Date Presented 4/8/2016
In this quantitative, nonexperimental investigation, a researcher-designed questionnaire was used to identify self-perceived barriers preventing older adults from using public transportation in one large county of the San Francisco Bay Area.
Primary Author and Speaker: Alexandra Mauro
Additional Authors and Speakers: Regan Kyler, Megan Chang, Matthew Heffernan
Contributing Authors: Carolyn Glogoski, Alice Chen, Brien Bowles
PURPOSE: The purpose of this study was to identify common barriers limiting the use of public transportation and to measure frequency of those barriers experienced by older adults. A review of the literature shows three main categories of potential barriers: age-related physical changes, social and psychosocial challenges, and age-related cognitive decline. Therefore, this study intends to understand the perceived barriers preventing public transportation use and the common age-related changes in the areas identified in the literature.
RATIONALE: The population of adults age 65 and older is rising, and many of these individuals will lose the ability to drive as a result of age-related changes; hence, it is expected that the use of public transportation as a means for community mobility could be increased. However, only a small amount of older adults utilize public transportation (Houser, 2005; Kim, 2011). Findings from this study will enable occupational therapists to develop evidence-based interventions to address specific perceived barriers in order to increase public transportation use as an option for increased community mobility.
DESIGN: A survey study design was used to examine frequently identified barriers to public transportation use. This study is pertinent because rather than only reporting prevalence levels of common age-related health concerns, it focuses on examining perceived barriers as they specifically affect an occupation that often must be altered as one ages.
PARTICIPANTS: One hundred twenty-five respondents from eight senior centers were recruited. Of those, only 56 met the inclusion criteria to complete the survey. Inclusion criteria included age 65 or older, at least moderate level of cognition, English speaking, community dwelling, and residing in the San Francisco Bay Area.
METHOD: A total of 20 items developed in this survey were based on the literature review, which addressed areas in physical health, psychosocial factors, and cognition. A review of existing research on common age-related health factors led to the content of the questions, which were then reviewed by two content experts to establish validity.
ANALYSIS: Descriptive and correlational statistics were used. Frequencies of perceived barriers within overarching physical, psychosocial, and cognitive domains were measured, and correlations between each of the proposed barriers evaluated. An independent t test revealed the effect of age-related health conditions on perceived barriers.
RESULTS: Of the 56 respondents between ages 65 and 91 yr, 43 (76.8%) were female. Common ethnicities were White (48.2%) and Asian/Pacific Islander (39.2%). Hypertension (48.2%) and arthritis (41.1%) were the most prevalent age-related health conditions. Physically, the prominent barriers were general weakness (40.80%), balance (37.30%), and pain (35.40%). Psychosocially, embarrassment about needing assistance and willingness to take more trips if he or she felt more confident were equally considered barriers at 34.70%. An independent t test revealed that the number of health conditions (0–3 and 4–6) had a significant effect on only three perceived barriers: sleep, dizziness, and numbness. Correlation statistics showed almost all categories were related to one another with only a few exceptions.
DISCUSSION: The majority of barriers were correlated, indicating the importance of considering a holistic approach to intervention because older adults utilizing public transportation likely experience a combination of barriers. A suggestion for future research is to examine different ethnic and age groups, particularly old-old adults.
IMPACT STATEMENT: This study highlights the benefits of focusing on perceived barriers as they affect occupation, compared with simply reporting prevalence levels of health concerns. Correlations between perceived barriers provide evidence that a holistic approach is warranted when planning interventions to increase public transportation use, and thus community mobility, to support productive aging for the older adult population.
References
Houser, A. (2005). Community mobility options: The older person’s interest. Retrieved from http://assets.aarp.org/rgcenter/il/fs44r_com_mobility.pdf
Kim, S. (2011). Assessing mobility in an aging society: Personal and built environment factors associated with older people’s subjective transportation deficiency in the US. Transportation Research: Part F, 14, 422–429. http://dx.doi.org/10.1016/j.trf.2011.04.011
