Contextual factors influencing the urban mobility infrastructure interventions and policies for older adults in low- and middle-income countries: a realist review

Abstract

Transportation is among the key aspects that influence active ageing. This realist review intends to understand the mechanisms of urban mobility infrastructure interventions and policies in low- and middle-income countries for older adults and to identify factors, which influenced the success or failure of interventions. We followed the steps suggested by Pawson and colleagues for a realist review. Electronic databases were searched from inception until August 2020. Studies were screened based on titles, abstracts and full text. The quality of included studies was assessed based on rigour and relevance. The evidence was obtained from 36 articles with diverse study designs conducted in 36 low- and middle-income countries. Findings were validated through stakeholder consultations from three low- and middle-income countries. Of the various individual factors identified, behaviour change communication interventions were low-cost, had a long-term impact and were efficient in increasing awareness among users to improve safety, social inclusion and about transport schemes for older adults. Improved transport infrastructure resulted in a shift from private to public transportation. For a sustainable urban transport infrastructure, good governance and involvement of stakeholders for planning and implementing transport interventions were considered necessary. Lack of evaluation, experience of transport planners, and inter-sectoral coordination were key challenges to successful interventions. The review highlighted a lack of older adult-specific transportation policies, and gender-targeted interventions for older women, suggesting a need for interventions and policies based on the contextual factors existing in a region.

Fostering an Age-Friendly Sustainable Transport System: A Psychological Perspective

“…It should also be a commitment of companies, who should be incentivized to think of sustainability policies from an age-friendly perspective as an added value to corporation targets. Moreover, in a recent review, Patil et al [91] reviewed 36 papers regarding mobility and active aging in many low-and middle-income countries around the world. The authors highlighted: (a) The need for policy makers to evaluate interventions and policy measures.…”

Multisectoral actions in primary health care: A realist synthesis of scoping review

“…The MSAs can operate at three levels: a) distal (strategic actions at the higher level), b) intermediary (contextualisation of strategic MSAs at the operational level), and c) proximal (implementation of MSAs to generate health service and delivery and utilisation). This initial program theory further helped to inform the eligibility criteria and develop the search strategy for a systematic search and explaining/interpreting the findings [ 21 ].…”

Navigating Public Transit: The Nexus of Service Quality and Government Influence

“…Studies have shown that government interventions, such as fiscal expenditure efficiency (Zou, 2022), policies supporting the service sector (Zhunussova & Dulambayeva, 2019), and subsidies for public transport (Rabie & Burger, 2019), can significantly impact public transportation usage. Improving service quality has been linked to a higher acceptance of public transport, thereby promoting a shift from private to public modes of transportation (Patil et al, 2022). Government intervention plays a crucial role in ensuring the provision of high-quality public transportation services.…”

“…Furthermore, assistance from the central government is essential for supporting public transport services and ensuring equality in service provision (Li & Deng, 2016). Various government interventions, such as educational initiatives and infrastructure enhancements, have been identified as key factors influencing the acceptance and utilization of public transport (Patil et al, 2022). Soft measures like information interventions and service improvements have also been identified as effective strategies for influencing mode choice and travel perception in public transport (Fan & Chen, 2020).…”