Paper
Objectives The Ministry of Land, Infrastructure, Transport and Tourism is promoting the introduction of green slow mobility (GSM) vehicles (can drive up to 20 km/h on public roads) for mobility assistance and potential long-term care prevention. We identified four key factors to pinpoint the challenges and enhance opportunities for introducing GSM; GSM's operational achievements, a comparison of the characteristics of GSM users and non-users, purpose for using GSM, and observation of GSM's contribution to long-term care prevention among older adults.Methods A pilot GSM study was conducted in Ikeda City, Osaka Prefecture, from October to December 2022. The service included three routes, operating six times daily on a fixed schedule, and was provided by 10 volunteer drivers. Passengers signaled for boarding, and service details were provided through leaflets. A self-administered mail survey was conducted before and after the demonstration test with 674 respondents to the post-questionnaire, and 502 respondents were asked at both time points about issues related to the service, user characteristics, and care prevention. To assess care prevention, we examined the percentage of favorable changes triggered by GSM based on "opportunities to go out," "personal and behavioral aspects," "social relations," and "psychological aspects." Additionally, we examined whether the health indices in the post-hoc survey were better among GSM users than non-users.Results Of the 223 scheduled GSM services, 214 (96.0%) were operated by 10 volunteers driving an average of 3.1 (SD 2.4) times weekly (0-11 times), indicating an uneven distribution of driving responsibilities. Among the users, 65 (9.6%) were more engaged in community activities and emotional support than non-users. The main purposes for using GSM services were shopping and medical visits, with approximately 70% of users finding it easier to go out owing to these services. The percentage of favorable changes were noted in 3.1-26.2% and 0.2-1.5% of users and non-users, respectively. In the post-test survey, users showed higher independence on the instrumental self-maintenance subscale than non-users.Conclusion GSM facilitates outings among older adults and may reduce the need for potential long-term care. However, a system is required to ensure that the service burden does not decrease even for a few driving volunteers. Additionally, GSM users are often socially active. Thus, strategies to increase service awareness among less active individuals should be developed.