ArticleBMC health services research2025
Digital healthcare services in the context of age-friendly community initiatives in China: a realist evaluation.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
backgroundUnderstanding digital healthcare services in age-friendly community (AFC) initiatives and their implementation is crucial for developing evidence-based policies and practices. In this study, we aim to explore the question, "What is it about digital healthcare services that work, for whom, and under what circumstances?" in top-down AFC initiatives using Shanghai, China, as a representative case.
methodsWe employed a novel realist evaluation methodology and gathered insights from critical informants and users, including policymakers, community officers responsible for implementing AFC initiatives, and older adults.
resultsThe findings revealed six context-mechanism-outcome configurations. The government-led top-down AFC initiative, along with its related policies, serves as a critical context for supporting the provision of digital healthcare services and improving outcomes for older adults and their communities. A bottom-up approach values individual demand-oriented methods, providing digital healthcare services in AFC initiatives by considering older adults' health and social situation as a critical context, utilizing digital care services and support as resources, and enhancing user experience. A feasible path forward is to support healthcare professional-led collaboration in developing and implementing digital healthcare services, aligning bottom-up and top-down practices, and focusing on individual demand, social equity, privacy concerns, and data-driven feedback.
conclusionsTop-up support, active engagement of providers, and closer local monitoring of digital healthcare service implementation in AFC initiatives may encourage long-term effectiveness and sustainability.
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