Evidence Based Practice Symposium - McMaster University

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content validity were amended based on the experts’ comments and included in a second round of review. This process of amendment and additional review continued until consensus of all exercises was reached. RESULTS Evaluation of the comprehensiveness of the entire programme achieved adequate content validity (80% CVI, mean 3.2) with the mean reflecting consensus on the need for minor additions or deletions of exercises in the programme. Written comments indicated the programme was comprehensive and that minor modifications were necessary. Comments indicated the programme was feasible to be conducted in the community as a ninety minute class run by a trained fitness instructor. Twenty seven exercises received adequate content validity (>70% CVI, mean >3.4) and therefore were not sent out for additional review. Four exercises received unacceptable content validity (3.4) and were included in the final programme. Two exercises received unacceptable content validity (
Age-Friendly Transit in Hamilton: Assessment using a Travel Chain Perspective Amie Enns and Brittany Strauss, MSc. OT Candidates 2012, McMaster University Project Supervisors: Lori Letts, PhD, OT Reg. (Ont.), FCAOT and Dr. Margaret Denton, PhD In affiliation with the Hamilton Council on Aging (HCoA) Background: The age-friendly initiative recognizes transportation as a key domain that influences the health and quality of life of older adults. The inability to access transportation can lead to reduced participation in community and social activities. Purpose: This study aimed to evaluate the accessibility and usability of the Hamilton Street Railway (HSR) for older adults, using a travel chain perspective. Methods: Ten older adults living in Hamilton completed a bus trip, individual interviews and participated in a focus group. Qualitative analysis was used to identify themes that reflected participants’ experiences and age-friendliness. Findings: Positive customer service, passenger’ attitudes/behaviours, affordability, planning, and the physical environment were identified as supportive of older adults’ bus access and use. Safety and physical ability were recognized as important factors that influence bus trip experiences. Conclusions: The study provided preliminary findings regarding users’ experiences and helped to develop recommendations to further the age-friendly initiative in Hamilton. Introduction The World Health Organization (WHO) describes age-friendly environments as those that support quality of life for older adults by facilitating ease of participation, health and security (WHO, 2007). Older adults often require more supportive and enabling environments to accommodate for the social and physical changes inherent to the aging process (Broom et al., 2010). In response to this, the WHO introduced the Age-Friendly initiative to provide guidelines that address the specific needs of older adults living in the community (WHO, 2007). The Hamilton Council on Aging (HCoA) is a senior driven organization dedicated to making Hamilton more age-friendly through the WHO’s Age-Friendly initiative. In previous years the HCoA, in collaboration with students, has focused on assessing neighbourhood walkability and accessibility of grocery stores and pharmacies. Transportation is another component of the Age-Friendly initiative, which is an important means of mobility for older adults living in the community. The HCoA has therefore deemed it important to determine the “age-friendliness” of Hamilton’s transit system, the Hamilton Street Railway (HSR). Literature Review Difficulties using public transportation, specifically the bus system may be linked to accessibility and usability issues (Iwarsson et al., 2003). Challenges accessing and using public transportation occur when there is a poor fit between the innate capacities of the user, the demands of the task, and the person’s environment (Broome et al., 2010). To properly address the usability and accessibility issues of the bus system, researchers emphasize the importance of using a travel chain perspective to evaluate the entire chain of events while travelling from origin to destination i.e., planning the trip, purchasing bus tickets, waiting at the bus stop, etc. (Iwarsson et al., 2003). The travel chain perspective proposes that poor accessibility at any stage of the bus trip can be a barrier to a person’s ability to use the bus system. Most studies employing a travel chain perspective have been conducted in Australia (Broome et al., 2010) and Sweden (Carlsson, 2004; Iwarsson et al., 2003), with limited research focused within Canada. The literature suggests that consumers themselves are experts on usability issues and are essential in identifying areas of need, which may facilitate environmental changes (Iwarsson et al., 2003; WHO, 2007). Therefore, this study provides a new contribution by using both objective and subjective perspectives to obtain a comprehensive understanding of accessibility and usability of the HSR. Methods Purpose The purpose of this research was to: (1) evaluate the accessibility and usability of the HSR using a travel chain perspective, (2) describe the impact of the environment on older adults’ community mobility; and (3) with the results, develop recommendations to further Hamilton’s age-friendly initiative. Research Question Using a travel chain perspective, to what extent is the HSR accessible and usable for older adults in Hamilton, Ontario? Design and Ethics Approval A descriptive, qualitative design was used to explore and understand participants’ lived experiences accessing and using the HSR. Ethics approval was obtained from the Student Research Ethics Committee of the HHS/FHS at McMaster University. Participants The sample included ten older adults over the age of 65. The majority of participants were women (n=7). Participants were volunteers with HCoA and resided in Hamilton. Most participants (n=8) considered themselves frequent bus users (1+ time/day), and all participants perceived themselves as healthy and independent with mobility, despite one participant who used a gait aid. Consent was obtained from all participants. Data Collection Data was collected from individual interviews with participants, observation of and report of their ability to access and use the HSR, and a follow-up focus group with eight of the participants. Individual bus trips were completed within the city of Hamilton. Individual interviews began at each participant’s home where questions about history of bus use and the process of planning a trip were explored. Observation commenced following the initial interview and continued throughout the duration of the bus trip until participants reached their destination. A field note form was used to collect objective and subjective data that evaluated each of the links within the travel chain. Following the individual bus trips, a focus group enabled member checking of findings. Data Analyses Conventional content analyses were used to generate findings. Key concepts with similar meanings were organized into categories
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