A Prospective Longitudinal Mixed Methods Study of Program Evaluation in an Intergenerational Program: Intergenerational Interactions and Program Satisfactions Involving Non-Frail, Frail, Cognitively Impaired Older Adults, and School Aged-Children

Figures & data

Figure 1. Conceptual framework of the study.

Figure 2. Procedural diagram of the prospective longitudinal mixed methods parallel convergent design of the study.

Table 1. Characteristics of participants according to generation

	Older adults			F	P	Children
Characteristics	Non-frail n = 8	Frail n = 6	Cognitively impaired n = 4			n = 9
Background Median age, years (IQR)	77 (72–83)	85 (80–88)	86(82–89)	6.0	.050^a	9(8–10)
Gender (female), n (%)	8(100.0)	6(100.0)	4(100.0)	－	1.00^b	8(88.9)
Living with family, n (%)	7(87.5)	5(83.3)	2(50.0)	2.3	.312^b	9(100.0)
Frailty Decreased physical strength, n (%)	－	6(100.0)	2(50.0)	14.0	.001^b	－
Decreased activity level, n (%)	－	4(66.7)	1(25.0)	7.6	.022^b	－
Decreased cognitive functions, n (%)	－	－	4(100.0)	18.0	<.001^b	－
Decreased psychological status, n (%)	2(25.0)	4(66.7)	－	5.3	.072^b	－
Fall risks(0－14), median (IQR)	4.5(3–7)	4.5(3–9)	5.0(2–7)	0.4	.819^a	－
Activity of daily living Bathel Index(0－20), median (IQR)	20(19–20)	20(19–20)	19(18–19)	1.5	.478^a	－
Cognitive impairment NM Scale(0－50), median (IQR)	50(48–50)	48(44–50)	35(21–43)	9.3	.009^a	－
Mental state Geriatric depression scale (GDS)-15 (0－15), median (IQR)	3.0(1–7)	4.5(3–8)	4.0(2–6)	1.0	.611^a	－
Program participation Number of times participated in the program, median times (IQR)	28(11–40)	44(25–53)	37(16–48)	1.3	.524^a	24(12–28)
Motivation to do the program	Lost opportunities to go out, and reduced contact with children. Want to interact with other generations. Felt a peaceful atmosphere when I came here. To expect intergenerational interaction with other generations through various activities.					Be provoked by a school mate. To understand the older adults. I calm down when I talk with older adults.

^a;Kruskal-Wallis test, ^b;Chi-square test, IQR; Inter-Quartile Range, NM Scale score; normal (50–48), border (47–43), mild (42–31), moderate (30–17), severe (16–0), Fall risks; the higher score means the high risk to fall, GDS-15; no depression (0–4), mild depression (5–8), moderate depression (9–11), severe depression (12–15).

Table 2. Observed and analyzed program sessions

Session		Number of events^✝	Activities
a:	Self-work	25	Origami, watercolors, knitting, handicraft
b:	Group-work	7	Calligraphy, quilting
c:	Intergenerational games	23	Bowling, balloon valley, hand gesture game. Communication game, word plays
d:	Cooking	6	Cake decorating, fruit punch, baking rice cakes
e:	Physical	13	Sitting stretches, limb exercises, rhythm exercises
f:	Traditional	11	Seasonal events: Japanese Tanabata (weaver festival), Bon festival dance (welcomes spirits of the dead), Christmas event, Japanese Rakugo (Stylized comic storytelling)
g:	Talking	7	Exchanging opinions, talking about event ideas, talking about family vacations

✝: Excluded sessions with less than 3 events.

Table 3. Interaction and satisfaction score

Score by participant group	SIERO interaction mean score†						Program satisfaction VAS-10 mean score
Session^†	Non-frail (n=8)	Frail (n=6)	Cognitively impaired (n=4)	Children (n=9)	F	p	Non-frail (n=8)	Frail (n=6)	Cognitively impaired (n=4)	Children (n=9)	F	p
a: Self-work (N=277)	5.2	4.0	2.7	4.0	6.2	<.001	9.0	9.2	9.2	8.2	8.0	<.001
b: Group-work (N=92)	2.8	3.3	2.3	3.9	1.8	.149	9.0	9.4	9.0	7.2	5.3	.002
c: Intergenerational games (N=213)	7.0	6.0	4.6	5.4	4.3	.006	9.1	9.4	9.5	8.2	5.6	.001
d: Cooking (N=47)	7.1	4.7	3.4	4.6	2.5	.070	9.2	9.7	9.4	8.6	1.3	.276
e: Physical (N=115)	5.6	6.7	3.3	5.6	2.0	.116	8.7	9.6	9.1	7.9	4.2	.007
f: Traditional (N=111)	6.4	4.3	3.1	5.7	3.4	.022	9.3	9.5	9.6	8.7	2.1	.108
g: Talking (N=68)	5.5	5.5	3.0	7.6	`2.2	.099	9.2	9.7	9.7	8.5	`4.4	.007

^†;Excluded sessions with less than 3 events, N; total observed number of the session, St. Luke’s Intergenerational exchanges and relations observation

(SIERO) inventory score ranged 0 to 17, Visual analogue scale (VAS) −10 score ranged 0 to 10.

Figure 3. Distribution of interactions (SIERO) and program satisfaction (VAS-10) scores by program and participant group.

Table 4. Intergenerational session observation morpheme results

Category and characteristic	Older adults			Children
	Non-frail n=139	Frail n=113	Cognitively impaired n=56	n = 103
Positive (%)
Talking to a different generation	27.1	17.5	9.0	20.5
Listening to a different generation	6.6	9.6	4.8	10.2
Praising a different generation	15.1	9.0	2.4	6.0
Watching a different generation	5.6	8.5	18.3	9.9
Paying attention to a different generation Negative (%)	9.2	9.8	6.3	23.9
Scolding a different generation	1.8	－	－	－
Concentrating on oneself/same generation	3.0	3.6	6.6	7.2

n = number of sentences identified from the observation records

Figure 4. Joint display of mean SIERO scores in each session by group.