Hierarchical service needs for physical fitness promotion among Urban Community older adults: a Kano model...

Physical fitness promotion services for older adults in urban communities represent a critical pathway for achieving healthy aging. While existing research has largely focused on service supply and intervention outcomes, the demand structure of older adults themselves, particularly the hierarchical differences in demand among subgroups with varying health statuses, remains insufficiently explored. This study, grounded in the Kano model, aims to identify the demand attributes of physical fitness promotion services for healthy older adults, those with chronic diseases, and those with care dependency in urban communities, to analyze the hierarchical structure and priority order of their demands, and to provide empirical evidence for optimizing community-based service provision.

Based on the Kano model, this study employed the Delphi technique, questionnaire surveys, and logical analysis to examine the hierarchical structure, expectation characteristics, and dependency characteristics of physical fitness promotion service demands among older adults in urban communities. A demand map was subsequently constructed.

The overall hierarchical level of physical fitness promotion demands among older adults in urban communities was relatively low. The demands of healthy older adults were primarily characterized by one-dimensional and must-be quality attributes. The demands of older adults with chronic diseases were more concentrated on must-be quality attributes. The demands of older adults with care dependency further converged on basic support and care coordination services.

The allocation of service content should neither be uniformly distributed across different groups of older adults irrespective of their physical conditions and life circumstances, nor simply apply a single set of service standards. Instead, while ensuring the provision of common foundational services, targeted arrangements should be made around the most salient practical needs of each group.