Journal of Aging Studies 26 (2012) 273–284

老龄化研究杂志 26(2012)273-284

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Journal of Aging Studies

老化研究杂志

journalhomepage:www.elsevier.com/locate/jaging
J o u r n a l h o m e p e: w w w.我正在经历。我有一个自己的世界

A conceptual framework for examining the promise of the NORC program and
Village models to promote aging in place☆
一个概念框架，用于审查 NORC 方案和 Village 模式促进就地老龄化的承诺
Emily A. Greenfield a, ,1, Andrew Scharlach b, Amanda J. Lehning c, Joan K. Davitt d
格林菲尔德 a，1，安德鲁 ·沙拉赫 b，阿曼达 ·j ·雷宁 c，琼 ·k ·达维特 d
a
Rutgers, The State University of New Jersey, School of Social Work, 536 George St., New Brunswick, NJ 08901, USA
罗格斯大学，新泽西州立大学，社会工作学院，536 乔治街，新布伦瑞克，NJ 08901，美国
b University of California, Berkeley, School of Social Welfare, 218 Haviland Hall, Berkeley, CA 94720, USA
加州大学伯克利分校，社会福利学院，218 哈维兰大厅，伯克利分校，加州 94720，美国
c University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI 48109, USA
密歇根大学，社会工作学院，1080 s。大学，安阿伯，密歇根州 48109，美国
d University of Pennsylvania, School of Social Policy & Practice, 3701 Locust Walk, Philadelphia, PA 19104, USA
宾夕法尼亚大学社会政策与实践学院，宾夕法尼亚州费城蝗虫步道 3701 号，19104 年，美国

article info abstract

一个真实的世界 Abstract

Article history: A growing paradigm shift emphasizes efforts to promote aging in place not only by helping aging individuals
文章历史: and families, but also by addressing and engaging communities. This paper explores the idea of developing
Received 23 October 2011 community supports for aging in place by examining two models that incorporate this approach into practice:
收于 2011 年 10 月 23 日 Naturally Occurring Retirement Community Supportive Service Programs (NORC programs) and Villages.
Received in revised form 16 January 2012 Drawing on research regarding social–relational aspects of communities and later-life health and well-being,
Accepted 30 January 2012 we present an integrative conceptual framework positing three categories of activities and services (civic
修订表格于 2012 年 1 月 16 日收到，于 engagement and empowerment activities; social relationship building activities; services to enhance access to
2012 年 1 月 30 日收到 resources)–as well as the initial outcomes and intermediate outcomes–through which the NORC program
and Village models potentially achieve their long-term goal of promoting aging in place. Based on this
Keywords: framework, we conclude with directions for future research on community initiatives that support aging in
关键词: place.
Aging in place 越来越多的范式转变强调努力促进就地老龄化，不仅要帮助老龄化的个人和家庭，而且还要解决社
老化就位
区问题并让社区参与进来。本文通过对自然发生退休社区支持服务项目(NORC 项目)和村庄两种模式
Community practice
社区实践 的研究，探讨了发展社区就地支持老龄化的思路。根据关于社区和晚年健康和福祉的社会关系方面
Aging services 的研究，我们提出了一个综合概念框架，其中提出了三类活动和服务(公民参与和赋权活动; 社会关
安老服务
系建设活动; 增加获得资源机会的服务)以及初步成果和中间成果，通过这些成果，NORC 方案和
Civic engagement
公民参与 Village 模式有可能实现促进就地老龄化的长期目标。在这个框架的基础上，我们总结了未来研究支
Social support 持老龄化的社区倡议的方向。
社会支持
Conceptual framework © 2012 Elsevier Inc. All rights reserved.
概念框架 2012 Elsevier inc. 保留所有权利。

that strive to strength-en facilitators, and minimize impediments,

The general ecological model of aging conceptualizes aging in
place as a person-environment process that results from the “fit”
between ever-changing individuals and their dynamic social and
physical environments (Lawton, 1990). Following from this insight,
efforts to promote aging in place can be framed broadly as actions
that allow indi-viduals to voluntarily remain in their current
residence in spite of potential changes in later life, such as declining
health. Researchers and practitioners alike have developed
老龄化的一般生态学模型将就地老化概念化为一个人-环境
过程，这个过程是由不断变化的个体与其动态的社会和物理环
境之间的“契合”而产生的(Lawton，1990)。从这一观点出发，促
进就地老龄化的努力可以广泛地框定为努力加强促进者和尽量
减少障碍的行动，使个人能够自愿留在目前的住所，尽管在以
后的生活中可能发生变化，例如健康状况下降。研究人员和从
业人员都已经开发
☆ Naturally Occurring Retirement Community Supportive Service Pro-grams
(NORC)
☆自然发生的退休社区支持服务计划(NORC)
Corresponding author. Tel.: + 1 732 391 4986; fax: + 1 732 932 8181. E-mail
addresses: egreenf@ssw.rutgers.edu (E.A. Greenfield), scharlac@berkeley.edu
(A. Scharlach), alehning@umich.edu (A.J. Lehning),
通讯作者。电话: + 17323914986; 传真: + 17329328181。电子邮件地址:
egreenf@ssw.rutgers.edu (e.a. Greenfield) ，scharlac@berkeley.edu
(A.Scharlach) ，alehning@umich.edu (A.j. Lehning) ,
jdavitt@sp2.upenn.edu (J.K. Davitt).
jdavitt@sp2.upenn.edu (j.k.
1 promote aging in place not only by enhancing supports and services
As lead author, Dr. Greenfield was responsible for the overall coordina-tion of
manuscript development and submission. All authors have contribut-ed substantially
to the conceptualization, development and writing of this manuscript and are listed
in reverse alphabetical order for that reason.
1 作为主要作者，格林菲尔德博士负责全面协调稿件的开发和提交。所有的作者都为这篇手稿的概念化、发展
和写作做出了巨大的贡献，并且由于这个原因被按字母顺序倒序列出。
0890-4065/$ – see front matter © 2012 Elsevier Inc. All rights reserved.
doi:10.1016/j.jaging.2012.01.003
2012 Elsevier inc. 保留所有权利 doi: 10.1016/j.jaging. 2012.01.003
and described a variety of efforts to promote aging in place, such as
better coordinated in-home personal assistance and health services
(Marek et al., 2005), services and support to family caregivers
(Sorensen, Pinquart, & Duberstein, 2002), assistive devices to help
older adults function independently in their own homes (Agree &
Freedman, 2000), and technol-ogy within homes to monitor
individuals' changing needs (Mynatt, Rowan, Craighill, & Jacobs,
2001).
并描述了促进就地老龄化的各种努力，例如更好地协调家庭个
人援助和保健服务(Marek 等，2005) ，对家庭照顾者的服务和
支持(Sorensen，Pinquart，& Duberstein，2002) ，帮助老年人在
自己家中独立运作的辅助设备(Agree & Freedman，2000) ，以
及 家 中 监 测 个 人 不 断 变 化 的 需 求 的 技 术 (Mynatt ， Rowan ，
Craighill，& Jacobs，2001)。
Recently, there have been a growing number of efforts to
for individual older adults and their families, but also by addressing
and engaging communities (Greenfield, 2012; Lehning, Scharlach,
& Price Wolf, in press). In theory, efforts to promote aging in place
in community serve to fos-ter interdependent relationships “to
enhance well-being and quality of life for older people at home and
as integral members of the community” (Thomas & Blanchard, 2009,
p. 14). Beyond physical well-being, aging in place in community is
also concerned with relationships, positive growth, life purpose, and
communal well-being.
最近，越来越多的努力不仅通过加强对个别老年人及其家庭
的支持和服务，而且通过向社区提供服务和参与社区活动来促
进就地老龄化(Greenfield，2012; Lehning，Scharlach，& Price
Wolf，in press)。理论上，促进社区老龄化的努力有助于建立相
互依存的关系,”以提高老年人在家和作为社区不可分割的成员
的福祉和生活质量”(Thomas & Blanchard，2009，第 14 页)。除
了身体健康之外，社区中的老龄化还与人际关系、积极成长、
生活目标和社区福利有关。
274 E.A. Greenfield et al. / Journal of Aging Studies 26 (2012) 273–284
274 e.a. Greenfield 等人/《衰老研究杂志》26(2012)273-284
director to respond to members' individual requests for services,
This paper explores the idea of developing community supports develop agreements with external service providers willing to serve
for aging in place by examining two models that in-corporate this BHV members at a discount, coordinate a pool of volunteers to help
approach into practice: Naturally Occurring Retirement Community BHV members with basic shopping and transportation needs, and
Supportive Service Programs (NORC programs) and Villages. Both work with members to orga-nize social and educational events.
models explicitly seek to pro-mote aging in place by enhancing the NORC 计划和 Village 模式在美国都是相对较新的发展。
strengths of communi-ties—a term which is used here to refer to Village 是“自治的、基层的、以社区为基础的组织，其发展的唯
geographic areas whose residents are connected through “some 一目的是使人们能够随着年龄的增长而留在自己的家中和社
combination of shared beliefs, circumstances, priorities,
区”(Village to Village Net-work VtV，2011)。2001 年，一群居住
relationships or concerns” (Chaskin, 1997, p. 522). We first provide
在马萨诸塞州波士顿市灯塔山附近的老年人创建了灯塔山村
a brief overview of the NORC program and Village models. Then,
we present an integrative conceptual framework positing the primary (BHV) ，他们寻求一种方法来帮助他人尽可能长久地生活在他
categories of activities and services–as well as the initial outcomes 们的社区里。现在，BHV 是一个独立的非营利组织，由成员自
and intermediate outcomes–through which the NORC program and 己管理，并得到成员会费和外部国家的支持，BHV 的目标是帮
Village models potentially achieve their long-term goal of 助其成员在适当的地方老化。建立 BHV 的社区居民雇用了一名
promoting aging in place. Next, we review the extant literature to
执行主任，负责回应成员的个人服务请求，与愿意以折扣价为
suggest ways in which these models' primary activities and services
respond to limitations within current supportive service delivery sys- BHV 成员提供服务的外部服务提供商达成协议，协调志愿者队
tems in the United States (U.S.) in light of existing knowledge on 伍，帮助 BHV 成员满足基本购物和交通需求，并与成员合作组
social–relational aspects of communities and later life health and 织社会和教育活动。
well-being. Within this review, we examine how these focal
activities are germane to the NORC program and Village models
while describing differences between the models. We conclude by Since the development of BHV in 2001, more than 60 sim-ilar
deriving from our conceptual framework five key directions for initiatives, known as “Villages,” have opened in the U.S. with at least
future research on NORC programs, Villages, and other community 120 more in development (VtV, 2011). This ex-pansion has been
aging initiatives. stimulated in large part by the publication of articles about BHV and
本文通过对自然退休社区支持服务项目(NORC 项目)和村庄 similar efforts in many major U.S. newspapers over the past several
两种模式的研究，探讨了发展社区就地支持老龄化的思路。这 years (Adler, 2009; Festa, 2007; Gleckman, 2010; Greene, 2008;
两种模式都明确寻求通过加强社区的力量来促进适当的老龄化 Gross, 2007). Also, BHV has worked collaboratively with NCB
Capital Impact, with funding from the Metlife Foundation and other
——这里使用的术语是指居民通过“共同的信仰、环境、优先事
sources, to develop a Village to Village (VtV) Network; VtV offers
项、关系或关切的某种组合”而联系在一起的地理区域(Chaskin，
web-based assistance and periodic national and regional
1997，第 522 页)。我们首先简要概述 NORC 计划和 Village 模 自从 BHV 在 2001 年开发以来，超过 60 个类似的项目，被
型。然后，我们提出了一个综合概念框架，设定了活动和服务 称为“村庄”，已经在美国启动，至少还有 120 个项目正在开发
的主要类别——以及初始成果和中间成果——通过这个框架， 中(VtV，2011)。这种扩张在很大程度上是由于过去几年在美国
NORC 方案和 Village 模型有可能实现促进就地老龄化的长期目 许多主要报纸上发表了关于 BHV 的文章和类似的努力(Adler，
标。接下来，我们回顾现有文献，根据现有的社区社会关系方 2009; Festa ， 2007; Gleckman ， 2010; Greene ， 2008; Gross ，
面的知识以及晚年生活健康和福祉，提出这些模式的主要活动 2007)。此外，BHV 还与 NCB Capital Impact 合作，利用大都会
和服务如何应对美国现有支持性服务提供系统的局限性。在这 人寿基金会和其他来源的资金，开发了一个村到村(VtV)网络;
次审查中，我们研究这些重点活动如何与 NORC 计划和 Village VtV 提供基于网络的援助，并定期在国家和地区提供援助
模型密切相关，同时描述模型之间的差异。最后，我们从我们
的概念框架中总结出未来 NORC 项目、村庄和其他社区老龄化
倡议研究的五个关键方向。

Brief overview of the NORC program and Village models

NORC 计划和 Village 模式简要概述

The NORC program and Village models both are relatively

recent developments in the U.S. Villages are “self-governing,
grassroots, community-based organizations developed with the sole
purpose of enabling people to remain in their homes and
communities as they age” (Village to Village Net-work VtV, 2011).
The Village concept emerged in 2001 with the founding of Beacon
Hill Village (BHV) by a group of se-niors living in the Beacon Hill
neighborhood of Boston, Mas-sachusetts, who sought a way to help
one another live as long as possible in their neighborhood. Now an
independent non-profit organization that is governed by the
members themselves and supported by member dues and external
do-nations, BHV aims to help its members to age in place. The
neighborhood residents who founded BHV hired an execu-tive
 (Altman，2006; Bedney，Goldberg，& Josephson，2010; Vladeck，
meetings “to help communities establish and continuously improve 2004)。NORC 方案旨在建立不同利益攸关方之间的伙伴关系，
management of their own Villages” (VtV, 2011). Other individuals 包括居民、地方政府、住房管理者和业主以及当地服务提供者，
and philanthropic organizations (e.g., the SCAN Foundation, the
以协调为 NORC 社区内的居民提供的服务和方案(Vladeck，
Archstone Foundation) have invested heavily in developing and
2004 年)。北欧人指的是那些没有被规划为老年人住房的地方，
evaluating Villages in specific geo-graphic locations, such as
California. Information gathered from Villages nationwide suggests 但随着时间的推移，由于长期居住在家中的老年人以及老年人
that Villages vary rather markedly (Scharlach, Graham, & Lehning, 的迁徙，老年人的比例已经相当可观(Ormond，Black，Tilly，&
in press). Most are free-standing grassroots efforts, but at least one Thomas，2004)。例如，2006 年《美国老年人再授权法》将北
in six have been developed by or in collaboration with an existing 美老年人委员会定义为”不是机构照料或协助生活环境”的领域，
health or social service provider. Some are highly-professionalized,
其中”(1)40% 的户主是老年人[60 岁或 60 岁以上] ，或(2)根据当
while others rely almost entirely on volun-teers. Some serve fewer
than 10 members, while some have nearly 500 members. Despite 地因素，存在着足够数量的老年人，总体而言，这使得一个组
this variation, a review of the available evidence suggests that 织能够为生活在社区的老年人提供有效的保健和社会服务”(PL
existing Villages share the following five characteristics: they are (a) 109-365,409)。NORC 项目最初针对的是与指定的住房管理人员
self-governing, 一起居住在年龄综合公寓楼内的北欧人，而 NORC 项目已经扩
会议“帮助社区建立并持续改善自己村庄的管理”(VtV，2011)。 展到了居住着大量老年人的独户住宅社区(Bronstein，Gellis，&
其他个人和慈善组织(例如 SCAN 基金会、 Archstone 基金会)已 Kenaley，2011)。
经在开发和评估特定地理位置的村庄方面投入了大量资金，如
加利福尼亚州。从全国范围内的村庄收集到的信息表明，村庄
的差异相当明显(Scharlach，Graham，& Lehning，in press)。大
多数是独立的基层努力，但至少有六分之一是由现有的健康或 NORC programs are typically administered by a lead agency as
opposed to being a free-standing entity. The lead agency, which
社会服务提供者发展或与其合作。一些是高度专业化的，而其
oftentimes is a community-based nonprofit social ser-vice provider
他几乎完全依赖志愿者。有些会员少于 10 人，有些会员接近
(e.g., Jewish Family Services), is responsible for developing
500 人。尽管存在这种差异，但对现有证据的回顾表明，现有 partnerships, managing finances, and coordinating the services that
村庄具有以下五个特征: (a)自治; are facilitated by the program (Vladeck; author citation). Common
services include social services, health care services, educational and
(b) geographically-defined, (c) membership organizations, that (d) recreational opportuni-ties, volunteer opportunities, and ancillary
provide or arrange services, (e) with the goal of help-ing their services (e.g., trans-portation and home repairs).
members to age in place (Scharlach et al., in press). NORC 项目通常由一个牵头机构管理，而不是一个独立的实
(c)成员组织，(d)提供或安排服务，(e)以帮助其成员在适当的地 体。领导机构通常是一个基于社区的非营利社会服务提供者(例
方安老为目标(Scharlach 等，新闻)。 如，犹太家庭服务) ，负责发展伙伴关系，管理财务，协调项目
NORC programs are community-level initiatives that bring 所促进的服务(Vladeck; 作者引用)。共同服务包括社会服务、医
together older adults and diverse stakeholders within a residential 疗保健服务、教育和娱乐机会、志愿服务和辅助服务(例如交通
area (e.g., an apartment building, neighborhood, town) with a
和家居维修)。
significantly large number of older adults to fa-cilitate and
coordinate a range of activities, relationships, and services to
promote aging in place (Altman, 2006; Bedney, Goldberg, & The NORC program concept began in 1986 at the Penn South
Josephson, 2010; Vladeck, 2004). NORC pro-grams aim to create House of New York City, a moderate-income cooperative
partnerships among diverse stake-holders–including residents, local NORC 项目的概念始于 1986 年，在纽约市的宾夕法尼亚南
government, housing managers and owners, and local service 大厦，一个中等收入的合作社
providers–to coordi-nate services and programs for residents within
communities designated as NORCs (Vladeck, 2004). NORCs refer
to loca-tions that were not planned as senior housing, yet over time
have developed a sizable proportion of older residents due to long-
time residents remaining in their homes throughout later life, as well
as in-migration of older adults (Ormond, Black, Tilly, & Thomas,
2004). For example, the 2006 Reauthorization of the Older
Americans Act defines a NORC as an area that is “not an
institutional care or assisted living setting” where “(1) 40% of the
household heads are older individuals [age 60 or over] or (2) a
critical mass of older individuals exists, based on local factors, that,
taken in total, allow an organization to achieve efficiencies in health
and social services to older individuals living in the communi-ty”
(PL 109–365, § 409). Whereas NORC programs originally targeted
NORCs within age-integrated apartment complexes with designated
housing managers, NORC programs have ex-panded to
neighborhoods of single-family homes where a critical mass of older
adults resides (Bronstein, Gellis, & Kenaley, 2011).
NORC 方案是社区一级的倡议，将老年人和住宅区(如公寓
楼、社区、城镇)内的不同利益攸关方与大量老年人聚集在一起，
促进和协调一系列活动、关系和服务，以促进就地老龄化
 E.A. Greenfield et al. / Journal of Aging Studies 26
(2012) 273–284
E.a. Greenfield 等人/老龄化研究杂志 26(2012)273-
284
of 2800 apartments in Manhattan (Altman, 2006). At that time, the
cooperative's board recognized that many long-time resi-dents were
facing challenges such as declining health and diffi-culties
navigating health and social services. The organization partnered
with the United Jewish Appeal (UJA) Federation of New York–a
network of more than 100 human service, health-care, and education
organizations that serve the New York metropolitan area–to work
with community members to help older residents age in place. Since
that time, NORC program advocates have secured both private
philanthropic and local government funds to support the expansion
of the model to other areas throughout New York (Altman, 2006).
Also, the Jewish Federations of North America (JFNA) en-gaged in
a federal advocacy campaign to implement NORC programs in other
regions of the U.S. during the 2000s (Bedney et al., 2010;
Enguidanos, Pynoos, Denton, Alexman, & Diepenbrock, 2010). To
date, there have been approximately 100 NORC programs
developed throughout the country, with about half located in the
state of New York (the large majority of which is in New York City).
曼哈顿的 2800 套公寓(Altman，2006)。当时，该合作社的董事
会认识到，许多长期居民面临着诸如健康状况下降以及在获得
保健和社会服务方面遇到困难等挑战。本组织与纽约犹太联合
呼吁联合会(UJA)合作，与社区成员合作，帮助老年居民在适当
的地方养老。 UJA 是一个由 100 多个服务于纽约都会区的人类
服务、保健和教育组织组成的网络。从那时起，NORC 项目的
倡导者已经获得了私人慈善基金和地方政府的资金，以支持该
模式在纽约其他地区的扩展(Altman，2006)。此外，北美犹太
人联合会(JFNA)也参与了一项联邦宣传运动，以在 2000 年代期
间 在 美 国 其 他 地 区 实 施 NORC 方 案 (Bedney 等 ， 2010;
Enguidanos ， Pynoos ， Denton ， Alexman ， & Diepenbrock ，
2010)。迄今为止，全国已经制定了大约 100 个 NORC 方案，其
中大约一半位于纽约州(其中绝大多数位于纽约市)。
Despite the growing prominence of Villages and NORC
programs nationwide, as well as substantial media and pol-icymaker
attention to them as innovative models for the fu-ture of home- and
community-based service delivery (Gross, 2007; U.S. Congress,
2006), there has been relatively little empirical research on either of
these models. Re-searchers and practitioners alike have noted the
critical need for rigorous outcome studies that examine the condi-
tions under which these models are effective in improving older
adults' health, well-being, and ability to age in place (Ormond et al.,
2004; Vladeck, 2004). Advancing this evi-dence base is necessary
for informing future efforts to expand and improve the
implementation of such initiatives.
尽管 village 和 NORC 项目在全国范围内日益突出，媒体和
政策制定者也大量关注这些项目，将其作为未来以家庭和社区
为基础的服务提供的创新模式(Gross，2007 年; 美国国会，2006
年) ，但对这两种模式的实证研究相对较少。研究人员和从业人
员都注意到，迫切需要进行严格的成果研究，以审查这些模型
在何种条件下有效改善老年人的健康、福祉和就地养老的能力
(Ormond 等，2004; Vladeck，2004)。推进这一证据基础对于通
知未来努力扩大和改善这些举措的实施是必要的。
275
A proposed conceptual framework of how the NORC program
and Village models promote aging in place
提出了 NORC 计划和 Village 模型如何促进老龄化的概念
框架
To work toward rigorous evaluation research, it is essen-tial to
develop a conceptual framework regarding the key processes
through which the NORC program and Village models might benefit
older adults and to specify the ways in which these processes
correspond with prior research on factors that promote older adults'
health, well-being, and aging in place. As Ormond et al. (2004)
observed: “Develop-ing good outcomes measures begins with
clearly stating the objectives that are expected to contribute to the
overarching goal of promoting successful aging in place” (p. 38).
为了努力开展严格的评估研究，必须制定一个概念框架，说
明 NORC 方案和 Village 模式可能通过哪些关键进程使老年人
受益，并具体说明这些进程如何与先前关于促进老年人健康、
幸福和就地老龄化因素的研究相一致。正如 Ormond 等人(2004
年)所指出的:”制定良好成果措施首先要明确说明有助于实现促
进成功就地老龄化这一总体目标的各项目标”(第 38 页)。
Based on extant research on the NORC programs and Villages,
as well as research on the importance of social– relational aspects of
communities for older adults' health and well-being (see review
below), Fig. 1 presents an integra-tive conceptual framework of the
primary categories of activi-ties and services–as well as the initial
and intermediate outcomes–through which the NORC program and
Village models potentially achieve their long-term goal of
promoting aging in place. The framework hypothesizes that NORC
pro-grams and Villages facilitate activities and services that lead to
initial outcomes among older adults. These initial outcomes po-
tentially result in subsequent benefits for aging individuals, their
communities, and the organizations/programs themselves
基于现有的关于 NORC 方案和村庄的研究，以及关于社区
的社会关系方面对老年人健康和福祉的重要性的研究(见下面的
审查) ，图 1 提出了一个主要活动和服务类别的综合概念框架，
以及初步和中期成果，通过这个框架，NORC 方案和村庄模式
有可能实现促进老龄化的长期目标。该框架假设 NORC 计划和
村庄促进导致老年人初步结果的活动和服务。这些最初的结果
可能会给老年人，他们的社区以及组织/项目本身带来后续的好
处
(i.e., intermediate outcomes), thereby enhancing participants' Organization (WHO), 2007). Due to space limi-tations, we do not
capacity to age in place (i.e., long-term goal). address the community and programmatic/ organizational areas of
(即中期成果) ，从而提高参与者在适当地方安老的能力(即长期 intermediate outcomes in this manuscript.
目标)。 该模型表明，这些变化可能导致老年人参与者的其他个人层
More specifically, the framework specifies three catego-ries of 面的益处(中间结果) ，如改善身体健康(例如，与慢性病有关的
activities and services that NORC programs and Vil-lages aim to 症状的严重程度)和心理社会福祉(例如，生活目标感和生活满
facilitate. First, NORC programs and Villages emphasize activities 意度)。这些个人结果反过来被认为有助于老年人就地老化的能
and services to promote participants' civic engagement and 力(长期目标)。我们预计在社区和组织/计划层面还有其他中间
empowerment, such as by providing opportunities for older adults to
成果。例如，公民参与和赋权活动可能会加强参与者的社区意
participate in governance boards and to exchange social support
识，可能会加强社区对老年人的整体友善程度。例如，这些活
among community members. Second, they emphasize social
relationship build-ing activities, such as group recreational, 动及其初步成果可能导致创造更容易进入的户外空间和建筑物，
educational, and health promotion activities. Third, Villages and 并使老年人参与社区一级的决策(世界卫生组织(世卫组织) ，
NORC pro-grams focus on services to enhance participants' access 2007 年)。由于空间有限，我们在本手稿中没有涉及中间成果的
to re-sources, such as by linking older adults with transportation 社区和规划/组织领域。
assistance or home repair services.
更具体地说，该框架规定了 NORC 项目和 Vil-lages 旨在促
进的三类活动和服务。首先，NORC 方案和 village 强调促进参
与者的公民参与和赋权的活动和服务，例如为老年人提供参与 An empirical review to identify primary activities and services
治理委员会和在社区成员之间交流社会支持的机会。第二，他 within the NORC program and Village models
们强调社会关系建设活动，如团体娱乐，教育和健康促进活动。 在 NORC 计划和 Village 模型中确定主要活动和服务的实证
第三，village 和 NORC 方案侧重于提供服务，以增加参与者获 审查
得资源的机会，例如将老年人与交通援助或家庭维修服务联系
Our conceptual framework identifies three categories of
起来。
activities and services that the NORC program and Village models
emphasize: (a) civic engagement and empowerment activities, (b)
We propose that these three categories of activities and services
social relationship building activities, and (c) services to enhance
lead to initial outcomes among older adult partici-pants. First, the
participants' access to resources. In the sections below, we review
model theorizes that civic engagement and empowerment activities
prior research to more fully define each of these categories, to
potentially enhance participants' feelings of self and collective
identify limitations within exist-ing supportive service systems with
efficacy as well as their sense of community. Second, the model
respect to each category,
posits that because of Villages and NORC programs' social
我们的概念框架确定了 NORC 方案和 Village 模式强调的三
relationship building ac-tivities, such as recreational activities,
participants potential-ly develop greater social support, and social 类活动和服务: (a)公民参与和赋权活动，(b)社会关系建设活动，
isolation is reduced. Third, the model posits that NORC programs' 以及(c)增强参与者获得资源的机会的服务。在下面的章节中，
and Villages' activities to enhance access to resources potentially 我们回顾了先前的研究，以更全面地界定每个类别，以确定现
reduce the level of unmet need among participants and en-hance 有的支持性服务系统对每个类别的局限性,
participants' ability to access support efficiently, effec-tively,
appropriately, and adequately.
我们建议这三类活动和服务在老年人参与者中取得初步成果。
首先，该模型理论认为，公民参与和授权活动可能会增强参与
者的自我和集体效能感以及他们的社区意识。第二，模型假设，
由于村庄和 NORC 项目的社会关系建设活动，如娱乐活动，参
与者潜在地发展更大的社会支持，社会隔离减少。第三，该模
型假定，NORC 方案和 village 旨在增加获得资源的活动可能会
降低参与者未满足的需求水平，并增强参与者有效、有效、适
当和充分获得支助的能力。

The model suggests that these changes potentially lead to other

individual-level benefits among older adult partici-pants
(intermediate outcomes), such as improved physical health (e.g.,
severity of symptoms related to chronic condi-tions) and
psychosocial well-being (e.g., feelings of purpose in life and life
satisfaction). These individual outcomes, in turn, are posited to
contribute to older adults' ability to age in place (long-term goal).
We anticipate that there are other intermediate outcomes at the
community and organi-zational/programmatic levels. For example,
civic engagement and empowerment activities, which potentially
enhance par-ticipants' sense of community, might strengthen a
communi-ty's overall aging-friendliness. For example, these
activities and their initial outcomes might lead to the creation of
more accessible outdoor spaces and buildings, as well as in-cluding
older adults in community-level decision-making (World Health
276 E.A. Greenfield et al. / Journal of Aging Studies 26 (2012) 273–284
276 e.a. Greenfield 等人/《衰老研究杂志》26(2012)273-284

Fig. 1. Conceptual framework of processes through which the NORC program and Village models potentially influence aging in place.
图 1. NORC 计划和 Village 模型可能影响到位老化的过程的概念框架。
利益。组织志愿服务、政治参与和积极加入志愿者协会是公民
参与的例子(Burr，Caro，& Moorhead，2002; Greenfield，2010)。
and to summarize evidence indicating that the focal activities and
A growing body of research suggests that older adults' civic
services are likely associated with individual outcomes among older
engagement–specifically through formal volunteering– is associated
adults. We also examine the ways in which these activities and
with their better mental and physical health, in-cluding reduced risk
services are germane to the NORC pro-gram and Village models,
of mortality, better functional health, and fewer depressive
while also discussing differences between NORC programs and
symptoms (Morrow-Howell, 2010). Fitting with these findings,
Villages with respect to each category.
research also provides longitudi-nal evidence that psychological
并总结证据表明，重点活动和服务可能与老年人的个人结果有
states related to civic engage-ment, such as feelings of altruism and
关。我们还研究了这些活动和服务与 NORC 计划和 Village 模 being useful to others, are associated with better mental and physical
式密切相关的方式，同时也讨论了 NORC 计划和 Village 在每 health among
个类别方面的差异。 越来越多的研究表明，老年人的公民参与——特别是通过正
式的志愿服务——与他们更好的身心健康有关，包括降低死亡
风险 、更好的功 能健康和 更少的抑 郁症状 (Morrow-Howell ，
2010)。与这些发现相吻合的是，研究还提供了与公民参与相关
Civic engagement and empowerment activities
公民参与和赋权活动 的心理状态的纵向证据，例如利他主义感觉和对他人有用的心
理状态与人们更好的身心健康相关
Researchers, practitioners, and policymakers alike have focused
increasing attention over the past decade on the con-cept of “civic
engagement” in later life (Cullinane, 2006). Civic engagement has
been defined as a type of productive and social activity, referring
specifically to individual or col-lective action that promotes the
common good. Organiza-tional volunteering, political participation,
and active membership in voluntary associations are examples of
civic engagement (Burr, Caro, & Moorhead, 2002; Greenfield,
2010).
在过去的十年里，研究人员、从业者和政策制定者都越来越
关注晚年“公民参与”的概念(Cullinane，2006)。公民参与被定义
为一种生产和社会活动，特别是指个人或集体行动，促进共同
older adults over time (e.g., Gruenewald, Karlamangla, Greendale,
Singer, & Seeman, 2007).
随 着 时 间 的 推 移 老 年 人 ( 例 如 ， Gruenewald ， Karlamangla ，
Greendale，Singer，& Seeman，2007)。
Classic community organizing theory further suggests that
collective interaction toward a common purpose can generate
enhanced critical awareness of a particular social condition. Such
critical consciousness leads to greater levels of identification with
the problem and willingness to partici-pate in the solution (Reed,
Newman, Suarez, & Lewise, 1997; Rothman, 1995; Weil, 2005).
For example, community in-volvement can foster feelings of
collective efficacy (i.e., be-liefs shared by community members that
they can create community change; Price & Behrens, 2003;
Sampson & Raudenbush, 1999) and personal feelings of
empowerment (Itzhaky & York, 2000a, 2000b; Zimmerman &
Rappaport, 1988). In addition, increasing levels of involvement in
com-munity organizations and engaging older adults in the plan-
ning of programs that involve them can also promote higher levels
of self-efficacy and personal autonomy (Ohmer, 2008; Tracy, Kemp,
& Whittaker, 1997).
经典的社区组织理论进一步表明，朝着共同目标的集体互动
可以产生对特定社会条件的更强的批判意识。这种批判意识导
致了对问题更高层次 的认同和 参与解决方案的意愿 (Reed，
Newman ， Suarez， & Lewise， 1997; Rothman ，1995; Weil，
2005)。例如，社区参与可以培养集体效能感(即社区成员共享
的信念，即他们可以创造社区变化 ; Price & Behrens，2003;
Sampson & Raudenbush，1999)和个人授权感(Itzhaky & York，
2000a，2000b; Zimmerman & Rappaport，1988)。此外，增加对
社区组织的参与程度和让老年人参与规划涉及他们的项目也可
以 促 进 更 高 水平 的 自 我 效能 感和 个 人 自 主 性 (Ohmer ， 2008;
Tracy，Kemp，& Whittaker，1997)。

Despite growing recognition of the potential benefits of civic

engagement in later life, as well as national surveys in-dicating that
Baby Boomers in particular are especially inter-ested in giving back
to their communities through volunteering and paid work in
retirement (Harvard School of Public Health & the MetLife
Foundation, 2006), there is on-going concern that contemporary
social institutions and ser-vice organizations in the U.S. are not
prepared to capitalize on older adults' skills to support their status as
productive and engaged members of society (Freedman, 1999).
Focus groups and interviews with Baby Boomers have highlighted
the
尽管人们越来越认识到公民参与在晚年生活中的潜在益处，
而且全国性的调查表明，婴儿潮一代特别有兴趣通过志愿服务
和退休后的有偿工作回馈社区(哈佛大学公共卫生学院和大都会
基金会，2006 年) ，但人们仍然担心，美国的当代社会机构和
服务组织不准备利用老年人的技能来支持他们作为社会生产性
和参与性成员的地位(Freedman，1999 年)。焦点小组和对婴儿
潮一代的采访强调了
 E.A. Greenfield et al. / Journal of Aging Studies 26
(2012) 273–284
E.a. Greenfield 等人/老龄化研究杂志 26(2012)273-
284 277

variety of ways in which local and national infrastructures could services or other enhancements to their physical or social
more effectively promote civic engagement in later life, such as by environment (McDonough & Davitt, 2011).
providing transportation to community activ-ities and creating ways NORC 方案和 Village 模式都侧重于促进参与者公民参与和
to contribute that can be done from home (Casner-Lotto, 2007; 赋权的活动，为老年人提供相互帮助的机会、倡议本身和更广
Lindblom, 2001). Research fur-ther suggests that barriers to civic 泛的社区(Bookman，2008)。Village 模式强调了一种强调参与、
engagement are especially acute among already disadvantaged
伙伴关系和教育的授权哲学(McDonough & Davitt，2011; Tracy
populations of older adults, such as older adults with health
等，1997)。大多数村庄代表了由社区居民组织的基层行动，他
problems (Li & Ferraro, 2006) and low levels of education (Choi &
Chou, 2010). Issues of inclusivity are especially important to con- 们看到了正规服务系统中的差距，并走到一起创建一个平行的
sider in light of research indicating that disadvantaged older adults 系统来填补这些差距(Bookman，2008)。例如，一些村民提到
potentially benefit more from civic engagement in contrast to more “政府的无能”，村民“不能信任政府... ... 决定我们如何度过余
privileged subgroups of older adults (e.g., Tan, Xue, Li, Carlson, & 生”(Metzger，2011，第 3 页)。通过这种方式，Village 模式似乎
Fried, 2006).
反映了民粹主义者对制度化社会服务体系的不信任，以及对私
地方和国家基础设施可以更有效地促进晚年公民参与的各种方
人公民共同行动能够更好地满足社区成员需求的期望。在许多
式，例如为社区活动提供交通工具，并创造可在家里做出贡献
村庄，成员参与制定以及正在进行的管理和实施这一举措，例
的方式(Casner-Lotto，2007; Lindblom，2001)。研究进一步表明，
如通过委员会或理事会的成员资格以及就成员所需资源的组合
公民参与的障碍在已经处于弱势地位的老年人群体中尤其严重，
不断提供反馈的机会。最近对全国村庄的一项研究发现，87%
例如有健康问题的老年人(Li & Ferraro，2006 年)和教育水平低
的村庄报告说，其成员高度参与村庄及其方案或政策的发展，
的老年人(Choi & Chou，2010 年)。考虑到研究表明，处境不利
87% 的村庄报告说，其成员高度参与监督或治理活动。此外，
的老年人可能从公民参与中获益更多，相比之下，处境优越的
62% 的人报告说，成员高度参与提供服务或互相支持(Lehning
老年人群体(如 Tan，Xue，Li，Carlson，& Fried，2006) ，包容
et al。 ，in press)。同样，许多村庄提供的社区活动有可能加强
性问题尤为重要。
成员对社区的承诺，并在理论上加强公民参与的实践(Chaskin，

Both the NORC program and Village models focus on ac-tivities
to promote participants' civic engagement and em-powerment by
providing opportunities for older adults to help each other, the
initiative itself, and the broader communi-ty (Bookman, 2008). The
Village model emphasizes an empow-erment philosophy focused on
participation, partnerships, and education (McDonough & Davitt,
2011; Tracy et al., 1997). Most Villages represent grassroots
initiatives organized by community residents who see the gaps in
formal service sys-tems and come together to create a parallel
system to fill those gaps (Bookman, 2008). For example, some
Village mem-bers have referred to “the incapability of government”
and that members “cannot trust government to … decide for us how
we want to spend the rest of our lives” (Metzger, 2011, p. 3). In this
way, the Village model appears to reflect a populist mistrust of
institutionalized social service systems, and an expectation that
private citizens, acting together, can do a better job of meeting the
needs of community members. In many Villages, members
participate in the development as well as the ongoing manage-ment
and implementation of the initiative, such as through board or
committee membership and opportunities to provide ongoing
feedback as to the mix of resources needed by mem-bers. A recent
study of Villages nationwide found that 87% of Villages reported
that their members had been highly involved in developing the
Village and its programs or policies, and 87% reported that members
were highly involved in oversight or governance activities.
Furthermore, 62% reported that mem-bers were highly involved in
providing services or support to one another (Lehning et al., in
press). Likewise, communal ac-tivities offered by many Villages
have the potential to reinforce members' commitment to the
community and, in theory, rein-force the practice of civic
engagement (Chaskin, Brown, Venkatesh, & Vidal, 2001;
McDonough & Davitt, 2011). Some Villages also encourage
members to become involved in advoca-cy for improvements in
Brown ， Venkatesh ， & Vidal ， 2001; McDonough & Davitt ，
2011)。一些村庄还鼓励成员参与倡导改善服务或其他改善其物
质或社会环境的活动(McDonough & Davitt，2011)。
Practitioners and academic researchers alike similarly have
situated NORC programs within frameworks that em-phasize older
adults as agents of change within their own lives and their
community as a whole (Ivery, Akstein-Kahan, & Murphy, 2010;
Vladeck, 2006). Similar to descrip-tions of Villages (McDonough &
Davitt, 2011), some scholars explicitly have framed NORC
programs within empowerment models (Anetzberger, 2010).
Program leaders have identified older adults' contributions to the
programs themselves as a primary way in which NORC programs
facilitate older adults' civic engagement. Conceptualizing older
adults as primary
同样，从业人员和学术研究人员也将 NORC 方案置于强调
老年人作为自身生活和整个社区变革推动者的框架内(Ivery，
Akstein-Kahan，& Murphy，2010; Vladeck，2006)。类似于对村
庄的描述(McDonough & Davitt，2011) ，一些学者明确地将
NORC 项目框定在授权模型中(Anetzberger，2010)。项目领导
者已经确定了老年人对项目本身的贡献，作为 NORC 项目促进
老年人公民参与的主要方式。将老年人概念化为主要的
partners (along with other stakeholders, such as housing managers community services, and health, only 48% agreed that the NORC
and healthcare providers), lead agencies that ad-minister NORC program resulted in their volunteering more (Bedney et al., 2007).
programs are responsible for calling upon older adults to design, 虽然 village 和 NORC 方案都将参与者对社区的贡献作为其
implement, and sustain the program (Vladeck, 2004). Older adults' 模式的一个明确组成部分，但有证据表明 Vil-lages 作为基层、
contributions to the programs include providing one-time input on 会员驱动的组织，通常由老年人自己领导-比 NORC 方案更能促
perceived community needs, facilitating community programs,
进老年人的公民贡献和增强能力，后者通常由服务组织与老年
providing active and ongoing leadership on the programs'
人合作发起和领导(Lehning et al。在关于社区老龄化倡议的同一
governance boards, and engaging in advocacy on behalf of the
programs (Altman, 2006; Bedney, Goldberg, & Josephson, 2010; 项全国性调查中(Lehning et al。 ，In press) ，来自 NORC 方案
Vladeck, 2006). In addition to providing opportunities for older 的受访者中只有 62% 报告说，老年人高度参与提供投入，39%
adults to sup-port each other and the program itself, NORC 报告说老年人高度参与倡议的制定，31% 报告说老年人高度参
programs might organize community-wide events that facilitate 与监督。此外，23% 的 NORC 计划表明，老年人高度参与了互
older adults' contributions to the broader community as well, such as
相提供服务或支持。如前所述，这些参与率远低于 village 报道
by having older adults serve as volunteers within local high schools
(Vladeck, 2004). Furthermore, practitioners have identified the 的参与率(Lehning et al。 ，in press)。同样，以前对 NORC 项目
potential for NORC programs to help older adults articulate shared 的研究发现，让老年人参与公民参与和赋权活动是该模式实施
interests and advocate for collec-tive causes (Alexander, 2006). As 中 更 具 挑 战 性 的 方 面 之 一 (Anetzberger ， 2010; Bedney ，
an example, a NORC pro-gram in New Jersey facilitated older Schimmel，Goldberg，Kotler-Berkowitz，& Bursztyn，2007)。
adults successfully petitioning government officials to add a bus 例如，对 NORC 方案参与者进行的全国性调查结果表明，虽然
stop near a community gathering place for older adults (Lehning et
70% 以上的受访者同意 NORC 方案增加了他们的社会接触、社
al., in press).
合作伙伴(以及其他利益相关者，如住房管理者和医疗保健提供 区服务意识和健康的说法，但只有 48% 的受访者同意 NORC 方
者) ，负责执行 NORC 项目的领导机构负责号召老年人设计、 案使他们的志愿服务更多(Bedney et al。 ，2007)。
实施和维持该项目(Vladeck，2004)。老年人对这些方案的贡献
包括提供一次性投入，了解社区需求，促进社区方案，在方案
的治理委员会中提供积极和持续的领导，以及代表方案参与宣
传活动(Altman，2006; Bedney，Goldberg，& Josephson，2010; Social relationship building activities
Vladeck，2006)。除了为老年人提供相互支持的机会以及方案 社会关系建设活动
本身之外，北爱尔兰老年人协会方案还可以组织全社区活动，
促进老年人对更广泛的社区作出贡献，例如让老年人在当地高 “Social relationships” has been used as an umbrella term for
constructs such as social integration, social networks, and social
中担任志愿者(Vladeck，2004 年)。此外，从业人员已经确定了
support (House, Umberson, & Landis, 1988; Krause, 2001). Social
NORC 项目的潜力，以帮助老年人阐明共同的兴趣和倡导集体 integration is the quantity and frequen-cy of social relationships
事业(Alexander，2006)。例如，新泽西的 NORC 项目帮助老年 (House et al., 1988). Social networks
人成功地请求政府官员在老年人社区聚会场所附近增加一个公 “社会关系”一直被用作一个总括性术语，如社会融合，社会
共汽车站(Lehning et al。 网 络 和 社 会 支 持 (House ， Umberson ， & Landis ， 1988;
Krause，2001)。社会整合是社会关系的数量和频率(House et
al。 ，1988)。社交网络
While both Villages and NORC programs include partici-pants'
contributions to community as an explicit part of their models, there
is some evidence to suggest that Vil-lages–as grassroots,
membership-driven organizations that are more typically led by
older adults themselves–are better positioned to foster older adults'
civic contributions and em-powerment than NORC programs, which
are typically initiat-ed and led by service organizations in
partnership with older adults (Lehning et al., in press). In the same
national survey of community aging initiatives (Lehning et al., in
press), only 62% of respondents from NORC programs reported that
elders were highly involved in providing input, 39% that older
adults were highly involved in developing the initiative, and 31%
that elders were highly involved in oversight. In ad-dition, 23% of
NORC programs indicated that older adults had been highly
involved in providing services or supports to one another. As
previously cited, these participation rates are substantially lower
than for those reported by Villages (Lehning et al., in press).
Similarly, previous studies of NORC programs have found that
engaging older adults in civic engagement and empowerment
activities is among the more challenging aspects of the model to
implement (Anetzberger, 2010; Bedney, Schimmel, Goldberg,
Kotler-Berkowitz, & Bursztyn, 2007). For example, results from a
na-tional survey of NORC program participants indicated that while
over 70% of survey respondents agreed with statements that the
NORC program increased their social contact, aware-ness of
278 E.A. Greenfield et al. / Journal of Aging Studies 26 (2012) 273–284
278 e.a. Greenfield et al。/Journal of Aging Studies 26(2012)273-284
refer to the structure of social relationships, including charac-
teristics such as density, homogeneity, and dispersion (House et al.,
1988). Social support, a function of social networks, is the assistance
provided by members of one's social network, including
informational support, emotional support, and tan-gible assistance
(Krause, 2001). A social convoy is comprised of friends and family
that form a protective base and can serve as resources when needed
(Fiori, Smith, & Antonucci, 2007). A social convoy has both
objective, structural charac-teristics (e.g., size, frequency of contact,
proximity) and subjective, functional characteristics (e.g., emotional
sup-port exchanged among network members (Fiori et al., 2007)).
指社会关系的结构，包括密度、同质性和分散性等特征(House
等，1988)。社会支持是社会网络的一种功能，是社会网络成员
提供的援助，包括信息支持、情感支持和有形援助(Krause，
2001)。社交车队由朋友和家人组成，他们构成了一个保护基地，
在需要时可以充当资源(Fiori，Smith，& Antonucci，2007)。社
交车队既有客观的结构特征(如大小、接触频率、接近程度) ，
也有主观的功能特征(如网络成员之间交换的情感支持)(Fiori 等，
2007)。
Research suggests that both objective and subjective as-pects of
social convoys change over time. The size and fre-quency of contact
with social network members generally decreases with age (Barnes,
Mendes de Leon, Bienias, & Evans, 2004; McPherson, Smith-Lovin,
& Brashears, 2006; Schnittker, 2007), particularly in regard to non-
kin network members (Shaw, Krause, Liang, & Bennett, 2007; van
Tilburg, 1998). In some cases, social networks can shrink to the
point that older adults become socially isolated. Social isolation
reflects an objective separation from a social net-work (e.g., living
in a rural area, living alone), which can lead to subjective feelings of
loneliness (Golden et al., 2009). Among adults age 65 and older, the
prevalence of at least occasional feelings of loneliness is between 15%
and 45% (Golden et al., 2009; Lauder, Sharkey, & Mummery, 2004;
Prince, Harwood, Blizard, Thomas, & Mann, 1997), and
approximately 50% of those age 80 and over often feel lonely
(Pinquart, 2003). Elders who have lower socioeco-nomic status,
mobility limitations, and difficulty performing activities of daily
living are more likely to report loneliness (Pinquart, 2003).
研究表明，社会车队的客观和主观方面都会随着时间的推移
而改变。与社交网络成员接触的规模和频率通常会随着年龄的
增长而减少(Barnes，Mendes de Leon，Bienias，& Evans，2004;
McPherson ， Smith-Lovin ， & Brashears ， 2006; Schnittker ，
2007) ， 特 别 是 非 亲 属 网 络 成 员 (Shaw ， Krause ， Liang ， &
Bennett，2007; van Tilburg，1998)。在某些情况下，社交网络
会缩小到老年人变得孤立的地步。社会隔离反映了与社会网络
的客观隔离(例如，生活在农村，独居) ，这会导致主观的孤独
感(Golden et al。在 65 岁及以上的成年人中，至少偶尔感到孤
独的比例在 15% 到 45% 之间(Golden et al。 ，2009; Lauder，
Sharkey ， & Mummery ， 2004; Prince ， Harwood ， lizard ，
Thomas，& Mann，1997) ，而在 80 岁及以上的人群中，大约
50% 的人经常感到孤独(Pinquart，2003)。社会经济地位低、行
动能力受限、日常生活活动困难的老年人更容易感到孤独
(Pinquart，2003)。
Both the structure and the function of an individual's so-cial
convoy impact elder health, well-being, and the ability to age in
place (Fiori et al., 2007). Social isolation, for exam-ple, has been
linked with depressive symptoms, feelings of hopelessness (Golden
et al., 2009), and an increased risk for morbidity (Tomaka,
Thompson, & Palacios, 2006) and mor-tality (Patterson & Veenstra,
2010). Older adults who are so-cially integrated rather than socially
isolated experience a reduced risk of mortality, higher self-rated
health, fewer de-pressive symptoms (Antonucci, Fuhrer, & Dartigues,
1997; Uchino, 2004) and higher expectations of aging in place (Tang
& Lee, 2011). Further, individuals with diverse social networks
comprised of both family and friends enjoy higher levels of well-
being than those with more restricted net-works made up primarily
of family or friends and individuals who are socially isolated (Fiori
et al., 2007).
个人的社会护卫队的结构和功能都会影响到老年人的健康、
幸福感以及就地老化的能力(Fiori et al。例如，社会隔离与抑郁
症状、绝望感(Golden et al。 ，2009)、发病风险增加(Tomaka，
Thompson & Palacios，2006)和死亡风险(Patterson & Veenstra，
2010)有关。社会融合而不是社会孤立的老年人，死亡风险降低，
自我评价健康水平提高，抑郁症状减少(Antonucci，Fuhrer，&
Dartigues，1997; Uchino，2004) ，对老龄化的预期提高(Tang &
Lee，2011)。此外，拥有由家庭和朋友组成的不同社会网络的
个人比那些主要由家庭或朋友以及社会孤立的个人组成的更受
限制的社会网络的个人享有更高水平的福祉(Fiori 等，2007)。
Increased access to resources and social support likely
constitutes a primary process through which having a large, diverse
social network enhances older adults' physical health and
psychosocial well-being (Antonucci & Akiyama, 1996). Older adults
who have friends and family members living nearby are more likely
to receive tangible assistance with er-rands and other activities of
daily living (Fiori, Antonucci, & Cortina, 2006), while those without
social support are at an increased risk for institutionalization when
they experience serious health problems (Gaugler, Duval, Anderson,
& Kane, 2007; Litwak & Longino, 1987; McCann et al., 2005).
Other
增加获得资源和社会支助的机会可能是一个主要进程，通过
这个进程，拥有一个庞大、多样化的社会网络可以增进老年人
的身体健康和心理社会福祉(Antonucci & Akiyama，1996 年)。
有朋友和家庭成员住在附近的老年人更有可能在办事和其他日
常生活活动方面得到切实的帮助(Fiori，Antonucci，& Cortina，
2006) ，而没有社会支持的老年人在遇到严重健康问题时，被送
进收容所的风险增加(Gaugler，Duval，Anderson ，& Kane，
2007; Litwak & Longino，1987; McCann 等，2005)。其他
 & Farney，2006)。研究表明，这些友谊可以提高生活满意度，
positive effects of social support include improved mental health, 尤其是那些独居的人(Aday 等，2006)。此外，老年中心的参与
better quality of life, and reduced mortality risk (Andrew, 2006; 与 减 少 压 力 (Farone， Fitzpatrick ， & Tran ， 2005) 和 抑 郁 症 状
Borglin, Jakobsson, Edberg, & Hallberg, 2006; Krause, 1997). Even
(Choi & McDougall，2007)有关。然而，对老年人长期影响的经
social support that does not in-volve direct assistance has a positive
验支持是有限的，因为很少有纵向评估老年人中心(Dal Santo，
impact on older adults. Emotional support, for example, is related to
a lower risk of mortality (Lyyra & Heikkinen, 2006). Perceived 2009)。此外，老年中心利用率不足的问题仍然令人关切; 老年
support has been found to be more important for well-being than re- 人参与老年中心的常见障碍包括出勤的耻辱感、对老年中心提
ceived support (Patrick, Cottrell, & Barnes, 2001). Knowing that 供什么服务的误解以及缺乏吸引人的活动(Fitzpatrick & McCabe，
others are available to offer assistance if needed may lower stress, 2008; Hostetler，2011)。针对这些担忧，老年中心内部的战略变
while actually receiving assistance may reduce feelings of self-
化已经出现在选定的地理区域，如纽约市的“创新老年中心”这
efficacy, self-reliance, and self-esteem (Fiori et al., 2007). Beyond
social support, social networks, particu-larly those that are rooted 些中心提供的活动和服务，如健身班和咖啡馆式的灵活用餐时
within informal neighborhood networks, are also likely to benefit 间，旨在特别吸引更活跃和更多样化的老年人群体(纽约市，市
older adults by fostering a sense of interdependence, sociality, 长办公室，2011 年)。
meaning, and personal expression (Cheang, 2002; Gardner, 2011).
社会支持的积极影响包括改善心理健康，提高生活质量和降低
死 亡 风 险 (Andrew ， 2006; Borglin ， Jakobsson ， Edberg ， &
Hallberg，2006; Krause，1997)。即使没有直接援助的社会支持 In contrast with the majority of formal community-based
supportive services, Villages and NORC programs facilitate various
对老年人也有积极的影响。例如，情感支持与降低死亡风险有
opportunities for participants to broaden their social networks and
关(Lyyra & Heikkinen，2006)。研究发现，感知支持对幸福感的
build social relationships. A core aspect of Vil-lages is their
重要性要高于再次获得支持(Patrick，Cottrell，& Barnes，2001)。 provision of group activities, such as interest groups, social
知道他人可以在需要的时候提供帮助可以减少压力，而实际上 gatherings, and cultural and educational pro-grams, which may help
接受帮助可以减少自我效能感、自我依赖感和自尊感(Fiori 等， to strengthen relationships among members while further enhancing
2007)。除了社会支持之外，社会网络，特别是那些植根于非正 their identification with the Village itself (Bookman, 2008;
McDonough & Davitt, 2011). Some Villages also offer group health
式社区网络的社会网络，也可能通过培养相互依赖、社会性、
promotion activi-ties, such as exercise classes and health education
意义和个人表达的感觉而使老年人受益(Cheang，2002; Gardner，
workshops, which potentially serve the dual purposes of directly
2011)。 promot-ing older adults' health in addition to providing them with
op-portunities to connect with others (McDonough & Davitt,
与 大多 数以 社区 为基础 的正 规支 助服 务不 同， village 和
Formal community-based supportive services in the U.S. rarely NORC 方案为参与者扩大其社会网络和建立社会关系提供了各
focus on fostering informal social relationships, and hence access to
种机会。Vil-lages 的一个核心方面是它们提供团体活动，如兴
diverse sources of social support, for older adults. One exception,
however, are senior centers, which typically receive financial 趣小组、社交聚会、文化和教育方案，这可能有助于加强成员
support through local government funds and the U.S. Older 之间的关系，同时进一步提高他们对村庄本身的认同(Bookman，
Americans Act (Turner, 2004). Se-nior centers address loneliness 2008; McDonough & Davitt，2011)。一些村庄还提供团体健康促
and social isolation by provid-ing opportunities for social interaction 进活动，如健身班和健康教育讲习班，这些活动除了为老年人
and the development of new friendships (Aday, Kehoe, & Farney,
提供与其他人联系的机会之外，还有可能达到直接促进老年人
2006). Research indicates that these friendships can result in
健康的双重目的(McDonough & Davitt,
improved life satisfaction, particularly among those who live alone
(Aday et al., 2006). Further, senior center participation is associated
with a decrease in stress (Farone, Fitzpatrick, & Tran, 2005) and
depressive symptoms (Choi & McDougall, 2007). Howev-er,
empirical support for the long-term impact on older adults is limited,
as there are few longitudinal evaluations of senior centers (Dal Santo,
2009). Furthermore, there is on-going concern regarding the
underutilization of senior cen-ters; common barriers to older adults'
participation in senior centers include perceived stigma of
attendance, mis-understandings around what senior centers offer,
and lack of appealing activities (Fitzpatrick & McCabe, 2008;
Hostetler, 2011). Responding to these concerns, strategic changes
within senior centers have emerged within select geographic areas,
such as New York City's “innovative senior centers." These centers
offer activities and services such as fitness classes and café-style
flexible meal times that are intended to be especially attractive to
more active and diverse subgroups of older adults (City of New
York, Office of the Mayor, 2011).
在美国，正式的社区支持服务很少注重培养非正式的社会关
系，从而为老年人提供多种来源的社会支持。然而，一个例外
是老年中心，它们通常通过地方政府基金和美国老年美国人法
案(Turner，2004)获得财政支持。老年中心通过提供社会互动和
发展新友谊的机会来解决孤独和社会隔离问题(Aday，Kehoe，
 E.A. Greenfield et al. / Journal of Aging Studies 26
(2012) 273–284
E.a. Greenfield 等人/老龄化研究杂志 26(2012)273-
284 279

2011). Villages also typically offer opportunities for social inter-
action through participation in governance councils, commit-tees,
and other group structures developed to oversee program operation
and implementation. Finally, many Villages encourage and support
members' volunteering to support other members (McDonough &
Davitt, 2011). All of these activ-ities have the potential to enhance
social networks and reduce isolation.
2011 年)。村庄通常还通过参与治理委员会、委员会和其他监督
方案运作和实施的团体结构，提供社会互动的机会。最后，许
多村庄鼓励和支持成员志愿支持其他成员(McDonough & Davitt，
2011)。所有这些活动都有增强社会网络和减少孤立的潜力。
Similar to Villages, social relationship building activities are a
major component of the NORC program model. Examples of group
activities include current events groups, men's groups, language
classes, and resident councils (Vladeck, 2004). A statewide study of
NORC programs in New Jersey indicated that many NORC
programs also incorporate evidence-based health promotion and
chronic care self-management pro-grams, in addition to more
general health education workshops and physical activity groups
(Greenfield, 2011). Similar to Vil-lages, NORC programs also
engage in activities to facilitate older adults' exchanges of peer
support. For example, a case study of a NORC program in the
Northeast highlighted its “neighbors helping neighbors” component
through which older adults volunteer to help each other with daily
living tasks, such as shopping and transportation to medical appoint-
ments (Bookman, 2008). Furthermore, qualitative interviews with
staff and residents of a NORC program in New York highlighted
how the program's broader community events, such as book clubs
and card games, provided occasions for more informal exchanges of
support among older adults (Bronstein et al., 2011). At this time,
there are no empirical data to explicitly compare and contrast NORC
programs and Villages in terms of this category of services and
activities.
与村庄类似，社会关系建设活动是 NORC 项目模型的主要
组成部分。团体活动的例子包括时事团体，男性团体，语言班
和居民委员会(Vladeck，2004)。对新泽西州 NORC 方案的一项
全州性研究表明，除了更普遍的健康教育讲习班和体育活动小
组外，NORC 的许多方案还包括循证健康促进和慢性护理自我
管理方案(Greenfield，2011 年)。与 Vil-lages 类似，NORC 计划
也参与促进老年人交流同伴支持的活动。例如，一个案例研究
NORC 项目在东北部强调其“邻里互助”的组成部分，通过老年
人志愿帮助彼此的日常生活任务，如购物和运输到医疗预约
(Bookman，2008 年)。此外，对纽约 NORC 方案的工作人员和
居民进行的定性访谈突出表明，该方案的更广泛的社区活动，
如读书俱乐部和纸牌游戏，为老年人之间更多的非正式交流支
持提供了机会(Bronstein 等，2011)。目前，没有经验数据来明
确比较和对比 NORC 项目和村庄在这类服务和活动方面的情况。
well-being, and aging in place. Studies have found that timely use of
home- and community-based services is associated with more
desirable outcomes among older adults and caregivers alike,
including lower levels of nursing home utilization (Chen &
Thompson, 2010; Dale & Brown, 2006; Jette, Tennstedt, &
Crawford, 1995; Tomita, Yoshimura, & Ikegami, 2010). Moreover,
previous studies have found that older adults who report greater
knowledge of community services anticipate being able to age in
place longer than older adults who report less knowledge (Tang
先前的研究表明，增加获得协调的、以社区为基础的支持服
务的机会可以促进老年人的健康、福祉和就地老龄化。研究发
现，及时使用家庭和社区服务与老年人和照顾者更理想的结果
相关，包括养老院利用率较低(Chen & Thompson，2010; Dale &
Brown，2006; Jette，Tennstedt，& Crawford，1995; Tomita，
Yoshimura，& Ikegami，2010)。此外，以往的研究发现，报告
对社区服务知识了解较多的老年人比报告知识较少的老年人预
期能够在原地安老更长时间(Tang)
& Pickard, 2008). There is a growing body of evidence for the
utility of deliberate efforts to coordinate health and sup-portive
services for older adults, thus preventing deteriora-tion in health and
functional status (Peikes, Chen, Schore, & Brown, 2009). Also,
studies have found that older adults are more likely to report having
their needs met and being satis-fied with care when they can
exercise choice regarding the types of services they receive and from
whom (Brown et al., 2007).
Pickard，2008).越来越多的证据表明，有意识地努力协调老年
人的健康和支持服务，从而防止健康和功能状态的恶化(Peikes，
Chen，Schore，& Brown，2009)。此外，研究发现，老年人更
有可能报告说，他们的需要得到了满足，并对照顾感到满意，
因为他们可以选择他们接受的服务类型和从谁那里得到的服务
(Brown 等人，2007)。
Aspects of service delivery systems and other social insti-tutions
in the U.S. create barriers that limit the ease by which community-
residing older adults can access long-term ser-vices and supports. In
the U.S., the majority of long-term ser-vices and supports is
provided in-kind by family, friends and
在美国，服务提供系统和其他社会机构的某些方面造成了障
碍，限制了居住在社区的老年人获得长期服务和支持的便利性。
在美国，大多数长期服务和支持是由家人、朋友和

Services to enhance participants' access to resources

提供服务以增加参加者获取资源的机会

Previous research indicates that enhancing access to coor-dinated,

community-based support services can promote older adults' health,
neighbors, and is valued at more than $375 billion a year (Houser & In addition, community-based support services are in many ways
Gibson, 2008). Given the historical lack of support for family fragmented, inefficient, difficult to access, and unresponsive to
caregivers in the U.S. (Elmore & Talley, 2009), neg-ative physical, individuals' changing needs and preferences over time (MetLife
psychological, and financial effects of caregiv-ing can undermine Mature Market Institute, 2010). Because home- and community-
family caregivers' long-term ability to assist older adult care based services in the U.S. are largely organized at the local level, are
recipients to continue to age in place (Gaugler, Kane, Kane, Clay, & funded by diverse sources (e.g., federal funds, state funds, county
Newcomer, 2003; Jette et al., 1995). Further, demographic changes, funds, municipal funds, user fees, philanthropic grants), are
including rising female participation in the workforce, increased delivered across a variety of settings and by a variety of service
longevity, and lower fertility rates, have reduced the ability of professionals (e.g., community-based nonprofit service providers,
informal care-givers to meet older adults' needs now and for the public social service agencies, acute care hospitals, home health
future (Spillman & Pezzin, 2000; Szinovacz & Davey, 2008). agencies) and have inconsistent eligibility criteria (e.g., by fi-nancial
它的价值每年超过 3750 亿美元(Houser & Gibson，2008)。鉴于 or medical need), locating, navigating, and managing potential
美国历史上缺乏对家庭照料者的支持(Elmore & Talley，2009) ， sources for formal support can be challenging even for those older
adults who have sufficient financial resources to pay for services.
照料的负面生理、心理和经济影响可能会削弱家庭照料者帮助
此外，以社区为基础的支持服务在许多方面支离破碎、效率
老年成人照料者继续就地老化的长期能力(Gaugler， Kane，
低下、难以获得，而且对个人不断变化的需求和偏好反应迟钝
Kane，Clay，& Newcomer，2003; jetet al。 ，1995)。此外，人
(MetLife Mature Market Institute，2010)。由于美国以家庭和社
口结构的变化，包括女性参与劳动力增加、寿命延长和生育率
区为基础的服务主要是在地方一级组织的，资金来源多种多样
降低，降低了非正式护理人员满足老年人现在和未来需求的能
(如联邦基金、州基金、县基金、市政基金、用户费用、慈善赠
力(Spillman & Pezzin，2000; Szinovacz & Davey，2008)。
款) ，通过各种环境和各种服务专业人员(如社区非营利服务提
供者、公共社会服务机构、急诊医院、家庭保健机构)提供，资
Formal systems of long term services and support in the U.S.
historically have been underfunded and inconsistently implemented, 格标准不一致(如财政或医疗需要) ，即使对于那些有足够财政
resulting in gaps in the overall system's ability to support older 资源支付服务费用的老年人来说，寻找、导航和管理正式支助
adults and caregivers in their homes or com-munities. The two major 的潜在来源也是一项挑战。
government health insurance pro-grams in the U.S., Medicare and
Medicaid, historically have focused on acute conditions and
institutional care, respec-tively (MetLife Mature Market Institute, Compounding these trends, the physical infrastructure
2010). Medicare ac-counts for only 20% of all long-term care characterizing many communities prevents persons with dis-abilities
spending through its coverage of home health and short-term nursing from accessing needed resources. First, much exist-ing housing
and re-habilitation facility care (Komisar & Thompson, 2007). Like- lacks accessibility features for those with mobility challenges, such
wise, Medicaid has begun only recently to shift its emphasis from as ramps, accessible bathrooms, wide doorways, and low
nursing home care to in-home care to meet the long-term needs of countertops (National Council on Disability, 2010; Pynoos, Nishita,
low-income, chronically ill older adults (Feder, Komisar, & Niefeld, Cicero, & Caraviello, 2008). Also, many communities suffer from a
2000; Shirk, 2006). Finally, ser-vices supported by the Older lack of or poorly
Americans Act–a federal policy that underlies many social services 综合这些趋势，许多社区的物质基础设施阻止身心障碍者获
for older adults–are con-strained by inadequate funding and are not
得所需的资源。首先，许多现有的住房缺乏无障碍特征，如坡
consistently available across communities (O'Shaughnessy, 2008).
Access to home- and community-based services remains especially 道、无障碍浴室、宽门道和低台面(国家残疾人委员会，2010 年;
challenging for a growing population of middle-income and near- Pynoos，Nishita，Cicero，& Caraviello，2008 年)。此外，许多
poor elders who typically do not qualify for government-funded 社区遭受缺乏或贫困
services, yet for whom the costs of sup-portive services render them
economically vulnerable (Sanders, Mutchler, Kuriansky, &
McMahon, 2008).
美国正式的长期服务和支持系统历来资金不足，执行不一致，
导致整个系统在支持老年人和照顾者在家庭或社区的能力方面
存在差距。美国两个主要的政府医疗保险项目，医疗保险和医
疗补助，历来分别侧重于急性病和机构护理(MetLife 成熟市场
研究所，2010 年)。通过覆盖家庭健康和短期护理及康复设施护
理，医疗保险账户仅占所有长期护理支出的 20% (Komisar &
Thompson，2007)。同样明智的是，医疗补助最近才开始将重点
从养老院护理转移到家庭护理，以满足低收入、慢性病老年人
的长期需求(Feder，Komisar，& Niefeld，2000; Shirk，2006)。
最后，《老年美国人法案》——一项为老年人提供许多社会服
务的联邦政策——所支持的服务受到资金不足的限制，而且在
各个社区并非始终如一(o’shaughnessy，2008)。对于越来越多的
中等收入和接近贫困的老年人来说，获得家庭和社区服务仍然
特别具有挑战性，他们通常没有资格获得政府资助的服务，但
支助服务的费用使他们在经济上处于弱势(Sanders，Mutchler，
Kuriansky，& McMahon，2008)。
280 E.A. Greenfield et al. / Journal of Aging Studies 26 (2012) 273–284
280 e.a. Greenfield et al。/Journal of Aging Studies 26(2012)273-284
宣传。总的来说，重点是促进各项服务，以防止由于缺乏获得
maintained sidewalks, inaccessible traffic patterns and per-ceived 基本资源的途径而可能导致的退化，例如为防止跌倒而进行的
safety issues, which further reduce mobility for people with 房屋改造。
functional limitations. Communities seldom are equipped to address
the transportation needs of those with physical challenges,
particularly in suburban and rural areas where transit systems are
often not extensive enough to allow for easy accessibility (Sullivan- Similarly, program leaders have identified helping older adults
Marx et al., 2009). Fur-thermore, with state and local budget cuts access a range of supports that span across social ser-vice and
increasing throughout the country, underfunded but high-demand healthcare delivery systems and that can meet older adults' diverse
paratransit services are likely to experience continued chal-lenges in and dynamic needs as a central element of the NORC program
providing services (Kausch, 2004). model (Vladeck, 2004). Utilization data from NORC programs in
保持人行道，无法进入的交通模式和每个认为的安全问题，这 New York indicate that they typically provide social services, such
进一步降低了功能受限的人的流动性。社区很少有能力满足那 as information and referral and case management, in addition to
些面临实际挑战的人的交通需求，特别是在郊区和农村地区， healthcare services, such as health management, care coordination,
因为这些地区的交通系统往往不够广泛，无法方便出入 and health promo-tion (MacLaren, Landsberg, & Schwartz, 2007).
Fitting with this range of services, most NORC programs in New
(Sullivan-Marx et al。此外，随着国家和地方预算削减在全国范
York have on staff both social workers and nurses (Vladeck, 2004).
围内不断增加，资金不足但需求旺盛的辅助运输服务可能在提
NORC programs are designed to create new services when possible
供服务方面继续面临挑战(Kausch，2004 年)。 and as necessary and to offer ancillary services (such as home
modifications) that respond to unmet service needs within particular
NORC programs and Villages aim to address community-level communities. Nevertheless, the model places greater emphasis on
challenges, including the limitations of existing home-and engaging in activities that serve to coordinate and increase access to
community-based service delivery systems, by facilitat-ing existing services (Vladeck, 2004). Community outreach, linkage and
participants' access to a range of resources to prevent poor health brokerage, partnership building among diverse service providers, and
and functional decline. These services include di-rect service case advocacy have been identified as central activities within
provision by paid staff and informal and formal volunteers, as well NORC programs (Ivery & Akstein-Kahan, 2010).
as information, referral, brokerage, and linkage to outside services. 同样，方案领导人已经确定，帮助老年人获得一系列支持，
Our understanding of Villages in this sense is derived from initial 这些支持跨越社会服务和医疗保健提供系统，并且能够满足老
descriptive reports generat-ed by both practitioners and researchers
年人的多样化和动态需求，这是 NORC 方案模式的一个核心要
(Bookman, 2008; McDonough & Davitt, 2011; Scharlach et al., in
press). Al-though there are variations among Villages, typically 素(Vladeck，2004 年)。来自 NORC 在纽约的项目的利用数据表
Village members receive access to direct services (e.g., grocery 明，他们通常提供社会服务，如信息和转诊和病例管理，以及
shop-ping, transportation), which are provided by program staff 保 健 服 务 ， 如 健 康 管 理 ， 护 理 协 调 和 健 康 促 进 (MacLaren ，
and/or volunteers and are designed to be flexible in response to Landsberg，& Schwartz，2007)。与这一系列服务相适应，纽约
members' needs (Bookman, 2008). Villages might also designate
的大多数 NORC 项目都有社会工作者和护士(Vladeck，2004)。
people within their organization to help members access outside
NORC 方案旨在在可能和必要的情况下创建新的服务，并提供
service providers (e.g., home repair agencies), which are vetted and
frequently discounted (McDonough & Davitt, 2011). Depending on 辅助服务(如家庭装修) ，以满足特定社区内未满足的服务需求。
organizational capacity and members' needs, assistance with 尽管如此，该模式更加强调参与活动，服务于协调和增加对现
accessing services varies on a continuum from providing one-time 有服务的访问(Vladeck，2004)。社区外联、联系和经纪、不同
information and referral to engaging in intensive case management, 服务提供者之间的伙伴关 系建设以及案例宣传已被确定为
coordi-nation of services, and advocacy with external providers.
NORC 方案的核心活动(Ivery & Akstein-Kahan，2010)。
Overall, the focus is on facilitating services to prevent dete-rioration
that might result from the lack of access to essen-tial resources, such
as home modifications to help prevent falls.
NORC 方案和 Villages 旨在解决社区一级的挑战，包括现有
家庭和社区服务提供系统的局限性，方法是促进参与者获得一
系列资源，以防止健康状况不佳和功能衰退。这些服务包括有
偿工作人员和非正式和正式志愿人员提供的直接服务，以及信
息、转介、经纪和与外部服务的联系。从这个意义上说，我们
对村庄的理解来源于从业者和研究人员最初的描述性报告
(Bookman，2008; McDonough & Davitt，2011; Scharlach et al。
尽管各个村庄之间存在差异，但通常情况下，村庄成员可以获
得由方案工作人员和/或志愿者提供的直接服务(例如购物、交
通) ，这些服务旨在灵活应对成员的需求(Bookman，2008)。村
庄也可以在其组织内指定人员，帮助成员接触外部服务提供商
(例如，家庭维修机构) ，这些服务提供商经过审查并经常打折
(McDonough & Davitt，2011)。根据组织能力和成员的需要，在
获得服务方面提供的援助各不相同，从提供一次性信息和转诊
到参与密集的案件管理、服务的国家协调以及与外部提供者的

A national study of 26 NORC programs and 35 Villages found
that NORC programs and Villages are equally likely to identify
service provision as a focal part of their programs. However, they
differ somewhat in how they do so. Whereas NORC programs are
more likely than Villages to emphasize community education and
inter-organizational collaboration as part of their service delivery
efforts, Villages are more like-ly than NORC programs to involve
older adults themselves as providers of services or support (Lehning
et al., in press). This difference reflects that NORC programs are
typically led by a formal service provider that aims to partner with
other pro-viders, stakeholders, and older adults, whereas Villages
are more typically grassroots organizations that develop outside of
the existing service delivery system and that are led by and for older
adults themselves.
一项针对 26 个 NORC 项目和 35 个村庄的全国性研究发现，
NORC 项目和村庄同样有可能将提供服务确定为其项目的重点
部分。然而，他们在如何做到这一点上有所不同。与 Villages
相比，NORC 方案更有可能强调社区教育和组织间合作，将其
作为提供服务工作的一部分，而 Villages 更有可能比 NORC 方
案让老年人自己作为服务或支持的提供者参与(Lehning et al。这
种差异反映出，NORC 方案通常由一个正式的服务提供者领导，
旨在与其他提供者、利益相关者和老年人合作，而 village 则更
典型地是在现有服务提供系统之外发展起来的基层组织，由老
年人自己领导并为老年人服务。
In summary, previous research indicates three categories of
services and activities that NORC program and Village models
emphasize: (a) civic engagement and empowerment activities, (b)
social relationship building activities, and (c) services to enhance
participants' access to resources. The above-reviewed research
indicates ways in which these ser-vices and activities address
existing limitations within tradi-tional service delivery systems, as
well as the significance of these services and activities for older
adults' physical health and psychosocial well-being.
总之，以往的研究表明，NORC 方案和 Village 模式强调三
类服务和活动: (a)公民参与和赋权活动; (b)社会关系建设活动;
(c)增加参与者获得资源的机会的服务。上述审查的研究表明，
这些服务和活动如何解决传统服务提供系统中存在的局限性，
以及这些服务和活动对老年人身体健康和心理社会福祉的重要
性。
have focused on a small number of programs in specific
metropolitan areas and have not exam-ined implementation and
outcomes across diverse sites (e.g., Bookman, 2008; Guengerich,
2009). Using this conceptual framework as a guide, we propose five
critical directions to sys-tematically advance research that will
inform theory, policy and practice on the NORC program and
Village models.
本文提出的概念框架旨在推进 NORC 计划和 Village 模型的
理论指导研究。该框架开始解决模型的相似性和差异性，以及
它们的优势、局限性和挑战，以促进老年人的健康、幸福、适
当的老龄化和最佳的成年人发展。我们预计，未来 NORC 项目
和村庄的实证研究将对这一概念框架提出修改意见。推进这项
研究是特别重要的，因为总体上缺乏严格的，多站点的研究或
其他村庄或 NORC 计划。迄今为止，大多数关于 NORC 方案的
研究集中在开发和描述整个方案模型(例如 Vladeck，2006 年) ，
并确定在特定社区内实施该模型的问题(例如 Ivery & Akstein-
Kahan，2010 年)。同样，对 village 的大多数探索都集中在特定
大都市地区的少数项目上，而没有考察不同地点的实施情况和
结果(例如 Bookman，2008; Guengerich，2009)。利用这个概念
框架作为指导，我们提出了五个关键方向，系统地推进研究，
这将为 NORC 计划和 Village 模型的理论、政策和实践提供信息。
1. How are the models actually implemented “on the ground”? With
the exception of preliminary findings from a national study of 26
NORC programs and 35 Villages (Lehning et al., in press), there
has been scant national research that ex-amines the specific
activities and services offered by di-verse sites nationally as they
implement the models in practice. This is an important gap to
address given that there is likely significant variation from
NORC program
这些模型实际上是如何“在实地”实现的？除了对 26 个 NORC 方
案 和 35 个 村 庄 进 行 的 全 国 性 研 究 的 初 步 调 查 结 果 之 外
(Lehning et al。 ，in press) ，很少有全国性的研究调查各种
不同地点在全国范围内实施模式时提供的具体活动和服务。
鉴于 NORC 计划可能存在重大差异，这是一个需要解决的重
要差距

Critical directions for research on community initiatives and aging

in place
社区倡议和就地老龄化研究的关键方向

The conceptual framework developed in this paper is pro-posed

with the intention to advance theoretically-guided re-search on the
NORC program and Village models. The framework begins to
address such issues as the models' sim-ilarities and differences, as
well as their strengths, limitations, and challenges for promoting
older adults' health, well-being, aging in place, and optimal adult
development. It is our ex-pectation that future empirical research on
NORC programs and Villages will suggest modifications to this
conceptual framework. Advancing this research is especially
important given the overall dearth of rigorous, multi-site research on
ei-ther Villages or NORC programs. To date, most research on
NORC programs has focused on developing and describing the
overall program model (e.g., Vladeck, 2006) and identify-ing issues
in implementing the model within specific com-munities (e.g., Ivery
& Akstein-Kahan, 2010). Similarly, most explorations of Villages
 E.A. Greenfield et al. / Journal of Aging Studies 26
(2012) 273–284
E.a. Greenfield 等人/老龄化研究杂志 26(2012)273-
284 281

to NORC program, as well as from Village to Village. In-depth,
multi-site research regarding NORC programs' and Villages'
specific activities also would be useful to advance fuller
understanding of how the NORC program and Vil-lage models
are similar and different from each other.
NORC 计划，以及从一个村庄到另一个村庄。对 NORC 方案
和村庄的具体活动进行深入、多点的研究，也将有助于促进
更充分地理解 NORC 方案和 Vil-lage 模型如何相似和彼此不
同。
2. To what extent do NORC programs and Villages achieve im-
portant initial, intermediate, and long-term outcomes and goals?
Despite the rapid expansion of and enthusiasm for NORC
programs and Villages over the past decade, there have been no
national, longitudinal studies of the impact of participation in
NORC programs and Villages over time. Moreover, not all
NORC program and Village sites are likely to offer the full range
of evidence-based compo-nents that have been shown to
contribute to the effective-ness of care coordination efforts, such
as regular contact between providers and clients, interdisciplinary
collabora-tion, and targeting services to older adults at particular
risk for adverse health outcomes (Peikes et al., 2009). Lack of
rigorous evidence regarding outcomes raises ques-tions among
policymakers, providers, and consumers alike whether investing
in NORC programs and Villages to pro-mote aging in place is a
sound use of resources. Our con-ceptual framework indicates the
importance of assessing initial outcomes (e.g., reduced social
isolation), intermedi-ate outcomes (e.g., improved physical
health), and the long-term goal of aging in place, as well as
linkages among these constructs.
NORC 计划和村庄在多大程度上实现了重要的初始，中期和长
期成果和目标？尽管 NORC 项目和村庄在过去的十年中迅速
扩展并且充满热情，但是还没有一个全国性的纵向研究关于
参与 NORC 项目和村庄随着时间的推移而产生的影响。此外，
并非所有 NORC 方案和 Village 网站都可能提供已被证明有
助于护理协调工作有效性的全部循证内容，例如提供者和客
户之间的定期接触、跨学科合作以及针对具有不良健康后果
特别风险的老年人的服务(Peikes 等，2009)。由于缺乏有关
结果的严格证据，政策制定者、供应商和消费者都提出了一
个问题，即投资于 NORC 项目和村庄以促进老龄化是否合理
使用资源。我们的概念框架表明了评估初始结果(例如，减少
社会隔离)、中间结果(例如，改善身体健康)的重要性，以及
就地老化的长期目标，以及这些结构之间的联系。
that potentially influence the effectiveness and sustainability of
NORC pro-grams and Villages. Additional scholarly
development in this area would benefit from ongoing attention to
similar-ities, as well as differences, between the NORC program
and Village models. For example, because NORC programs are
more typically developed as programs within lead agencies in
comparison to Villages, NORC programs theo-retically can draw
on the existing resources of the lead agency (e.g., staff expertise,
formal rules and procedures, and office space) in ways that
freestanding organiza-tions–such as many Villages–cannot do.
Similarly, because NORC programs are typically developed in
areas where a large enclave of older adults lives, it is possible
that NORC programs can leverage resources more efficiently
(see Golant, 2008, for a discussion), especially if offered in
“vertical” multi-unit buildings as opposed to “horizon-tal”
neighborhoods (see Bronstein & Kenaley, 2010, for a discussion).
In another example, Villages are largely funded by membership
fees and donations, generally sources of unrestricted revenue,
which may enable Vil-lages to be more flexible in their response
to members' expressed needs (Scharlach et al., in press). This
compo-nent could impact sustainability if members feel their
什么内部和外部资源有助于 NORC 项目和村庄的有效性和可持
续性？尽管不是本文的重点(由于空间限制) ，我们的概念框
架确定资源作为过程的起点，通过 NORC 方案和 Village 模
型可能实现其促进适当老龄化的长期目标。因此，有必要进
一步发展理论，以指导对内部资源(例如工作人员和志愿人员)
和外部资源(例如部分侧重于老龄化的地方基金会)进行实证
研究，这些资源可能影响 NORC 方案和村庄的有效性和可持
续性。这一领域的额外学术发展将受益于对 NORC 项目和
Village 模 型之间相似性和差异 性的持续关注。例如，与
village 相比，NORC 方案通常是作为牵头机构内部的方案开
发的，因此 NORC 方案在理论上可以利用牵头机构的现有资
源(例如，工作人员专业知识、正式规则和程序以及办公空
间) ，而独立组织(例如许多 village)无法做到这一点。同样，
由于 NORC 项目通常是在老年人聚居的地区开发的，因此
NORC 项目有可能更有效地利用资源(参见 Golant，2008 年
的讨论) ，特别是在“垂直”多单元建筑而不是“水平”社区(参
见 Bronstein & Kenaley，2010 年的讨论)。在另一个例子中，
village 的资金主要来自会员费和捐赠，通常是不受限制的收
入来源，这可能使 Vil-lages 能够更灵活地回应成员表达的需
求(Scharlach et al。这个组成部分可以影响可持续性，如果成
员感到他们的

3. What internal and external resources contribute to NORC

programs' and Villages' effectiveness and sustainability? Al-
though not a focus of this manuscript (due to space con-straints),
our conceptual framework identifies resources as the starting
point for the processes through which the NORC program and
Village models potentially achieve their long-term goal of
promoting aging in place. Accord-ingly, additional theory
development is necessary to guide empirical research on the
internal resources (e.g., staff and volunteers) and external
resources (e.g., local foundations that focus, in part, on aging)
 specific needs are more readily addressed via the Village. We
therefore recommend research to identify the re-sources
necessary not only for implementing primary ac-tivities and 5. To what extent are Villages and NORC programs cost-effective
services, but also for maintaining them and achieving Villages' for participants as well as other stakeholders? Em-pirical
and NORC programs' intended out-comes over time. evidence is needed to examine the extent to which the NORC
特定需求更容易通过村庄得到满足。因此，我们建议进行研 program and Village models are “good investments,” particularly
in light of evidence that some Villages and NORC programs have
究，以确定不仅用于实施初级活动和服务，而且用于维持这
closed altogether be-cause of insufficient resources to maintain
些活动和实现村庄和 NORC 方案随着时间的推移预期成果所
operations (e.g., Bronstein & Kenaley, 2010). At the individual
需的资源。 level, research is needed regarding whether the economic and
social value of services received (e.g., the retail cost of sim-ilar
4. Are NORC programs and Villages effective at meeting the needs services) exceeds participant fees and other out-of-pocket
of the diverse range of older adults who might benefit as expenditures. At the societal level, research is needed regarding
participants? In addition to examining the programmat-ic and whether reductions in public expendi-tures for expensive services
community contexts that promote NORC programs and Villages' (e.g., emergency rooms, acute hospitalizations, nursing homes)
effectiveness, it is also important to identify whether they are associated with participation in NORC programs and Villages
especially effective or ineffective for par-ticular subgroups of exceed finan-cial inputs from external sources (e.g., federal and
older adults. For example, concerns have been raised regarding state governments, local communities, private foundations).
replicating the fee structure for Villages in lower-income Research on input mix efficiency also is needed in order to assess
communities where it may be difficult for older adults to afford what is the right mix of public–private support and to enhance
the full membership fee (Bookman, 2008; McDonough & Davitt, flexibility and responsiveness while not devolving all long-term
2011). Others have questioned whether the Village model itself care to the community level (Ormond et al., 2004).
might be predicated on individualistic sociocultural expectations 村庄和 NORC 项目在多大程度上对参与者和其他利益相关者具
that might not be responsive to the needs of groups with stronger 有成本效益？需要有经验证据来检验 NORC 方案和 Village
familism values (e.g., Scharlach et al., in press). Moreover,
模式在多大程度上是”好的投资”，特别是鉴于有证据表明，
models that are based on active consumer en-gagement might
pose a challenge for older adults with physical or mental health 由于维持运营的资源不足，一些 Village 和 NORC 方案已经
limitations, who might also po-tentially have the most to gain 完全关闭(例如 Bronstein & Kenaley，2010)。在个人层面，
from participation. A recent national survey of Villages reported 需要研究所收到的服务的经济和社会价值(例如，类似服务的
that members tend to have fewer assistance needs compared to 零售成本)是否超过参与者费用和其他自付费用。在社会一级，
the general U.S. older adult population (Scharlach et al., in press); 需要进行研究，以确定与参与北朝鲜和北朝鲜方案和村庄有
in con-trast, data from NORC program participants in New York
关的昂贵服务(如急诊室、急性住院、养老院)的公共开支减
in-dicated that participants were slightly more likely to rate their
health as fair or poor in contrast to the older adult pop-ulation in 少是否超过外部来源(如联邦和州政府、地方社区、私人基金
the U.S. as a whole (Vladeck, Segel, Oberlink, Gursen, & Rudin, 会)的财政投入。还需要对投入组合效率进行研究，以评估公
2010). Additional research is needed re-garding the ability of 私支助的正确组合，并提高灵活性和反应能力，同时不将所
NORC programs and Villages to ad-dress challenges to wider 有长期护理下放到社区一级(Ormond 等，2004 年)。
implementation and inclusion (Bookman, 2008) and to continue
to support aging in place over time as their own members become
frail or disabled.
NORC 方案和村庄是否有效地满足了可能作为参与者受益的各
种老年人的需求？除了审查促进 NORC 方案和村庄有效性的
方案背景和社区背景之外，还必须确定这些方案对特定老年
人群体是特别有效还是无效。例如，有人对在低收入社区复
制村庄的收费结构表示关切，因为在这些社区，老年人可能
难以支付全额会员费(Bookman，2008; McDonough & Davitt，
2011)。其他人则质疑村庄模式本身是否可以建立在个人主义
的社会文化期望之上，而这种期望可能无法满足具有较强家
庭主义价值观的群体的需求(例如，Scharlach 等人在新闻界)。
此外，基于积极消费者参与的模式可能对身心健康有限的老
年人构成挑战，他们也可能从参与中获益最多。最近一项针
对村庄的全国性调查报告显示，与美国一般老年人口相比，
村民的援助需求往往较少(Scharlach 等人在新闻中) ; 相比之
下，来自纽约 NORC 项目参与者的数据表明，与整个美国的
老年人口相比，参与者更有可能将自己的健康状况评为一般
或差(Vladeck，Segel，Oberlink，Gursen，& Rudin，2010)。
需要进一步研究 NORC 方案和村庄是否有能力应对更广泛实
施和包容方面的挑战(Bookman，2008 年) ，并随着自己的成
员变得虚弱或残疾，继续支持老龄化。
282 E.A. Greenfield et al. / Journal of Aging Studies 26 (2012) 273–284
282 e.a. Greenfield et al。/Journal of Aging Studies 26(2012)273-284
Antonucci，T.c. ，Fuhrer，r。 & Dartigues，j。(1997)。社会关系和减压症状在
社区居住的法国老年人样本。心理学和衰老，12,189-195。
Thus, the conceptual framework developed in this paper
Barnes, L. L., Mendes de Leon, C. F., Bienias, J. L., & Evans, D. A. (2004). A
suggests several primary areas for future theoretically guided longitudinal study of black–white differences in social resources. The Journals
research. Examining these areas is critically important for informing of Gerontology: Psychological Sciences and Social Sciences, 59B(3), S146–
the efforts of diverse stakeholders who are inter-ested in promoting S153.
巴恩斯，L.l. ，门德斯德莱昂，C.f. ，Bienias，J.l. ，& 埃文斯，D.a. (2004)。
aging in place in community. Such stake-holders include consumers
社会资源中黑白差异的追踪研究。老年学杂志: 心理科学和社会科学，59B
who seek effective strategies for aging in their own homes and (3) ，S146-S153。
communities; policymakers who aim to support innovative programs Bedney, B. J., Goldberg, R. B., & Josephson, K. (2010). Aging in place in natu-rally
to promote the health and well-being of older adults in a cost- occurring retirement communities: Transforming aging through supportive
effective man-ner; and funders who are committed to supporting service programs. Journal of Housing for the Elderly, 24, 304–321.
Bedney，B.j。 ，Goldberg，R.b。 ，& Josephson，k。(2010)。老龄化在自然
meaning-ful improvements in community-based supports for older
集会发生的退休社区: 通过支持性服务项目改变老龄化。老年人住房杂志，
persons. The development and articulation of this conceptual
24,304-321。
framework is a step toward advancing this emerging and essential
research agenda. Bedney, B., Schimmel, D., Goldberg, R., Kotler-Berkowitz, L., & Bursztyn, D.
因此，本文开发的概念框架提出了未来理论指导研究的几个 (2007). Exploring the impact of NORC-SSPs on participants: The NORCs
national evaluation initiative. Retrieved from. http://www.
主要领域。审查这些领域对于告知对促进社区老龄化感兴趣的 norcs.com/local_includes/downloads/19711.pdf
贝德尼 ·b ·希梅尔 ·d ·戈德堡 ·r ·科特勒-伯科维茨 ·l ·& Bursztyn ·d ·(2007)。
各种利益攸关方的努力至关重要。这些利益攸关方包括: 在自己
探索 NORC-SSPs 对参与者的影响: NORCs 国家评估倡议。检索自。
家中和社区寻求有效老龄化战略的消费者; 旨在支持以具有成本 Http://www.Norcs. com/local _ includes/downloads/19711.图片来源:
效益的男性方式促进老年人健康和福祉的创新方案的决策者; 以 Bookman, A. (2008). Innovative models of aging in place: Transforming our
communities for an aging population. Community, Work, & Family, 11, 419–
及致力于支持切实改进以社区为基础的老年人支助的供资者。 438.
这个概念框架的发展和阐述是推进这个新兴和重要的研究议程 Bookman，a. (2008).老龄化的创新模式: 为老龄化人口改造我们的社区。社区，
工作和家庭，11,419-438。
的一个步骤。
Borglin, G., Jakobsson, U., Edberg, A., & Hallberg, I. (2006). Older people in
Sweden with various degrees of present quality of life: Their health, social
support, everyday activities and sense of coherence. Health and Social Care in
the Community, 14, 136–146.
References 鲍格林，g。雅各布森，u。埃德伯格，a。和霍尔伯格，i。(2006)。瑞典老年
参考文献 人目前的生活质量有不同程度: 他们的健康、社会支持、日常活动和一致
性。社区中的健康和社会护理，14,136-146。
Aday, R. H., Kehoe, G. C., & Farney, L. A. (2006). Impact of senior center Bronstein, L., Gellis, Z. D., & Kenaley, B. L. (2011). A neighborhood naturally
friendships on aging women who live alone. Journal of Women & Aging, 18, occurring retirement community: Views from providers and residents. Journal
57–73. of Applied Gerontology, 30(1), 104–112.
Aday，R.h. ，Kehoe，G.c. ，& Farney，L.a。(2006)。老年中心友谊对独居老 Bronstein，l。 ，Gellis，Z.d。 & Kenaley，b. l. (2011)。一个自然形成的社区
年女性的影响。Journal of Women & Aging，18,57-73 妇女与老龄化杂志， 退休社区: 来自供应商和居民的意见。应用老年学杂志，30(1) ，104-112。
18,57-73。 Bronstein, L., & Kenaley, B. (2010). Learning from vertical NORCs: Challenges and
recommendations for horizontal NORCs. Journal of Housing for the Elderly, 24,
Adler, J. (2009 January 4). Sometimes it takes a Village to age safely at home.
237–248.
Chicago Tribune Retrieved from. www.chicagotribune.com
Bronstein，l. & Kenaley，b. (2010).向垂直北欧人学习: 对水平北欧人的挑战和
(2009 年 1 月 4 日)《芝加哥论坛报》(Chicago Tribune)
建议。老年人住房杂志，24,237-248。
Agree, E. M., & Freedman, V. A. (2000). Incorporating assistive devices into
community-based long-term care: An analysis of the potential for sub-stitution Brown, R., Carlson, B. L., Dale, S., Foster, L., Phillips, B., & Schore, J. (2007).
and supplementation. Journal of Aging and Health, 12(3), 426–450. Cash and counseling: Improving the lives of Medicaid beneficiaries who need
personal care or home- and community-based services. Princeton, NJ:
同意，E.m。 & Freedman，v. a。(2000)。将辅助设备纳入以社区为基础的长
Mathematica Policy Research.
期护理: 分析替代和补充的潜力。老龄与健康杂志，12(3) ，426-450。 布朗，r。 ，卡尔森，b。 ，戴尔，s。 ，福斯特，l。 ，菲利普斯，b。和斯科
尔，j。(2007)。现金和咨询: 改善需要个人护理或家庭和社区服务的医疗
Alexander, K. J. (2006). Naturally occurring retirement communities: An in-
补助受益人的生活。普林斯顿，新泽西州: 数学政策研究。
troduction. Journal of Jewish Communal Services, 81(3–4), 191–193.
亚历山大 ·肯尼迪(2006)。自然形成的退休社区: 介绍。犹太社区服务杂志， Burr, J. A., Caro, F. G., & Moorhead, J. (2002). Productive aging and civic par-
ticipation. Journal of Aging Studies, 16(1), 87–105.
81(3-4) ，191-193。
(2002).生产性老龄化与公民参与。老龄化研究杂志，16(1) ，87-105。
Altman, A. (2006). The New York NORC-Supportive Service Program. Journal of
Jewish Communal Services, 81(3–4), 195–200.
(2006)。纽约北欧支持服务计划。犹太社区服务杂志，81(3-4) ，195-200。
Andrew, M. K. (2006). Social capital, health, and care home residence among older
adults: A secondary analysis of the health survey for England 200. European
Journal of Ageing, 2, 137–148.
安德鲁，M.k. (2006)。老年人的社会资本、健康和居家护理: 英格兰 200 年健
康调查的二次分析。欧洲老龄化杂志，2,137-148。
Anetzberger, G. J. (2010). Community Options of Greater Cleveland, Ohio:
Preliminary evaluation of a naturally occurring retirement community program.
Clinical Gerontologist, 33, 1–15.
Anetzberger，g。(2010)。俄亥俄州大克利夫兰的社区选择: 自然发生的退休社
区计划的初步评估。临床老年病学家，33,1-15。
Antonucci, T. C., & Akiyama, H. (1996). Convoys of social relations: Family and
friendships within a life span context. In R. Blieszner, & V. H. Bedford (Eds.),
Handbook of aging and the family (pp. 355–371). Westport, CT: Greenwood.
安东努奇与秋山(1996)。社会关系的护航: 生命周期背景下的家庭和友谊。作
者: r。 Blieszner，& v，老龄化和家庭手册(第 355-371 页)。康涅狄格州韦
斯特波特: Greenwood。

Antonucci, T. C., Fuhrer, R., & Dartigues, J. (1997). Social relations and de-
pressing symptomatology in a sample of community-dwelling French older
adults. Psychology & Aging, 12, 189–195.
 Fiori, K. L., Antonucci, T. C., & Cortina, K. S. (2006). Social network typologies
Casner-Lotto, J. (2007). Boomers are ready for nonprofits—But are non-profits and mental health among older adults. Journal of Gerontology: Psychological
ready for them? Retrieved from. http://www.civicventures. Sciences, 61B, P25–P32.
org/breakthrough/reports/ConfBdreport5-25.pdf Fiori，K.l。 ，Antonucci，T.c。 ，& Cortina，K.s。(2006)。社交网络类型与
(2007)婴儿潮一代已经为非营利组织做好了准备ーー但非营利组织准备好迎接 老年人的心理健康。老年学杂志: 心理科学，61B，P25-P32。
他们了吗 Fiori, K. L., Smith, J., & Antonucci, T. C. (2007). Social network types among older
Chaskin, R. J. (1997). Perspectives on neighborhood and community: A re-view of adults: A multidimensional approach. The Journals of Gerontology:
the literature. Social Service Review, 71(4), 521–547. Psychological Sciences and Social Sciences, 62B, 322–330.
查斯金，R.j. (1997)。关于邻里和社区的观点: 文学的回顾。社会服务评论， (2007).老年人的社交网络类型: 一个多维的方法。老年学期刊: 心理科学和社会
71(4) ，521-547。 科学，62B，322-330。
Chaskin, R. J., Brown, P., Venkatesh, S., & Vidal, A. (2001). Building community Fitzpatrick, T. R., & McCabe, J. (2008). Future challenges for senior center
capacity. Hathorne, NY: Aldine de Gruyter. programming to serve younger and more active Baby Boomers. Activities,
(2001)。建立社区能力。纽约哈索恩: 阿尔丁 ·德 ·格鲁伊特。 Adaptation, & Aging, 32(3/4), 198–213.
Fitzpatrick，t。 & McCabe，j。(2008)。未来的挑战，老年中心的规划，以服
Cheang, M. (2002). Older adults' frequent visits to a fast-food restaurant:
Nonobligatory social interaction and the significance of play in a ‘third place.’. 务更年轻和更积极的婴儿潮一代。活动，适应，老龄化，32(3/4) ，198-
Journal of Aging Studies, 16(3), 303–321. 213。
张学明(2002)。老年人经常光顾快餐店: 非强制性的社交互动和在“第三位”玩 Freedman, M. (1999). Prime time: How baby boomers will revolutionize retire-
耍的重要性.老龄化研究杂志，16(3) ，303-321。 黄金时间: 婴儿潮一代将如何革命性地退休
Chen, Y., & Thompson, E. A. (2010). Understanding factors that influence success ment and transform America. New York: Public Affairs.
of home- and community-based services in keeping older adults in community 纽约: 公共事务。
settings. Journal of Aging and Health, 22, 267–291. Gardner, P. J. (2011). Natural neighborhood networks: Important social networks in
陈，y。 & 汤普森，e。(2010)。了解影响以家庭和社区为基础的服务在社区 the lives of older adults aging in place. Journal of Aging Studies, 25(3), 263–
环境中保持老年人成功的因素。老龄与健康杂志，22,267-291。 271.
加德纳，p. j. (2011)。自然社区网络: 老年人生活中的重要社会网络。老龄化研
Choi, N. G., & Chou, R. J. (2010). Time and money volunteering in mid- and late-
life: Relationship between past and current volunteering behaviors and 究杂志，25(3) ，263-271。
predictors of stability and change. Ageing & Society, 30, 559–581. Gaugler, J. E., Duval, S., Anderson, K. A., & Kane, R. L. (2007). Predicting nursing
Choi，n. g. ，& Chou，R.j. (2010).中老年志愿者的时间和金钱: 过去和现在的 home admission in the U.S.: A meta-analysis. BMC Geriatrics, 7, 13.
志愿行为之间的关系以及稳定和变化的预测因子。老龄化与社会， Gaugler，J.e。 ，Duval，s。 ，Anderson，K.a。 ，& Kane，R.l。(2007)。预
30,559-581。 测美国养老院的入院率: 一个荟萃分析。BMC 老年病学，7,13。
Choi, N., & McDougall, G. (2007). Comparison of depressive symptoms between Gaugler, J. E., Kane, R. L., Kane, R. A., Clay, T., & Newcomer, R. (2003).
homebound older adults and ambulatory older adults. Aging Mental Health, Caregiving and institutionalization of cognitively impaired older people:
11(3), 310. Utilizing dynamic predictors of change. The Gerontologist, 43, 219–229.
Choi，n。 & McDougall，g。(2007)。居家老年人和不能走动的老年人抑郁症 高格勒，J.e. ，凯恩，R.l. ，凯恩，R.a. ，克莱，t，& 新人，r。(2003)。认知
状的比较。老年心理健康，11(3) ，310。 障碍老年人的照顾和制度化: 利用变化的动态预测。老年病学家，43,219-
City of New York, Office of the Mayor (2011). Mayor Bloomberg announces eight 229。
providers selected to develop the city's first ‘innovative senior cen-ters’. [Press Gleckman, H. (2010, February 9). Village' groups help seniors remain in their
release]. Retrieved from. http://www.nyc.gov/html/dfta/ homes as they grow older. The Washington Post. Retrieved from www.
downloads/pdf/pr_release/innovative_senior_center.pdf washingtonpost.com
纽约市长办公室(2011)。布隆伯格市长宣布选出八家供应商来开发纽约市第一 Gleckman，h。(2010,2 月 9 日)。当老年人变老的时候，村里的团体帮助他们
家 “ 创 新 型 高 级 中 心 ” 。 [ 新 闻 稿 ] 。 检 索 自 。 Http://www.nyc. 留在家里。华盛顿邮报。检索自 www。网址: washingtonpost. com
gov/html/dfta/downloads/pdf/pr _ release/innovative _ senior _ center.译者注: Golant, S. (2008). Affordable clustered housing-care: A category of long-term care
Cullinane, P. (2006). Promoting purposeful lives for greater good: Civic en- options for the elderly poor. Journal of Housing for the Elderly, 22(1/2), 3–44.
gagement programs of aging organizations. Generations, 30(4), 109–111. Golant，s. (2008).负担得起的集中式住房护理: 为老年贫困人口提供的一类长
促进有目的的生活，为了更大的利益: 老龄化组织的公民参与计划。世代， 期护理选择。老年人住房杂志，22(1/2) ，3-44。
30(4) ，109-111。
Dal Santo, T. S. (2009). Senior center literature review: Reflecting & respond-ing to Golden, J., Conroy, R. M., Bruce, I., Denihan, A., Greene, E., Kirby, M., et al. (2009).
community needs. Retrieved. http://www.ncoa.org/assets/files/ Loneliness, social support networks, mood and wellbeing in community-dwelling
pdf/Literature_Review_of_Senior_Centers.pdf elderly. International Journal of Geriatric Psychiatry, 24, 694–700.
老 年 中 心 文 献 回 顾 : 反 映 和 响 应 社 区 需 求 。 检 索 戈登，j。康罗伊，R.m. ，布鲁斯，i。 ，丹尼汉，a。 ，格林，e。 ，科比，M.等
http://www.ncoa.org/assets/files/pdf/Literature _ review _ of _ Senior _ centers. (2009)。社区老人的孤独感、社会支持网络、情绪和幸福感。国际老年精神病学
pdf 杂志，24,694-700。
Dale, S. B., & Brown, R. (2006). Reducing nursing home care use through Greene, K. (2008 November 14). It takes a village. The Wall Street Journal, p. R4.
consumer-directed personal care services. Medical Care, 44, 760–767. Retrieved from www.wsj.com
Dale，S.b。 ，& Brown，r。(2006)。通过消费者导向的个人护理服务减少养 2008 年 11 月 14 日，《华尔街日报》 ，p. R4
老院护理的使用。医疗保健，44,760-767。 Greenfield, E. A. (2010). Identifying the boundaries and horizons of the con-cept of
Elmore, D. L., & Talley, R. C. (2009). Family caregiving and U.S. federal policy. In civil engagement for the field of aging. In G. O'Neill, & S. F. Wilson (Eds.),
S. H. Qualls, & S. Zarit (Eds.), Aging families and caregiving (pp. 209–231). Civil Engagement in an Older America (pp. 7–14). Washington, DC: The
New York: Wiley. Gerontological Society of America.
Elmore，D.l. & Talley，R.c. (2009).家庭护理和美国联邦政策。在 s。 Qualls & Greenfield，E.a。(2010)。确定老龄化领域民事参与概念的界限和视野。在
s。 Zarit (ed 老龄化的家庭和照顾(第 209-231 页)。纽约: 威利。 G.o’neill & S.f。 Wilson (Eds 老美国的民事参与(第 7-14 页)。华盛顿特区:
Enguidanos, S., Pynoos, J., Denton, A., Alexman, S., & Diepenbrock, L. (2010). 美国老年学会。
Comparison of barriers and facilitators in developing NORC programs: A tale Greenfield, E. A. (2011). An overview of NORC-SSPs in New Jersey. Retrieved
of two communities. Journal of Housing for the Elderly, 24, 291–303. from http://socialwork.rutgers.edu/Libraries/Aging/NJ_NORCs_1_12_11.
Enguidanos ， s 。 ， Pynoos ， j 。 ， Denton ， a 。 ， Alexman ， s 。 ， & sflb.ashx.
Diepenbrock，l。发展 NORC 项目的障碍和促进者的比较: 两个社区的故 (2011) 新 泽 西 州 NORC-SSPs 概 述 。 检 索 自
事。老年人住房杂志，24,291-303。 http://socialwork.rutgers.edu/Libraries/Aging/NJ _ norcs _ 1 _ 12 _ 11.
Farone, D., Fitzpatrick, T., & Tran, T. (2005). Use of senior centers as a moderator sflb.ashx。
of stress-related distress among Latino elders. Journal of Gerontological Social
Work, 46(1), 65.
(2005).利用老年中心作为拉丁裔老年人压力相关痛苦的调节剂。老年学社会
工作杂志，46(1) ，65。
Feder, J., Komisar, H. L., & Niefeld, M. (2000). Long-term care in the United States:
An overview. Health Affairs, 19, 40–56.
科米萨尔，H.l。 & 尼菲尔德，m。(2000)。美国的长期护理: 概述。Health
Affairs，19,40-56 健康事务，19,40-56。
Festa, E. (2007 March 10). A village for the elders. The Washington Post. Retrieved
from www.washingtonpost.com
2007 年 3 月 10 日《华盛顿邮报》 ，网址: www.washingtonpost
 E.A. Greenfield et al. / Journal of Aging Studies 26
(2012) 273–284
E.a. Greenfield 等人/老龄化研究杂志 26(2012)273-
284
Greenfield, E. A. (2012). Using ecological frameworks to advance a field of
research, practice, and policy an aging-in-place initiatives. The Gerontol-ogist,
52(1), 1–12.
格林菲尔德，E.a. (2012)。利用生态学框架推进研究、实践和政策领域的就地
老龄化倡议。老年学家，52(1) ，1-12。
Gross, J. (2007 August 13). Elderly organize to meet problems of aging. The New
York Times. Retrieved from www.newyorktimes.com
Gross，j。(2007 年 8 月 13 日)老年人组织起来应对老龄化问题。《纽约时报》
Gruenewald, T. L., Karlamangla, A. S., Greendale, G. A., Singer, B. H., & Seeman,
T. E. (2007). Feelings of usefulness to others, disability, and mortality in older
adults: The MacArthur study of successful aging. Journals of Gerontology:
Psychological and Social Sciences, 62(4), P28–P37. Guengerich, T. (2009).
Neighbors helping neighbors: A qualitative study of
格林尼沃尔德，T.l. ，Karlamangla，A.s. ，格林代尔，g. a. ，Singer，B.h. ，&
Seeman，T.e. (2007)。对他人有用的感觉，老年人的残疾和死亡率: 麦克阿瑟
关于成功衰老的研究。老年学杂志: 心理和社会科学，62(4) ，P28-P37。
Guengerich，t。(2009)。邻居帮助邻居: 一项定性研究
Villages operating in the District of Columbia. Washington, DC: AARP.
哥伦比亚特区的村庄。华盛顿特区: AARP。
Harvard School of Public Health & the MetLife Foundation (2006). Reinvent-ing
aging: Baby Boomers and civic engagement. Retrieved from http://
www.hsph.harvard.edu/chc/reinventingaging/Report.pdf
哈佛大学公共卫生学院和大都会基金会(2006)。重塑老龄化: 婴儿潮一代和公
民参与。检索自 http://www.hsph.harvard.edu/chc/reinventingaging/Report。
Pdf
Hostetler, A. J. (2011). Senior centers in the era of the “Third Age:” Country clubs,
community centers, or something else? Journal of Aging Studies, 25(2), 166–
176.
Hostetler，A.j. (2011).“第三纪”时代的老年中心: 乡村俱乐部，社区中心，还是
别的什么？老龄化研究杂志，25(2) ，166-176。
House, J. S., Umberson, D., & Landis, K. R. (1988). Structures and processes of
social support. Annual Review of Sociology, 14, 293–318.
房子，J.s. ，Umberson，d 和兰迪斯，K.r. (1988)。社会支持的结构和过程。社
会学年度回顾，14,293-318。
Houser, A., & Gibson, M. J. (2008). Valuing the invaluable: The economic value of
House，a。 & Gibson，M.j。(2008)珍视无价之宝:
family caregiving, 2008 Update. Washington, DC: AARP Public Policy Institute.
家庭照料，2008 年更新。华盛顿特区: 美国退休人员协会公共政策研究所。
Itzhaky, H., & York, A. S. (2000). Empowerment and community participa-tion:
Does gender make a difference? Social Work Research, 24(4), 225–234.
Itzhaky，h。 & York，A.s。(2000)。授权和社区参与: 性别有影响吗？社会工
作研究，24(4) ，225-234。
Itzhaky, H., & York, A. (2000). Sociopolitical control and empowerment: An
extended replication. Journal of Community Psychology, 28(4), 407–415.
(2000).社会政治控制与赋权: 一个扩展的复制。社区心理学杂志，28(4) ，407-
415。
Ivery, J. M., & Akstein-Kahan, D. (2010). Naturally Occurring Retirement
Communities (NORC) initiative in Georgia: Developing and managing
collaborative partnerships to support older adults. Administration in Social
Work, 34(4), 329–343.
Ivery，J.m。 & Akstein-Kahan，d。(2010)。自然出现的退休社区(NORC)在乔
治亚州的倡议: 发展和管理合作伙伴关系，以支持老年人。社会工作管理，
34(4) ，329-343。
Ivery, J. M., Akstein-Kahan, D., & Murphy, K. C. (2010). NORC supportive
services model implementation and community capacity. Journal of
Gerontological Social Work, 53(1), 21–42.
艾弗里 ·j ·m ·阿克斯坦-卡恩 d ·墨菲 K.c. (2010)。NORC 支持服务模型的实
施和社区能力。老年社会工作杂志，53(1) ，21-42。
Jette, A. M., Tennstedt, S., & Crawford, S. (1995). How does formal and infor-mal
community care affect nursing home use? Journal of Gerontology: Social
Sciences, 50B, S4–S12.
Jette，am，Tennstedt，s。 ，& Crawford，s。正式和非正式的社区护理如何影
响养老院的使用？老年学杂志: 社会科学，50B，S4-S12。
Kausch, G. M. (2004). The ADA complementary paratransit requirement: Case
studies in smaller transit agency challenges and solutions. San Jose, CA: Mineta
Transportation Institute.
考施，通用汽车(2004)。ADA 辅助运输要求: 小型运输机构面临的挑战和解决
方案的案例研究。加利福尼亚州圣何塞: Mineta 交通研究所。
Komisar, H. L., & Thompson, L. S. (2007). National spending for long-term care.
Washington, DC: Georgetown University. Retrieved from http://ltc.
georgetown.edu/pdfs/whopays2006.pdf
283
Komisar，h。 & Thompson，L.s。(2007)。国家长期护理支出。华盛顿特
区 : 乔 治 城 大 学 。 检 索 自 : http://ltc 。
Georgetown.edu/pdf/whopays2006.Pdf
Krause, N. (1997). Received support, anticipated support, social class, and
mortality. Research on Aging, 19, 387–422.
(1997)。接受支持，预期支持，社会阶层和死亡率。老龄化研究，19,387-
422。
Krause, N. (2001). Social support. In R. H. Binstock, & L. K. George (Eds.),
Handbook of aging and the social sciences (pp. 272–294). New York:
Academic Press.
Krause，n. (2001).社会支持。宾斯托克 & 乔治(编辑)老龄化与社会科学手
册(第 272-294 页)。纽约: 学术出版社。
Lauder, W., Sharkey, S., & Mummery, K. (2004). A community survey of
loneliness. Journal of Advanced Nursing, 46, 88–94.
拉德，w。沙基，s。和木乃伊，k。(2004)。关于孤独的社区调查。高级
护理杂志，46,88-94。
Lawton, M. P. (1990). Knowledge resources and gaps in housing for the aged.
In D. Tilson (Ed.), Aging in place (pp. 287–309). Glenview, IL: Scott,
Foresman, & Co..
劳顿，M.p. (1990)。老年人住房方面的知识资源和差距。在 d。蒂尔森(教
育)，就地老化(第 287-309 页)。伊利诺伊州格伦维尤: Scott，foreman，
& co。.
Lehning, A. J., Scharlach, A. E., & Price Wolf, J. (in press). An emerging typol-
ogy of community aging initiatives. Journal of Community Practice.
Lehning，a. j. ，Scharlach，a. e. ，& Price Wolf，j. (in press).一种新兴的社
区老龄化计划打字学。社区实践杂志。
Li, Y., & Ferraro, K. F. (2006). Volunteering in middle and later life: Is health a
benefit, barrier, or both? Social Forces, 85(1), 497–519.
李，y，& 费拉罗，肯尼迪(2006)。在中年和晚年做志愿者: 健康是一种好
处，障碍，还是两者兼而有之？Social Forces，85(1) ，497-519 社会
力量，85(1) ，497-519。
Lindblom, D. (2001). Baby Boomers and the new age of volunteerism. Re-
trieved from http://www.nationalserviceresources.org/filemanager/
download/465/lindblom.pdf
《婴儿潮时期出生的人与志愿服务的新时代》(2001)
Litwak, E., & Longino, C. F. (1987). Migration patterns among the elderly: A
developmental perspective. The Gerontologist, 27, 266–272.
Litwak，e。 & Longino，C.f。老年人的迁移模式: 一个发展的视角。老年
医学家，27,266-272。
Lyyra, T., & Heikkinen, R. (2006). Perceived social support and mortality in
older people. Journals of Gerontology: Series B: Psychological and Social
Sciences, 61, S147–S152.
Lyyra，t，& Heikkinen，r. (2006).感知老年人的社会支持和死亡率。老年
学杂志: 系列 b: 心理和社会科学，61，S147-S152。
MacLaren, C., Landsberg, G., & Schwartz, H. (2007). History, accomplish-
ments, issues and prospects of supportive service programs in naturally
occurring retirement communities in New York State: Lessons learned.
Journal of Gerontological Social Work, 49(1–2), 127–144.
MacLaren，c。 ，Landsberg，g。和 Schwartz，h。(2007)。纽约州自然发
生的退休社区支持性服务项目的历史、成就、问题和前景: 经验教训。
老年学社会工作杂志，49(1-2) ，127-144。
Marek, K. D., Popejoy, L., Petroski, G., Mehr, D., Rantz, M., & Lin, W. C.
(2005).
马雷克，K.d. ，Popejoy，l. ，Petroski，g. ，more，d. ，Rantz，m. ，&
Lin，W.c. (2005)。
Clinical outcomes of aging in place. Nursing Research, 54, 202–211.
就地老化的临床结果。护理科研，54,202-211。
McCann, J. J., Hebert, L. E., Li, Y., Wolinsky, F. D., Gilley, G. W., Aggarwal,
N. T., et al. (2005). The effect of adult day care services on time to nursing
home placement in older adults with Alzheimer's Disease. The Gerontol-
ogist, 45, 754–763.
McCann，J.j. ，Hebert，L.e. ，L.，y. ，Wolinsky，F.d. ，Gilley，G.w. ，
Aggarwal，N.t. 等(2005)。成人日托服务对老年阿尔茨海默病患者家
庭安置时间的影响。老年医学专家，45,754-763。
McDonough, K. E., & Davitt, J. K. (2011). It takes a village: Community prac-
tice, social work, and aging in place. Journal of Gerontological Social
Work, 54(5), 528–541.
McDonough，K.e。 & Davitt，J.k。(2011)。这需要一个村庄: 社区实践，
社会工作，和老龄化的地方。老年学社会工作杂志，54(5) ，528-541。
McPherson, J. M., Smith-Lovin, L., & Brashears, M. E. (2006). Social isolation
in America: Changes in core discussion networks over two decades.
American Sociological Review, 71, 353–375.
麦克弗森，J.m. ，史密斯-洛文，l. & Brashears，M.e. (2006)。美国的社会隔离: MetLife Mature Market Institute (2010). Aging in place 2.0: Rethinking solu-tions
二十年来核心讨论网络的变化。美国社会学评论，71,353-375。 to the home care challenge. Retrieved from http://www.metlife.
com/assets/cao/mmi/publications/studies/2010/mmi-aging-place.pdf
美国大都会保险成熟市场研究所(2010)。2.0: 重新思考家庭护理挑战的解决方
案 。 检 索 自
http://www.MetLife.com/assets/cao/mmi/publications/studies/2010/mmi-
Aging-place. pdf
Metzger, N. (2011). Why Villages? Retrieved from dupontcirclevillage.org/
Documents/ Why%20Villages-NMetzger.doc.
为什么是村庄? 检索自 dupontcirclevillage. org/Documents/Why% 20 Villages-
nmetzger.doc。
Morrow-Howell, N. (2010). Volunteering in later life: Research frontiers. Journals
of Gerontology: Psychological and Social Sciences, 65(4), P461–P469.
Morrow-Howell，n. (2010)。晚年志愿服务: 研究前沿。老年学杂志: 心理学和
社会科学，65(4) ，P461-P469。

Mynatt, E. D., Rowan, J., Craighill, S., & Jacobs, A. (2001). Digital family portraits:
Providing peace of mind for extended family members. Proceedings of the 2011
ACM Conference on Human Factors in Computing Systems (pp. 333–340).
CHI.
迈纳特，E.d. ，罗恩，J.Craighill，s. ，& Jacobs，a. (2001)。数字家庭肖像: 为
大家庭成员提供心灵的宁静。2011 年 ACM 计算机系统中人的因素会议记
录(333-340 页)。CHI.
National Council on Disability. (2010). The state of housing in American in the 21st
century: A disability perspective. Washington, DC: Author Available at
www.ndc.gov.
国家残疾人委员会。(2010).21 世纪美国的住房状况: 残疾人视角。华盛顿特区:
作者: www.ndc. gov。
O'Shaughnessy, C. (2008). The aging services network: Broad mandate and
increasing responsibilities. Public Policy and Aging Report, 18(3), 1–18.
O’shaughnessy，c. (2008)。老龄化服务网络: 广泛的授权和不断增加的责任。
公共政策与老龄化报告，18(3) ，1-18。
Ohmer, Mary L. (2008). The relationship between citizen participation and
organizational processes and outcomes and the benefits of citizen participation
in neighborhood organizations. Journal of Social Service Research, 34, 41–60.
Ohmer，Mary l. (2008).公民参与与组织过程和结果之间的关系以及公民参与邻
里组织的好处。社会服务研究杂志，34,41-60。

Ormond, B.A., Black, K.J., Tilly, J., & Thomas, S. (2004). Supportive services pro-
grams in naturally occurring retirement communities. Washington, DC: U.S.
Department of Health and Human Services, Assistant Secretary for Planning
and Evaluation, Office of Disability, Aging, and Long-Term Care Policy.
Ormond，b.a. ，Black，k.j. ，Tilly，j. & Thomas，s. (2004).自然发生的退休社
区中的支持性服务项目。华盛顿特区: 美国卫生和公共服务部，残疾、老
龄化和长期护理政策办公室规划和评估助理部长。

Patrick, J. H., Cottrell, L. E., & Barnes, K. A. (2001). Gender, emotional support,
and well-being among the rural elderly. Sex Roles, 45, 15–29.
Patrick，J.h。 ，Cottrell，L.e。 ，& Barnes，K.a. (2001)。农村老年人的性别、
情感支持和幸福感。性别角色，45,15-29。
Patterson, A. C., & Veenstra, G. (2010). Loneliness and risk of mortality: A
longitudinal investigation in Alameda County, California. Social Science &
Medicine, 71, 181–186.
帕特森，A.c. ，& Veenstra，g. (2010)。孤独和死亡风险: 加利福尼亚州阿拉梅
达县的纵向调查。社会科学与医学，71,181-186。
Peikes, D., Chen, A., Schore, J., & Brown, R. (2009). Effects of care coordina-tion
on hospitalization, quality of care, and health care expenditures among
Medicare beneficiaries. JAMA, 301(6), 603–618.
Pekes，d。 ，Chen，a。 ，Schore，j。 & Brown，r。(2009)。护理协调对医疗
保险受益人住院治疗，护理质量和医疗保健支出的影响。JAMA，301(6) ，
603-618.
Pinquart, M. (2003). Loneliness in married, widowed, divorced, and never married
older adults. The Journal of Social & Personal Relationships, 20(1), 31–53.
(2003).已婚、丧偶、离异和从未结婚的老年人的孤独感。The Journal of Social
& Personal Relationships，20(1) ，31-53 社会与人际关系杂志，20(1) ，31-
53。

Price, R. H., & Behrens, T. (2003). Working Pasteur's Quadrant: Harnessing science
and action for community change. American Journal of Communi-ty
Psychology, 31, 219–223.
普莱斯，R.h。 ，& 贝伦斯，t。(2003)。Working Pasteur’s Quadrant: harness
science and action for community change 巴斯德工作象限: 利用科学和行动
改变社区。美国社区心理学杂志，31,219-223。
Prince, M. J., Harwood, R. H., Blizard, R. A., Thomas, A., & Mann, A. H. (1997).
Social support deficits, loneliness and life events as risk factors for de-pression
in old age. The Gospel Oak Project VI. Psychological Medicine, 27, 323–332.
王子，M.j. ，哈伍德，R.h. ，蜥蜴，R.a. ，托马斯，a. 和曼，A.h. (1997)。社
会支持缺失、孤独和生活事件是老年抑郁症的危险因素。The Gospel Oak
Project VI 福音橡树计划六。心理医学，27,323-332。
Pynoos, J., Nishita, C., Cicero, C., & Caraviello, R. (2008). Aging in place, housing, and
the law. Elder Law Journal, 16, 77.
Pynoos，j。 ，Nishita，c。 ，Cicero，c。 ，& Caraviello，r。(2008)。就地老化，
住房和法律。老年法律杂志，16,77。
Reed, B., Newman, P., Suarez, Z., & Lewise, E. (1997). Interpersonal practice beyond
diversity and toward social justice: The importance of critical consciousness. In C.
Garvin, & B. Seabury (Eds.), Interpersonal practice in social work (pp. 44–78). (2nd
ed.). Boston: Allyn & Bacon.
里德，b。纽曼，p。苏亚雷斯，z。和路易斯，e。(1997)。人际实践超越多样性，
走向社会正义: 批判意识的重要性。在 c。 Garvin，& b。 Seabury (Eds、社会
工作中的人际关系实践(第 44 至 78 页)。(第二版).波士顿: 阿林和培根。
Rothman, J. (1995). Approaches to community intervention. In J. Rothman, J. L. Erlich,
& J. E. Tropman (Eds.), Strategies of community intervention (pp. 26–63). (5th ed.).
Itasca, IL: F. E. Peacock.
罗斯曼 j。(1995)。社区干预的方法。在 j ·罗斯曼，j ·l ·埃利希，和 j ·e ·托普曼
(编辑)社区干预的策略(第 26-63 页)。(第 5 版).伊利诺伊州艾塔斯卡: f ·e ·孔雀。
Sampson, R. J., & Raudenbush, S. W. (1999). Systematic social observation of public
spaces: A new look at disorder in urban neighborhoods. American Journal of
Sociology, 105(3), 603–651.
桑普森，R.j. ，& Raudenbush，S.w. (1999)。公共空间的系统社会观察: 城市社区
无序的新视角。美国社会学期刊，105(3) ，603-651。
Sanders, S. J., Mutchler, J. E., Kuriansky, J. A., & McMahon, J. (November 2008).
Introducing a new measure of income adequacy: The elder economic security
standard index. Paper presented at the 61st annual meeting of the Gerontological
Society of America, National Harbor, MD.
Sanders，S.j。 ，Mutchler，j。 ，Kuriansky，j。 ，& McMahon，j。(2008 年 11
月)。介绍一种衡量收入充足性的新方法: 老年人经济保障标准指数。在马里兰
州国家港市美国老年学会第 61 届年会上发表的论文。
Scharlach, A., Graham, C., & Lehning, A. (in press). The 'Village' model: A con-sumer-
driven approach for aging in place. The Gerontologist.
格雷厄姆与雷宁(出版社)。“村庄”模式: 消费者驱动的老龄化方法。老年医学家。
Schnittker, J. (2007). Look closely at all the lonely people: Age and the social
psychology of social support. Journal of Aging and Health, 19, 659–682.
Schnittker，j.仔细观察所有孤独的人: 年龄和社会支持的社会心理。老龄与健康杂
志，19,659-682。
Shaw, B., Krause, N., Liang, J., & Bennett, J. (2007). Tracking changes in social
relations throughout late life. Journal of Gerontology. Social Sciences, 62B(2), S90–
S99.
Shaw，b. Krause，n. ，Liang，j. ，& Bennett，j. (2007).追踪晚年社会关系的变化。
老年医学杂志。社会科学，62B (2) ，S90-S99。
Shirk, C. (2006). Rebalancing long-term care: The role of the Medicaid HCBS waiver
program. National Health Policy Forum Background Paper. Retrieved from
http://www.nhpf.org/library/background-papers/ BP_HCBS.Waivers_03-03-06.pdf
谢淑丽 c。(2006)。重新平衡长期护理: 医疗补助 HCBS 豁免计划的作用。国家卫
生 政 策 论 坛 背 景 文 件 。 检 索 自 http://www.nhpf. org/library/background-
papers/BP _ hcbs。Waivers _ 03-03-06.Pdf
Sorensen, S., Pinquart, M., & Duberstein, P. (2002). How effective are inter-ventions
with caregivers? An updated meta-analysis. The Gerontologist, 42(3), 356–372.
Sorensen，s. ，Pinquart，m. ，& Duberstein，p. (2002).与照顾者进行干预的效果如
何？一个更新的荟萃分析。老年医学家，42(3) ，356-372。
Spillman, B. C., & Pezzin, L. E. (2000). Potential and active family caregivers: Changing
networks and the ‘sandwich generation’. Milbank Quarterly, 78, 347–374.
Spillman，B.c. ，& Pezzin，L.e。(2000)。潜在的和积极的家庭照顾者: 改变网络和
“三明治一代”。Milbank 季刊，78,347-374。
Sullivan-Marx, E., Davitt, J., Steinberg, H., Schlossberg, D., Wormley, D. L., Kerman,
L., et al. (2009). Using spatial modeling to design elder-friendly urban environments:
Applied collaborative research in west Philadelphia.
Sullivan-Marx，e. ，Davitt，j. ，Steinberg，h. ，Schlossberg，d. ，Wormley，d. l. ，
Kerman，l. 等(2009)。使用空间建模来设计老年人友好的城市环境: 在费城西
部的应用协作研究。
284 E.A. Greenfield et al. / Journal of Aging Studies 26 (2012) 273–284
格林菲尔德等人/老龄化研究杂志 26(2012)273-284
In C. D. Tomlin, D. Culhane, & S. Kinnevy (Eds.), Philly.Dot.Map: The shapes of
在 C.d. 汤姆林，D.卡尔汉，和 s。肯尼维(教育编辑) ，费城。地图: 形状
Philadelphia. : The Cartographic Modeling Lab, University of Pennsylvania.
Szinovacz, M. E., & Davey, A. (2008). The division of parent care between
费城。: 宾夕法尼亚大学制图模型实验室。Szinovacz，M.e. ，& Davey，a。
(2008)。父母照顾孩子的分工
spouses. Ageing and Society, 28, 571–597.
配偶. 老化与社会，28,571-597。
Tan, E. J., Xue, Q., Li, T., Carlson, M. C., & Fried, L. P. (2006). Volunteering: A
physical activity intervention for older adults—The Experience Corps®
Program in Baltimore. Journal of Urban Health: Bulletin of the New York
Academy of Medicine, 83(5), 954–969.
Tan，e。 ，Xue，q。 ，L.，t。 ，Carlson，M.c。 ，& Fried，L.p. (2006)。志
愿服务: 老年人的身体活动干预ーー巴尔的摩的体验团计划。城市健康杂
志: 纽约医学院公报，83(5) ，954-969。
Tang, F., & Lee, Y. (2011). Social support networks and expectations for aging in
place and moving. Research on Aging, 33, 444–464.
(2011).社会支援网络及居家安老的期望。老龄化研究，33,444-464。
Tang, F., & Pickard, J. (2008). Aging in place or relocation: Awareness of
community-based long-term care and services. Journal of Housing for the
Elderly, 22(4), 404–422.
Tang，f。 & Pickard，j。(2008)。在原地老化或搬迁: 对社区长期护理和服务
的认识。老年人住房杂志，22(4) ，404-422。
Thomas, W. H., & Blanchard, J. M. (2009). Moving beyond place: Aging in
community. Generations, 33(2), 12–17.
《超越空间: 社区老龄化》 ，33(2) ，12-17。
Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isola-tion,
loneliness, and social support to disease outcomes among the el-derly. Journal
of Aging and Health, 18, 359–384.
Tomaka，j。 Thompson，s。 & Palacios，r。(2006)。社会孤立感、孤独感和
社会支持与老年人疾病预后的关系。老龄与健康杂志，18,359-384。
Tomita, N., Yoshimura, K., & Ikegami, N. (2010). Impact of home and community-
based services on hospitalization and institutionalization among individuals
eligible for long-term care insurance in Japan. BMC Health Services Research,
10.
新泽西州富田、吉村、池上(2010)。在日本，家庭和社区服务对符合长期护理
保险条件的个人住院和机构化的影响。BMC 健康服务研究，10。
Tracy, E., Kemp, S., & Whittaker, J. (1997). Person-environment practice: The
social ecology of interpersonal helping. Hawthorne, NY: Aldine De Gruyter.
特蕾西，e。肯普，s。和惠特克，j。人-环境实践: 人际帮助的社会生态学。霍
桑，纽约: Aldine De Gruyter。
Turner, K. W. (2004). Senior citizens centers: What they offer, who partici-pates,
and what they gain. Journal of Gerontological Social Work, 43, 37–47.
(2004).老年人中心: 他们提供什么，谁参与，他们得到什么。老年学社会工作
杂志，43,37-47。
U.S. Congress (2006). Naturally occurring retirement communities: A model for
aging in place, 109th Congress. Retrieved from http://www.gpo.gov/
fdsys/pkg/CHRG-109shrg36211/pdf/CHRG-109shrg36211.pdf
美国国会(2006)《自然出现的退休社区: 就地老龄化模型》 ，第 109 届国会
Uchino, B. N. (2004). Social support and physical health: Understanding the health
社会支持与身体健康: 了解健康
consequences of relationships. New Haven, CT: Yale University Press.
纽黑文，康涅狄格州: 耶鲁大学出版社。
van Tilburg, T. (1998). Losing and gaining in old age: Changes in personal network
size and social support in a four-year longitudinal study. The Journals of
Gerontology: Psychological Sciences and Social Sciences, 53B(6), S313–S323.
范蒂尔堡，t。(1998)。老年时期的失去和获得: 四年追踪研究中个人网络规模
和社会支持的变化。老年学杂志: 心理科学和社会科学，53B (6) ，S313-
S323。
Vladeck, F. (2004). A good place to grow old: New York's model for NORC sup-
Vladeck，f。(2004)一个变老的好地方: 纽约 NORC 的模式
portive service programs. New York: United Hospital Fund.
纽约: 联合医院基金。
Vladeck, F. (2006). Residential-based care: New York's NORC-supportive services
program model. In B. Berkman, & S. D'Ambruoso (Eds.), Handbook of social
work in health and aging (pp. 705–714). New York: Oxford University Press.
Vladeck，f。(2006)。居家护理: 纽约 norc 支持性服务项目模式。在 b。
Berkman，& s。 d’ambruoso (Eds，健康和老龄化社会工作手册(第 705-714
页)。纽约: 牛津大学出版社。
Vladeck, F., Segel, R., Oberlink, M., Gursen, M. D., & Rudin, D. (2010). Health
indicators: A proactive and systematic approach to healthy aging. City-scape: A
Journal of Policy Development and Research, 12(2), 67–84.
Vladeck，f. ，Segel，r. ，Oberlink，m. ，Gursen，M.d. ，& Rudin，d. (2010).
健康指标: 健康老龄化的主动和系统方法。城市景观: 政策发展和研究杂志，
12(2) ，67-84。
VtV (2011) Welcome to the Village to Village Network. Retrieved from
http://www.vtvnetwork.org.
VtV (2011)欢迎来到村到村网络。检索自 http://www.vtvnetwork. org。
Weil, M. (2005). Introduction: Contexts and challenges for 21st century
communities. In M. Weil (Ed.), The handbook of community practice (pp. 3–
33). Thousand Oaks, CA: Sage.
(2005).引言: 21 世纪社区的背景和挑战。在 m。 Weil (Ed，《社区实践手册》
(第 3-33 页)。千橡，加利福尼亚州: Sage。
World Health Organization (WHO) (2007). Global age-friendly cities: A guide.
世界卫生组织(WHO)(2007)。全球年龄友好型城市: 指南。
Geneva, Switzerland: WHO Press.
瑞士日内瓦: 世卫组织出版社。
Zimmerman, M. A., & Rappaport, J. (1988). Citizen participation, perceived control,
and psychological empowerment. American Journal of Community Psychology,
16, 725–750.
齐默尔曼，M.a。 & Rappaport，j。(1988)。公民参与，感知控制和心理授权。
美国社区心理学杂志，16,725-750。