Access to Employment,Volunteer Activities,and Community Events and Perceptions of Age-Friendliness: The Role of Social Connectedness

Abstract

The aim of this study was to investigate the direct and indirect effects of access to employment, volunteer opportunities, and community events on older adults’ perception of age-friendliness and feelings of connectedness. Data were from an age-friendly community survey conducted in a Midwestern city in the United States. We analyzed the responses of 264 older adult residents (50 years and older) using path analysis. Results showed that access to community events, job resources, and connectedness were predictors of older adults’ perceptions of age-friendliness of their community, and that connectedness mediated the relationship between access to community events and perceived age-friendliness. The findings help to refine the concept of an age-friendly community from older adults’ perspectives and emphasize the importance of fostering interactions through community events to enhance older adults’ feelings of connectedness.

Keywords

age-friendliness social connectedness access to community resources and events

In recent years, the rapid aging of the population and the growing proportion of older adults living in cities has led to increased discussions related to the development of age-friendly environments (Lui, Everingham, Warburton, Cuthill, & Bartlett, 2009; World Health Organization [WHO], 2007). Age-friendly environments promote health, well-being, and participation across life stages through features, such as accessibility, equitability, inclusivity, safety, security, and supportiveness by providing human-centered services and support (WHO, 2007).

The WHO launched the Age-Friendly Cities Project in an effort to create age-friendly environments that support people to age in places of their choice (Lui et al., 2009). The WHO established international guidelines based on the active aging framework: optimizing opportunities for health, participation, and security to enhance people’s quality of life as they age (Parekh et al., 2018; WHO, 2007). The WHO’s (2007) guidelines address eight domains of age-friendliness: outdoor spaces and buildings, transportation, housing, respect and social inclusion, social participation, civic participation and employment, communication and information, and community support and health. Furthermore, the WHO established an age-friendly global network to encourage the exchange of experiences and mutual learning between cities and communities around the world (WHO, 2018). Membership in the global network reflects a community commitment to a five-year process to make a community more age-friendly. Approximately 705 cities in 39 countries have joined the age-friendly global network (WHO, 2018), including 282 communities in the United States (AARP, 2018).

Research has focused on conceptualizing age-friendly communities by using ecological perspectives (e.g., Smith, Lehning, & Dunkle, 2013). Ecological lens highlights individuals’ interactions with their surroundings, including physical, social, and service environments, that play an important role in the well-being and health of older adults (Menec, Means, Keating, Parkhurst, & Eales, 2011). Among these domains, the social environment has been least studied. It is not clear which elements of the social environment—such as volunteer and work opportunities and community events—are the most important to make residents feel socially connected. Our understanding of what makes a community age-friendly from the perspective of older adult residents themselves is also limited. This study aims to shed light on these questions.

Older Adults’ Perceptions of Age-Friendliness

Since 2007 when the WHO released their guidelines for the eight domains of age-friendliness, researchers have used these domains to assess whether a community is age-friendly (e.g., Levasseur et al., 2017). However, this approach may not be consistent with residents’ perceptions of age-friendliness. Depending on the nature of the age-friendly indicators, Menec, Newall, and Nowicki (2016) distinguished between objective and subjective assessments. They argue that the physical environment—such as how many benches and housing units are available for older adults—needs to be measured by a knowledgeable professional. In contrast, older adult residents themselves are in a better position to assess service experiences. Menec and colleagues (2016) found that ratings of age-friendliness from municipal officials were higher than residents’ ratings, on average. To figure out a strategy for community development, residents’ views on age-friendliness may be more beneficial than government officials, particularly in terms of the social environment (Menec et al., 2016).

Age-Friendly Community Initiatives: Social Environment

The WHO’s eight domains can be categorized into three strands: physical, social, and service environments (John & Gunter, 2016). According to John and Gunter’s (2016) study, the physical environment has structural and built attributes, including outdoor spaces and buildings, transportation, and housing; the social environment has person-to-person interactions, including civic participation and employment, respect and social inclusion, and social participation; and the service environment has person-to-agency attributes, including community support and health services and communication and information.

All three environments play a critical role in supporting residents’ ability to age in place. However, social environmental aspects have received less attention in previous research as compared to physical environmental aspects (Norstrand, Glicksman, Lubben, & Kleban, 2012), despite the recognition that the social environment plays an important role in physical and psychological well-being (Kaskie, Imhof, Cavanaugh, & Culp, 2008). According to the social capital theory, interactions among individuals form social networks, norms of reciprocity, and trustworthiness; these characteristics of a social life allow community members to act together more effectively to achieve collective goals (Putnam, 2000). Thus, the social environment enables individuals to maintain meaningful interpersonal bonds, provides opportunities to participate in community activities, and develops new social roles and relations through social interactions (John & Gunter, 2016).

Access to Community Resources and Perception of Age-Friendliness

Within the social environment, older adults’ unpaid (i.e., volunteering) and paid (i.e., employment) participation in community activities can be a key means to achieve an age-friendly environment (Rémillard-Boilard, Buffel, & Phillipson, 2017). A checklist by WHO (2007) suggests that an age-friendly community has the following:

[a] range of flexible options for older volunteers is available, with training, recognition, guidance and compensation for personal costs; a range of flexible and appropriately paid opportunities for older people to work is promoted; venues for events and activities are conveniently located, accessible, well-lit and easily reached by public transport. (pp. 44, 50, 58)

Gonzales and Morrow-Howell (2009) also emphasize the importance of productive engagement through volunteering and employment for older adults in age-friendly communities. They maintain that barriers to older adults’ employment are related to systematic ageism, such as an inefficient position-fulfillment process. In addition, older adults have limited information and access to volunteer opportunities (Gonzales & Morrow-Howell, 2009). These obstacles to older adults’ engagement could be addressed by accessing community resources that accommodate needs and facilitate participation to promote older adults’ physical and psychological well-being, which is the goal of an age-friendly community (Richard, Gauvin, Gosselin, & Laforest, 2008). In line with this, accessing social networks and resources is necessary for older adults to participate continuously in community activities. Hence, variations likely exist between older adults with sufficient engagement resources and those with limited resources, which may be relevant to their perceptions of age-friendliness.

Social Connectedness and Perception of Age-Friendliness

Building and maintaining social connections is critical as an individual gets older (Scharlach, 2009). Studies have shown that socially connected people are less likely to experience health or mortality risks and are more likely to have good physical and psychological health (Cacioppo & Cacioppo, 2014; Holt-Lunstad, 2017). Emlet and Moceri (2012) investigated the important role of social connectedness in an age-friendly environment. They found three themes that emerged through focus group interviews in a community forum in the United States: social reciprocity, meaningful interactions, and structural needs and barriers. The results highlight the importance of social connectedness in building perceptions of an age-friendly community. Despite its critical role in age-friendly communities, the relationship between social connectedness and perceptions of age-friendliness has not been the subject of extensive empirical testing.

The process for becoming a more age-friendly community is mediated by proximal factors, including individual characteristics, social interaction, and psychological processes (Menec et al., 2011). Scharlach (2017) stated that a supportive physical and social infrastructure promotes social engagement, while social engagement provides opportunities for meaningful interpersonal connections, without restrictions based on age or disability. Social connectedness could be fostered by social engagement and participation (Emlet & Moceri, 2012), and older adults who feel more connected to their community may perceive a more age-friendly environment in their communities.

Taken together, limited research exists regarding how older adults’ experiences accessing community resources and events for engagement or participation are associated with their perceptions of age-friendliness. Also, despite many researchers agreeing that social interaction and social connectedness are a key aspect of an age-friendly community (Emlet & Moceri, 2012), little is known about the potential mediating role of social connectedness in the relationship between community resources and events and older adults’ perceptions of age-friendliness of their communities. To fill this knowledge gap, the present study proposed two research questions and corresponding hypotheses. First, is older adults’ access to community resources and events associated with their perceived age-friendliness of their community? We hypothesized that older adults’ access to community resources and events is positively associated with their perceptions of age-friendliness. Second, do feelings of connectedness mediate the relationship between community resources and events and perceptions of age-friendliness? We hypothesized that feelings of connectedness mediate the relationships between access to community resources and events and perceptions of age-friendliness.

Method

Data and Sample

This study used survey data from the first year of an age-friendly initiative in a large city in the Midwestern United States. Older adult residents aged 50 and older answered questions about the eight age-friendly domains: transportation, housing, outdoor spaces and buildings, communication and information, civic participation and employment, respect, inclusion, and social participation. Two types of questionnaires were administered: a comprehensive representative survey and a shorter convenience survey. The data were collected from September to November in 2016. The dataset is publicly available and completely de-identified.

The comprehensive representative survey used random sampling and was conducted through the mail—inviting participation from 1,500 older adult residents drawn from the city’s voter registration list, stratified by ZIP code and age group in four pilot neighborhoods. These neighborhoods were selected because they were priority sites for the city and reflected areas of higher density of vulnerable older adults in poverty (i.e., low income and unemployment), isolation (i.e., living alone), and poor health status (i.e., one or more disability; Martin et al., 2014). The shorter survey used convenience sampling at community events via the Survey Monkey online tool and through a paper survey.

Valid sample sizes were 346 responses from the comprehensive survey and 875 responses from the shorter survey. Among the total 1,221 valid responses, variables of interest in the present study were included in the comprehensive survey. Of 346 responses, the cases of no response on the focal variable were removed from analyses of the present study. The final sample size was 264.

Characteristics of the community and participants

The respondents to the survey live in the capital city of a Midwestern state with a population of 860,000+ (U.S. Census Bureau, 2016). Individuals aged 50 years and over make up 26% of the total city population (U.S. Census Bureau, 2016). Four pilot areas show a relatively high density of vulnerable older adults compared with the rest of the county (The Mid-Ohio Regional Planning Commission, 2016). Survey data showed that the median age of participants was 63 years. The majority were female (64%) and White (71%). Homeownership rates were high among participants (75%), and over half of the respondents lived with a spouse or partner (51%). The respondents reported social security retirement (39%), wages from work (36%), and traditional pensions (19%) as their main income resources.

Measures

Outcome

Perceived age-friendliness was measured by two items. Participants rated both the city and their neighborhood as a good place to live as they aged on a 5-point Likert-type scale with the range of responses running from 1 (strongly disagree) to 5 (strongly agree). A reliability test showed .91 of Cronbach’s alpha value in the current study. For an overall score, the range of responses was recoded from 0 to 4, and combined scores ranged from 0 to 8.

Mediator

Connectedness was measured by using two items including “I already feel connected to my community” and “I frequently feel disconnected from my community.” The latter was reversed coded. The range of response on the two items was different. To have a consistent measurement, we transformed a 5-point Likert-type scale into a binary variable reflecting yes or no answers. After running a reliability test (Cronbach’s value was .69), the two items were combined.

Independent variables

The current study used access to volunteer and job resources and access to community events as an element for social interaction.

Access to volunteer resources

This variable was measured by three items. Respondents indicated 1 (yes) or 0 (no) on the access to resources related to (a) transportation, (b) obtaining information, and (c) different options depending on their abilities or interests for local volunteer activities. The Cronbach’s alpha value for the overall scale in this sample was .83, and values were combined for an overall score that ranged from 0 to 3.

Access to job resources

This variable was measured by five items. Respondents indicated 1 (yes) or 0 (no) on the access to resources regarding (a) job training or job skill building, (b) a job with good fit for their abilities, (c) places to find out about available jobs, (d) professional networking, and (e) help with resume writing or interview practice. The Cronbach’s alpha value for the overall scale was .92 in the current study, and values were combined for an overall score that ranged from 0 to 5.

Access to community events

This variable was measured by six items. Respondents reported 1 (yes) or 0 (no) on questions about (a) conveniently located entertainment, (b) programs geared to older adults, (c) affordable programs for older adults, (d) programs that involve both younger and older people, (e) cultural activities, and (f) local schools that involve older adults in activities. The Cronbach’s value for the overall scale was .95 in the current study, and values were combined for an overall score that ranged from 0 to 6.

Covariates

We controlled for older adult residents’ demographic characteristics, including age, gender (0 = male, 1 = women), ethnicity (0 = other, 1 = White), education (0 = less than bachelor’s degree, 1 = bachelor’s degree or higher), live alone (0 = no, 1 = yes), employment status (0 = nonwork, 1 = work), health (0 = poor, 1 = good), and income (0 = higher than 200% of poverty line, 1 = less than 200% of poverty line). Those variables have been commonly used in previous studies about older adults’ connectedness and age-friendly communities (e.g., Smith et al., 2013).

Analyses

Data analyses were conducted in two phases. In the first phase, we conducted descriptive analyses using SPSS 24.0 software to identify means, frequencies, and the bivariate correlations among the main study variables. Before running path analysis, we handled missing data using multiple imputation (MI). Variables of interest in the current study generated 13% of the missing values. To reduce the chance of bias introduced by item nonresponse in multivariate analyses, missing data were imputed using Mplus 8 software. In MI, missing data can be generated from a Markov Chain Monte Carlo (MCMC) method (Schafer, 1997). The imputed data sets can be analyzed by using standard procedures for complete data and combining the results from these analyses (Asparouhov & Muthén, 2010).

In the second phase, we conducted path analyses using Mplus (Muthén & Muthén, 1998-2017). We used maximum likelihood (ML) as an estimator. The model fit was prespecified based on the guideline of West, Taylor, and Wu (2012). Good fit of model indicates a nonsignificant chi-square (p > .05), but a nonsignificant chi-square is difficult to obtain with large sample sizes (Bowen & Guo, 2011). Thus, reporting with the values of others—such as comparative fit index (CFI), Tucker–Lewis index (TLI), standardized root mean square residual (SRMR), and root mean square error approximation (RMSEA)—is recommended (Bowen & Guo, 2011). CFI and TLI values of .95 or higher indicate a good fit. The cutoff of SRMR and RMSEA is respectively .08 and .06 (West et al., 2012). Among these indices, we used four commonly used values: CFI, TLI, SRMR, and RMSEA.

Results

Descriptive Analyses

The sample in the current study ranged in age from 50 to 100 years, with an average age of 64 years (SD = 9.6). The majority were female (62%) and White (68%). Over half had an education level that was less than a bachelor’s degree (57%), most reported their health as good (97%), and most lived with other people (72%). About half (41%) had an income of less than 200% of the poverty line (standard of the federal: household size of two).

The Pearson correlation test of all variables was conducted. These coefficients revealed no multicollinearity (r < .8). Access to community volunteer and job resources and events, and connectedness were positively correlated with age-friendliness. Among covariates, age, education (bachelor’s or higher), and health (good) were positively correlated with age-friendliness. Also, access to community volunteer and job resources and events were positively correlated with connectedness. Among covariates, age, race (White), and education (bachelor’s or higher) were positively correlated with connectedness, while income (below 200% poverty line) was negatively correlated with connectedness.

Path Analyses

The model had a good fit based on our prespecified fit criteria: chi-square = 156.89, p < .001; CFI = .976; TLI = .977; and SRMR =.071, excepting RMSEA = .146 (90% confidence interval [CI] = [.125, .168]). The summary of path analyses of perceived age-friendliness is presented in Figure 1. In standardized results for the full model, connectedness and access to job resources and community events were directly related with age-friendliness. Specifically, one-unit increase in connectedness was linked with a .22-unit increase in age-friendliness. In addition, one-unit increase in access to job resources and community events was associated with .24- and .25-unit increase in age-friendliness, respectively. As covariates, all demographic variables were nonsignificant with age-friendliness.

Figure 1.

Summary of path analysis of perceived age-friendliness.

Access to community events were directly related to connectedness. That is, one-unit increase in access to community events was associated with .37-unit increase in connectedness. Among covariates, age was positively related with connectedness while income was negatively related with connectedness. That is, one-unit increase in age was associated with .02-unit increase in connectedness; one-unit increase in income (below the poverty line) was associated with .37-unit decrease in connectedness.

In addition, access to community events had an indirect effect on age-friendliness through its relationship to connectedness (see Table 1). The standardized indirect effect of access to community events on age-friendliness through psychological connectedness was .08 (p < .01). The total effect of access to community events on age-friendliness was .33 (p < .001).

Table 1.

Standardized Indirect Effect of Connectedness.

Path	Direct effect	Indirect effect	Total effect
Access to volunteer resources → Age-friendliness	.032	—	0.064
Connectedness		.032
Access to job resources → Age-friendliness	.244	—	.220
Connectedness		−.024
Access to community events → Age-friendliness	.246**	—	.326***
Connectedness		.080**

Note. Boldfaced values indicate statistical significance.

p < .05. **p < .01. ***p < .001.

Discussion

The purpose of this study was to investigate how access to community resources and events directly and indirectly shaped older adults’ perception of the age-friendliness of their community through feelings of connectedness. The findings show that access to community events, job resources, and feelings of connectedness positively predicted older adults’ perceptions of community age-friendliness. Furthermore, the findings illustrate that older adults who had access to community events were more likely to have a sense that their community is age-friendly through the feelings of connectedness.

Our findings did not support all our hypotheses. However, a nonsignificant result does not mean that access to volunteer resources was a less important factor in older adults’ sense of attachment to, and the perceived age-friendliness of, their communities. This result may be explained through a dynamic identified in previous studies (e.g., Menec et al., 2011; Parekh et al., 2018), suggesting that taking older adult volunteers for granted, making assumptions about their interests and abilities, may discourage participation in community activities and psychological attachment to community. Thus, we should consider appropriate ways to respect their commitments and contributions (Emlet & Moceri, 2012). For example, the community studied is planning to work with organizations that have existing awards programs to encourage recognition of older adult volunteers’ contributions to the community.

The results may also reflect a poor match between potential volunteers and their preferences, skills, and knowledge. Some research has suggested that the volunteer services of baby boomers are different from that of previous generations, because they are a diverse cohort and their engagement is multi-faceted (Chambré & Netting, 2018). Existing volunteer program frameworks and traditional volunteer opportunities may not meet baby boomers’ expectations (Chambré & Netting, 2018; Johnson, Parel, Cobb, & Uy, 2003). Thus, community organizations should tailor their volunteer programs and management strategies for this population. To address the potential mismatch between preferences, skills, and knowledge for baby boomers interested in volunteering, electronic volunteer matching applications (app) such as www.volunteerlocal.com or www.goldenvolunteer.com might be good resources. Also, to encourage older adults to volunteer, regardless of their education level, mobility, and physical or cognitive limitations, the SageServe app—developed by Lee and Moudlin (2018)—is a promising idea that is being developed specifically for homebound older adults.

Finally, older volunteers may have already established their volunteer habits (Emlet & Moceri, 2012) and their familiarity with volunteering makes it unnecessary to access such resources. Also, volunteer activities may not be older adults’ top priority in their later lives (Chambré & Netting, 2018). Taken together, further research is needed to understand more accurately the relationship between older adults’ experience with access to community volunteer resources and age-friendliness.

In addition, our findings show that access to job resources directly predicted age-friendliness. This result reflects the growing trend of older adults that want to continue working. Older adults want or need to extend their working lives for various reasons, including financial need and/or a need for a sense of belonging-to-society (Gordon, 2018). For older adults who require job-related community support, access to job resources is a good determinant of whether they perceive their community as age-friendly. However, in this study, access to job resources did not appear to create a sense of connectedness. During the job-seeking period, meaningful interactions may not occur until after older adults are hired by local companies. After getting a job, older adults may have more chance to interact with their co-workers or supervisors. With respect to this result, we need further research to determine what social interactions occur, and the nature of these interactions, during the job-seeking process. As the need for job-related support from the community is expected to increase, employment services for older workers are needed. In one such effort, Employment For Seniors (an agency in the community under study) offers an opportunity to match mature job seekers to employers through an annual career expo.

The findings reveal that direct and indirect access to community events predicted age-friendliness through social connectedness. This result is consistent with the social inclusion perspective (e.g., Scharf, Phillipson, Kingston, & Smith, 2001). Feelings of belonging are enhanced when older adults interact with other community members at community events, and the increased connectedness can positively relate to their perceptions of age-friendliness. Although the mediating role of social connectedness was not strong, this finding cannot be ignored. Importantly, in the current study connectedness was the strongest predictor for perceptions of age-friendliness. Thus, these findings emphasize the importance of older adults’ emotional connectedness to community, which is consistent with previous research (e.g., Emlet & Moceri, 2012). Increasing older adults’ feelings of connectedness by increasing their access to community events can be a good strategy for increasing perceptions of age-friendliness.

The findings support the study community’s efforts to create accessible community events for people of all ages. Summer barbeque events that include transportation services provide one example of this strategy. From infants to elders, all generations can connect, sharing their stories while setting up, serving, or cleaning up together at the event. By becoming involved in community events, older adults’ additional social bonds and feelings of belonging to the community will be reinforced; this, in turn, will help to avoid social isolation. Ultimately, older adults will perceive their communities as age-friendly.

Limitations and Future Research

This study has several limitations. First, robust psychometry measurement is an integral part of any quantitative study, but we have not confirmed the validity of the measurements used. For a more statistically powerful test, future research should develop theory and evidence-based measurements and test using exploratory factor analysis and confirmatory factor analysis.

Second, physical environment factors were not included in this study. However, two aspects of physical and social environments related to engagement should be considered simultaneously in the age-friendly community. In future research, we suggest testing the interaction between physical and social factors for engagement and the impacts on connectedness and perceptions of age-friendliness.

Third, this study did not consider structurally disadvantaged groups. Previous aging studies showed that socioeconomic factors, such as income and education, are strong predictors of the quality of life for older adults, including health life expectancy (Kim & Kim, 2014, 2016, 2017, 2018). In a similar vein, individual’s perception of age-friendliness might vary by socioeconomic status, including income and education (Scharlach & Lehning, 2013; Xie, 2018). In our analysis, age, gender, ethnicity, income, health, and education were treated as covariates to control their impact on each variable. As a next step, we need to conduct further research on how perceptions of age-friendliness vary across different groups (e.g., lower income vs. higher income, lower educated group vs. higher educated group). This approach may give us better information about how to target specific strategies based on different individual characteristics.

Fourth, we need a detailed identification of the concept of social engagement. Little information is available regarding whether older adults are involved in formal or informal participation, how many times they access community assets, and the quality of their social interactions. Depending on these factors, their connectedness and perceptions of age-friendliness might differ. Future research should consider the impact of the quality and quantity of social interactions and the type of participation (formal and informal) on older adults’ sense of connectedness.

Implications

Our findings have several implications for policy makers, planners, and program developers regarding engagement strategies to increase residents’ perception of age-friendliness in their community. First, leaders need to use various channels of communication to inform residents about community events and activities. Older adults tend to lack awareness about available community support services (Denton et al., 2008). Thus, an advertising strategy should be considered that reflects the characteristics of the target population. For example, the oldest groups of older adults may be more familiar with paper information or TV than information from the Internet (Mitchell, Gottfried, Barthel, & Shearer, 2016). Their preferred channels for access to information (e.g., local newspaper and news shows) and locations (e.g., churches or grocery stores) should be considered. In contrast, young-older adults (e.g., baby boomers) are more likely to access Internet information. For them, Internet advertising for community events and resources can be utilized.

Second, when planning community-based senior engagement initiatives, planners should consider the existing infrastructure in their communities. For older adult residents, the biggest barrier to access to community services is mobility (Alley, Liebig, Pynoos, Banerjee, & Choi, 2007; Novek & Menec, 2014). Even if they want to be involved in community activities, mobility issues may limit their participation. This does not apply only to frail older adults, but also to older adults who cannot drive by themselves. To increase access to community resources and events, transportation services and a wide range of mobility options should be provided. In this article, we did not focus on the physical environment. However, to optimize the effect of social services, physical infrastructure is a prerequisite. In this community, most older adults drive cars rather than using public transportation. Thus, not being able to drive represents the biggest challenge to tackle in older adults’ involvement in community activities. To reduce such restrictions, this community is planning to provide more flexible public transportation services for older adults, and has followed an age-friendly event checklist, including using venues/locations close to public transit routes (The Mid-Ohio Regional Planning Commission, 2017).

Third, frontline workers and implementers of community programs should foster interpersonal connectedness. Connectedness is crucial for life satisfaction and health in older adults (Cornwell, Laumann, & Schumm, 2008). Frontline workers can empower older adults to access opportunities that allow frequent substantive interactions with other community members. They can also promote the development of significant bridging of social capital across age cohorts. As human services have a tendency to rely on relationship-based and person-centered skills, implementers play a critical role in the continuous access of older adults to community events and resources. Thus, it is necessary for frontline workers and implementers to understand the characteristics of older adults and community residents. They are also necessary to monitor the changing needs of older adult residents to facilitate their continuous social engagement. Such efforts will help enhance a feeling of belonging. To do this, age-friendly community guidelines for implementers should be developed to help frontline workers serve in an appropriate way. Ultimately, this will maximize the effects of age-friendly initiatives.

Footnotes

Acknowledgements

The authors acknowledge and thank the funders, the Osteopathic Heritage Foundation, the Central Ohio Area Agency on Aging, Franklin County Office on Aging, The Columbus Foundation, National Church Residences, the Ohio State University College of Social Work, and AARP Ohio of the Age-Friendly Columbus initiatives and study participants for the contribution of their time, effort, and dedication.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Mi Sun Choi

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