Enhancing social participation in older adults with noncommunicable diseases: insights from system dynamics modeling

This study developed system dynamic modeling (SDM) based on the International Classification of Functioning, Disability and Health (ICF) framework to simulate and identify key leverage points for enhancing social participation among older adults with noncommunicable diseases (NCDs), aiming to offer a robust theoretical foundation for designing effective interventions.

Utilizing a system dynamics modeling, we simulated intervention strategies to augment social participation among older NCDs patients. Initial insights from in-depth interviews with 31 older individuals informed the construction of a causal loop diagram, elucidating the multifactorial relationships and feedback mechanisms among pertinent variables. Data from 500 patients were analyzed using correlation analysis, an independent weighting approach, and multiple regression to identify key variables, determine their equation coefficients, and construct a stock flow diagram for the model. The model then simulated social participation trends over 16 months under varying intervention intensities.

The results showed significant improvements in mobility function, functional ability, pain management, and social support, resulting in increases of 54.9%, 32.4%, 28.7%, and 25.0%, respectively, at a 10% intervention level. When intervention intensity was escalated to 20%, the impact became even more pronounced, with mobility function leading the way at a 127.5% increase, followed by pain management (63.6%) and functional ability (62.8%), and social support (48.7%). Self-care and emotional functions showed minimal improvement in social participation, with increases of less than 3% and 5%, respectively.

Improving social participation in older NCDs adults requires understanding complex system dynamics. This study highlights mobility function, functional ability, pain management, and social support as key leverage points, stressing the need for targeted interventions based on individual assessments.