Development of a Built Environment–Self-Efficacy–Activity Engagement–Self-Rated Health Model for Older Adults in Urban Residential Areas

The aging population has posed significant challenges to the built environment (BE) in urban residential areas, particularly in addressing older adults’ activity and health needs. Understanding how the BE influences older adults’ activity and health is crucial for promoting active and healthy aging. This study explored the interactions among the BE, self-efficacy (SE), activity engagement (AE), and self-rated health (SH) for older adults in urban residential areas. A random sampling technique selected 372 older adults residing in urban residential areas to participate in the questionnaire survey. Spearman correlation and hierarchical regression analysis were used to develop the BE-SE-AE-SH model for older people based on social cognitive theory. Accessibility, land use mix, and street connectivity affect activity engagement by influencing older persons’ walking and self-care abilities. Land use mix discourages walking ability and activity engagement, while esthetics encourages activity engagement. Land use mix, street connectivity, transportation, walking ability, self-care ability, and activity engagement enhance older adults’ self-rated health. Practical recommendations for age-friendly urban residential areas include the following: (1) optimize elevators and footpaths; (2) decentralize small businesses and create multi-use parking; (3) shorten crossings and enhance pavements; (4) add natural and humanistic elements; (5) limit car speed and install traffic signals.