Evidence Based Practice Symposium - McMaster University

from which themes emerged. Themes reflected the general
experiences of participants and age-friendliness.
Results
Seven themes emerged from the data relating to older adults
experiences’ with HSR bus access and use:
Planning: The HSR facilitated the renewal and purchase of bus
passes. Participants relied on pamphlets or communication with bus
drivers or passengers to obtain information about scheduling.
Familiarity with the bus route and schedules assisted participants
with planning, especially for the return trip.
Affordability: All participants perceived the bus as an affordable
mode of transportation. Participants were appreciative of the
“Golden Buss Pass” for users over 80 years. Participants reported
the payment options for pass purchases (i.e. cash, direct deposit)
provided choice and was supportive of their financial status.
Physical environment (a) on the bus, b) outside of the bus, c) space
and crowding: Participants expressed concern with identifying the
bus number as it approached, advertisements positioned across
windows obstructing the view and the audio announcing system
was too low. Accessible low floor buses provided ease with
embarking/disembarking. The vertical poles, handrails, accessible
seats, announcing system and options to signal need to disembark
were identified as supportive of older adults’ bus use. Most bus
stops were located close to the participants’ homes and offered a
shelter and bench to rest; signage at the bus stop was not always
present. Participants reported pedestrian crosswalks signalled too
quickly for their needs. Crowding on the bus varied throughout the
day and was associated with buggies, strollers, wheelchairs and gait
aids. All participants were able to navigate the bus regardless of
space and crowding.
Customer service/accommodations: Participants reported bus
drivers were often friendly and accommodating. Unfriendly bus
drivers had a negative effect on participants’ experience. Bus
drivers were identified as a primary source of information for users.
Participants reported it is important for driver’s to be aware of
safety risks (i.e. enough time for participants to seat before moving,
pull close to curb for safe disembarking).
Physical ability: Participants recognized it was their responsibility
to be aware of their physical limitations and accommodate as
necessary (i.e. rest when needed).
Passengers’ attitudes and behaviours: Participants identified that
most passengers on the bus are polite and accommodating. They
also recognized that others’ behaviours could not be controlled.
Negative attitudes and behaviours were associated with passengers
of all ages.
Safety: Participants reported safety impacted their trip and
influenced bus use. They identified a personal responsibility to be
aware of safety risks and plan the trip accordingly, as well the
HSR’s responsibility to ensure passengers arrive safely to their
destination.
Discussion/Limitations
Among these themes, safety was identified as being embedded
within all aspects of age-friendly travel. Many of the participants
felt the role of the bus driver was to facilitate a safe bus trip from
origin to destination. In addition, participants identified that
organization on the bus influenced their trip and felt that managing
crowding is both a responsibility of the HSR and the passengers
themselves. It was anticipated that there would be greater
challenges with bus access and use for older adults. Although this
may be partly attributed to the sample, findings from this study
illustrate that the HSR has already implemented policies and
guidelines to support bus use for older adults. The
recommendations developed from the findings help to further
progress to the HSR to becoming more age-friendly.
The participants recruited were more homogenous than
originally intended, limiting the diversity in experiences observed.
Recommendations
Short Term Long Term
-Eliminate advertisements
across windows
-Increase readability of signs
on and off the bus
-Increase volume of
announcing system
-Emphasize proper boarding
organization by driver
-Education on proper bus
etiquette
-Increase time at pedestrian
crosswalks
-Increase number of rest areas
-Increase frequency and
development of new routes
based on changes to the city
Implications for Occupational Therapy (OT)
Using a public transit system is an occupation in itself and a
means to access other community-based occupations. The WHO’s
age-friendly initiative focuses on removing barriers in the
environment that may impact older adults’ participation in
occupations. Use of a travel chain perspective allows OTs to
evaluate all aspects of the occupation of riding transit to help
determine barriers and supports. By advocating for changes to the
transit system, older adults are enabled to participate in occupations
within their communities, enhancing their health and quality of life.
Conclusions
Given the importance of transportation in the lives of older
adults, this study provided preliminary findings regarding the users’
experiences and perceived issues with accessing and using the
HSR. Creating an age-friendly transit system will involve
overcoming the barriers and maximizing the facilitators inherent to
bus use. Further research should be conducted targeting infrequent
bus users with greater physical challenges to determine if their
accessibility and usability issues reflect those identified here.
Acknowledgements
We would like to thank Lori Letts and Dr. Margaret Denton for
their continued support and guidance throughout this project. We
would also like to acknowledge Shelagh Kiely, the HSR and the
participants for their assistance throughout this process.
References
Broome, K., Worrall, L., McKenna, K., & Boldy, D. (2010). Priorities for an agefriendly
bus system. Canadian Journal on Aging, 29(3), 435-444.
Carlsson, G. (2004). Travelling by urban public transport: Exploration of usability
problems in a travel chain perspective. Scandinavian Journal of Occupational
Therapy, 11 (2), 78-89.
Hamilton Council on Aging (HCoA). (2010). Age-friendly Hamilton: First report to
our community. Retrieved from
http://www.coahamilton.ca/pdf/hamilton,%20a%20city%20for%20all%20ages.pdf
Iwarsson, S., Stahl, A., & Carlsson, G. (2003). Accessible transportation: Novel
occupational therapy perspectives. In L. Letts, P. Rigby, & D. Stewart (Eds.),
Using environments to enable occupational performance (pp. 235-251).
Thorofare: SLACK Incorporated
World Health Organization. (2007). Global age-friendly cities: A guide. Geneva:
Author