack of awareness of the importance of screening due to cognitive biases, (3) Screening behavior caused by fatalistic views is systematically underestimated, and (4) Affirm the value of early screening. For subjective norms (The impact of external information on screening behavior), 4 themes emerged: (1) Family support, (2) Advice from a healthcare professional, (3) information support from online media, (4) Personal experience and suggestions from friends. For perceived behavior control, 4 themes emerged: (1) Unbearable pain and embarrassment, (2) Busyness of life and work, (3) Medical treatment process and transportation convenience, and (4) Screening costs. The colonoscopy screening behavior of first-degree relatives of colorectal cancer patients is affected by behavioral attitudes, subjective norms (The impact of external information on screening behavior), and perceived behavior control. Clinical medical staff should correct their behavioral cognitive biases from the perspective of first-degree relatives, use positive belief factors to avoid wrong cognition, pay attention to a variety of sources of support, stimulate the self-efficacy of first-degree relatives, and create a suitable environment for colonoscopy screening, to promote the change of colonoscopy screening behavior of first-degree relatives.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241305344"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the Patient Health Questionnaire-9 for Saudi Caregivers: A Cross-Sectional Study in Saudi Arabia.","authors":"Salman M Alreshidi","doi":"10.1177/00469580231221287","DOIUrl":"10.1177/00469580231221287","url":null,"abstract":"<p><p>To evaluate the psychometric properties of the Arabic-language Patient Health Questionnaire-9 (PHQ-9) among Saudi caregivers of patients with chronic diseases. Using a cross-sectional design, 94 Saudi caregivers (37 male and 57 female) in the medical city participated in the study. A comparative assessment was conducted on 4 models proposed in the existing PHQ-9 literature to gauge their compatibility through confirmatory factor analyses. This study evaluates convergent validity through a correlation analysis, examining the relationship between the PHQ-9 and the Depression, Anxiety, and Stress Scale-21 (DASS-21). Among the various models we examined, the single-factor structure of the PHQ-9 displayed the best fit with the data we gathered. Notably, the Cronbach alpha coefficient for the PHQ-9 registered at .81, indicating a high level of internal consistency. Factor loadings spanned a range from .39 to .76. The convergent validity of the PHQ-9 and DASS-21 was deemed satisfactory. It is established that the PHQ-9 serves as an effective tool for depression screening among Saudi caregivers in Saudi Arabia. Its strengths lie in its demonstrated validity, dependability, brevity, and convenience of administration, positioning it as a valuable resource for preventative measures and performance assessment within mental health settings.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580231221287"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Age-Friendly Communities Action Plan on Trajectories of Older Canadians' Depressive Symptoms Between 2018 and 2020: Multilevel Results From the Canadian Longitudinal Study on Aging.","authors":"Mélanie Levasseur, Daniel Naud, Verena Menec, Marie-France Dubois, Christina Wolfson, Lauren E Griffith, Lise Trottier, Jacqueline McMillan, Mélissa Généreux, Mathieu Roy, Yves Couturier, Parminder Raina","doi":"10.1177/00469580231225918","DOIUrl":"10.1177/00469580231225918","url":null,"abstract":"<p><p>As the COVID-19 pandemic impacted mental health, this longitudinal study examined the effect of age-friendly communities (AFC) action plan on older adults' depressive symptoms. Using the CLSA, the CLSA COVID-19 Questionnaire study, survey of Canadian municipalities, and the census, the depressive symptoms trajectories were modeled with multilevel multinomial regressions. Most respondents (66.1%) had non-depressed trajectories, 28.1% experienced a moderate increase in depressive symptoms, and 5.8% had a depressed trajectory. AFC action plans did not have a protective effect on these trajectories. Being a female, greater loneliness, lower income, ≥2 chronic conditions, inferior social participation, weaker sense of belonging, COVID-19 infection, and pandemic stressors predicted a depressed trajectory. Neighborhood's deprivation had a weak protective effect on the declining trajectory. Although AFC action plans provided no benefits during the pandemic, volunteers facilitating resource access and social interactions could limit any increase in depressive symptoms.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580231225918"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}