title: Relevance of community structures and neighbourhood characteristics for participation of older adults: a qualitative study.
abstract: OBJECTIVE
  Community and neighbourhood structures contribute not only to the health and well-being, but also to the participation of older adults. The degree of participation depends on both the living environment and the individual's personal characteristics, preferences and perception. However, there is still limited empirical evidence on how community and neighbourhood structures are linked to participation and health in the aged population.
  
  
  METHODS
  A qualitative exploratory approach was chosen with a series of problem-centred, semi-structured focus group discussions. Study participants were selected from within the city of Augsburg, Southern Germany, and from two municipalities in surrounding rural districts. The interviews took place in 2013. Structuring content analysis was used to identify key concepts.
  
  
  RESULTS
  We conducted 11 focus group discussions with a total of 78 different study participants. The study participants (33 men and 45 women) had a mean age of 74 years (range 65-92 years). Only two study participants lived in an assisted living facility. Of all study participants, 77% lived in urban and 23% in rural areas. We extracted four metacodes ('Usual activities', 'Requirements for participation', 'Barriers to participation' and 'Facilitators for participation') and 15 subcodes. Health and poorly designed infrastructure were mentioned as important barriers to participation, and friendship and neighbourhood cohesion as important facilitators.
  
  
  CONCLUSIONS
  This qualitative study revealed that poor design and accessibility of municipal infrastructure are major barriers to participation in old age in Germany. Community and neighbourhood structures can be part of the problem but also part of the solution when accessibility and social networks are taken into account.
authors.affiliation: Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Marchioninistr. 17, 81377, Munich, Germany. ralf.strobl@med.uni-muenchen.de.|German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany. ralf.strobl@med.uni-muenchen.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Strobl
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Maier
authors.affiliation: Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Marchioninistr. 17, 81377, Munich, Germany.
authors.forename: Alicja
authors.initials: A
authors.lastname: Ludyga
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mielck
authors.affiliation: Institute for Medical Information Processing, Biometrics and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Marchioninistr. 17, 81377, Munich, Germany.|German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Grill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001107:Architectural Accessibility; D005260:Female; D017144:Focus Groups; D005858:Germany; D006801:Humans; D008297:Male; D010465:Perception; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012111:Residence Characteristics; D012424:Rural Population; D012944:Social Support
keywords: Aged; Environment design; Focus groups; Qualitative research; Social participation; Social support