Identifying Active Ageing Policy Needs at the Meso-Level

Abstract

Active ageing (AA) is recognised as a concept leading to positive benefits for individuals and society; however, its operationalization at the policy level presents challenges. In particular, while AA implies the interplay between macro, meso, and micro levels, the topic of AA policy needs at the meso level is underresearched. In order to increase knowledge in this area, the present study investigated a total of 154 organisations through a self-administered questionnaire in the Italian Marche region. Of these organisations, 111 reported having implemented 192 AA initiatives. The main policy needs identified concern requests for help in planning and sustainability, as well as economic and human resources. The presence of needs at the policy level was associated with the specific AA domain of volunteering and civic engagement and seemed to be present when initiatives dealt with the reduction of inequalities in terms of generational differences and differences in terms of digital skills. To appropriately manage policy needs, those results call for policy action in order to involve representatives of meso-level organisations through co-decisional policy tools and to promote intergenerational programmes in general and in the field of digitalization in particular, given its benefits for both generations.

1. Introduction

Active ageing (AA) is widely recognised as an effective prevention tool by both the research community and international organisations. It is useful to foster physical and mental health, wellbeing, and improving the quality of life of older individuals [1,2,3]. This concept has been described as a “win-win” solution since it also implies benefits for society at large [4]. For example, older people can make productive contributions in many fields, including the economy, resulting in an increase in gross domestic product (GDP) and a decrease in public spending on pensions and health services [5].

However, many studies have shown the difficulties of applying the AA concept at the policy level [6]. The primary challenge concerned the cultural shift from viewing old age prevalently as a passive state characterised by disengagement and caring needs to a new paradigm of ageing as an active and positive phase of life. This paradigm offers opportunities to both older individuals and society as a whole [7]. The former view was internationally dominant at the policy level, and it took several years before the application of the latter new view of ageing began to take root. Initially, attempts to operationalize the concept of AA at the policy level neglected its multidimensionality, as they only focused on the pursuit of increasing the participation of older people in the labour market [8]. However, the multidimensionality of the concept was later progressively recognised, and other domains, such as volunteering, lifelong learning, caregiving, culture, and leisure, were included [1,9]. Despite the latter, the full and proper implementation of the AA concept at the policy level is still far from being accomplished [10].

Thus, the question remains on how to effectively influence policy making in the field of AA while identifying the actual policy needs in this area. Based on the available literature, policy needs regarding AA can be mainly identified and addressed through policy recommendations and implications derived from the empirical results of studies dealing with this topic [11].

The large majority of these studies focus on the individual (micro) level. They highlight that older individuals with more (human, health, social, economic, and cultural) resources find it easier to age actively in any domain. In this perspective, policy makers should promote the implementation of AA for older people in general while also planning specific policy initiatives that consider older people’s socio-economic inequalities [12].

By managing microdata on a large scale, it has also been possible to study the AA phenomenon at the macro level by providing information through selected common indicators, by countries, or, in the case of one-country studies, by regions. For instance, the application of the Active Ageing Index (AAI) has revealed that some European countries have similar characteristics and policy challenges or needs in terms of AA [13]. Similarly, when the AAI is applied at the national level, the same mechanism goes for regions within the country [14,15,16]. In this way, different geographical contexts, each with their own specificities and differences in terms of culture, infrastructure, economic development, inequalities, and so on, can learn from one another and can identify policy objectives based on their current state of the art [17].

However, it is useful to consider that while identifying and addressing policy needs at both the micro and macro levels is highly important, the meso-level—which affects the stakeholders’ perspective—should not be overlooked. Given the interrelation among micro, meso, and macro levels, it is crucial to recognise that the implementation of AA requires the simultaneous interaction among those three levels, each with its own unique characteristics [18]. Therefore, it is essential to address the needs of each level by providing opportunities, tools, and policy solutions.

Indeed, it is very unlikely that AA policies directly address older individuals without any mediation by NGOs, third-sector organisations, unions, companies, or other meso-level organisations. Yet, there is a paucity of studies investigating the needs of meso-level organisations providing or implementing active ageing initiatives. An exception is represented by the study of Principi and colleagues [19], which focused on the specific AA domain of volunteering using case study methodology in eight European countries. It has been shown that policy needs of voluntary organisations are mainly related to needing help in retaining older volunteers with competing roles (e.g., informal family caregivers or providing grandparenting), scarce visibility and recognition of volunteering, and sustainability of volunteering [19], among other needs. However, it is important to note that the study is over a decade old and did not address meso-level organisations that provided opportunities and initiatives in AA domains other than volunteering.

Therefore, the main objective of this study is to identify the needs of meso-level organisations that may be addressed at the macro-policy level in relation to AA initiatives and services they provide.

In order to have a link with criticalities encountered at the micro level related to older people’s socio-economic inequalities strongly affecting opportunities to be involved in AA, another objective of this study is to understand the role of meso-level AA initiatives addressing the issue of the reduction of inequalities, on experiencing or not policy needs. Indeed, it is worth mentioning that reducing inequalities is a key international objective. Through the 2030 agenda for sustainable development, the United Nations (UN) identified the sustainable development goal (SDG) 10, with the specific purpose of reducing inequalities [20]. In an AA perspective, inequalities may be understood as differences in resource holding. Considering that older people with fewer resources face more barriers to active ageing than others, it is important to consider whether specific AA initiatives for the benefit of this group are being implemented at the meso level.

This paper focuses on the meso level and aims to explore the policy needs of organisations providing AA initiatives, as well as whether these initiatives aim to reduce inequalities. The goal of ensuring no one is left behind (SDG 10) [20] is explored in the AA concept by investigating possible initiatives to provide adequate AA opportunities to groups such as older people with poor education and socio-economic status in general. Additionally, initiatives aimed at reducing age discrimination and stereotypes (e.g., to reduce the intergenerational conflict or the digital divide, and so on). It is hypothesised that the experience or lack of organisational policy needs may have a relation with the type of (reduction of) inequality addressed by the initiative.

2. Materials and Methods

In order to identify the policy needs of meso-level organisations providing AA initiatives, a self-administered questionnaire was adopted, to be filled out between June and mid-October 2021 by representatives of meso-level organisations via web through “Lime Survey”. The survey was conducted in central Italy, in the Marche region (eastern coast).

The questionnaire included both closed and open questions to investigate, among other aspects, the activities carried out within the initiative (through a description); the AA domains concerned; criticalities during the implementation; main recipients; resources used; type of inequalities addressed by the initiative; strengths and weaknesses, etc.

The survey was promoted through regional channels and mailing lists of the main voluntary organisations active in the Marche region on AA issues. These include the Volunteering Services Centre (CSV), Third Sector’s Forum, Social Territorial Areas (ATS—the Italian acronym for Social Territorial Areas, a sort of local authorities composed by several municipalities that have as their principal aim the programming and implementation of social services in their areas of responsibility), the National Association of Italian Municipalities (ANCI), and the main voluntary organisations of and for older people, e.g., self-management of Solidarity Services (AUSER), the National Association of All Ages Active for Solidarity (ANTEAS), the Association for the Rights of Older People (ADA), and the mailing list of the Marche Region’s Departments. The aim was to reach—using a cascading system at all regional territorial levels—the largest possible number of organisations involved in the development and implementation of AA initiatives in the region. This procedure was supplemented with an online search of organisations using keywords related to AA topics and domains, followed by targeted phone calls, in order to reach as many targeted organisations as possible.

Each organisation (through its contact persons and after signing the informed consent electronically) could enter up to five possible initiatives. To ensure high-quality data, in case of incomplete or missing answers, the research team contacted the compilers via e-mail and/or phone.

Data were entered into an Excel database and systematically “cleaned”. A unique ID number was assigned to each initiative/case entered.

Following this procedure, a total of 154 organisations participated in the survey. Despite the many efforts to include the highest possible number of meso-level organisations, this sample cannot be considered representative of meso-level organisations providing AA initiatives in the Marche region. Among the 154 organisations reached, 43 stated that they did not implement any AA-related initiatives. The remaining 111 organisations reported having developed AA-related initiatives in the Marche region, resulting in a total of 192 initiatives recorded in the database. If an organisation entered more than one initiative, the second part of the ID corresponds to the number of the initiative entered (e.g., 77_2 would indicate the second initiative entered by organisation 77).

2.1. Variables

Type of organisation—The meso-level organisations involved in the study were categorised according to the question: “Type of organisation (tick only one of the following options): Academia, Association, ATS, Company, Municipality, Union, Other (to specify)”. Based on the answers to the option “Other”, two supplemental types of organisations were created: the University of the third age and for adults (U3A) and the social cooperative. Active ageing domains—Active ageing domains represented in the 192 initiatives were measured with the question: “Active ageing domains considered by the initiative: (tick one or more of the following options): Volunteering and Civic engagement, Leisure activities, Lifelong learning, Informal caregiving, Culture, Sport, Tourism, Agriculture and gardening, Grandparenting, Co-housing, Labour market, Other (specification)”. This last option, where present, was recorded into the most appropriate already existing AA domain(s). These domains were derived from the definition of AA adopted in the study: the totality of work, social, educational and leisure activities carried out by mature/older people (aged 55+ if still in the labour market or aged 60+ if out of the labour market), including those in the following areas: “volunteering and civic engagement”, “lifelong learning”, “labour market”, “culture”, “tourism”, “sports”, “leisure activities”, “informal caregiving”, “grandparenting”, “agriculture and gardening”, “co-housing”, as well as any other possible domains concerning “activation of older persons”. The generality of the activities considered is deliberate, in order to leave the discussion open to any sphere that might be deemed useful and appropriate. This definition is aligned with the definition of the World Health Organisation [3], and it has also been used at the national level [21]. The adopted definition of AA excludes interventions aimed at older persons considered to be exclusively passive subjects in need of assistance, whether health-related and/or social. For each domain, a dichotomous variable was created: Yes = 1; No = 0. Inequalities—the type of (reduction of) inequality addressed through the initiative—were studied by investigating transversal aspects considered by the AA initiative. The provided alternatives were: intergenerationality; health conditions and health promotion; gender and/or equal opportunity aspects; ethnic background; socio-economic status (income, occupation); educational qualification/level of education; residential area (e.g., urban, rural); transportation and accessibility (e.g., physical, technological, etc.); lifecourse perspective; environmental sustainability; digitalization. Respondents were allowed to choose more than one option. For each aspect, a dichotomous variable was created: Yes = 1; No = 0.

Geographical area—as an additional aspect analysed, this variable aimed at investigating the territorial scope of the AA initiative. It was measured using the categories of “municipality” (1) and “broader than municipality” (0), with the latter including provincial, ATS, regional, national, or European levels.

Policy needs—policy needs of organisations implementing AA initiatives—were identified by analysing answers to the open-ended question, “Describe the weaknesses/criticalities of the initiative”. Based on the answers, two authors categorised them in terms of what needs to be addressed through public policies. Controversial views were discussed with a third author.

Additionally, a dichotomous variable was created in order to measure, at a general level, the absence (0) or presence (1) of policy needs.

2.2. Analyses

First, policy needs were described by type of organisation and AA domains. The potential correlation between policy needs was tested through Pearson’s correlation coefficient. Bivariate analyses were then performed using the chi-square test in order to identify potential explanatory variables for policy needs. Finally, a multivariate logistic analysis was performed with policy needs as the dependent variable. The significance level was set at p < 0.05. Statistical analyses were carried out using SPSS for Win V24.0 (SPSS Inc., Chicago, IL, USA).

3. Results

3.1. Sample Description

Table 1. Types of organisations, by implementation or not of AA initiatives (%).

Type of Organisation	With AA Initiatives (N = 111)	Without AA Initiatives (N = 43)	Total Organisations (N = 154)
Association	31.6	11.7	40
Municipality	27.9	41.9	49
U3A	13.5	-	15
ATS	11.7	20.9	22
Union	7.2	4.6	10
Company	3.6	9.2	8
Social Cooperative	2.7	11.7	8
Academia	1.8	-	2
TOTAL	100.0	100.0	154

describes the meso-level organisations investigated, which implemented or did not implement AA initiatives. Of the 111 organisations that reported AA initiatives, associations and municipalities accounted for 31.6% and 27.9%, respectively, followed by U3A and ATS, each with more than 10%.

Of the organisations that reported not implementing any AA initiatives, the largest proportion was made up of municipalities (41.9%) and ATS (20.9%), both of which belong to the public administration.

Table 2. AA domains considered by the initiatives by type of organisation (row%).

AA Domains	Type of Organisation
	Association	Municipality	U3A	ATS	Union	Company	Social Coop.	Academia	Total (N)
Volunteering and Civic engagement	46.5	17.8	10.9	10.9	10.9	1.0	1.0	-	101
Leisure activities	35.0	32.0	14.0	8.0	5.0	2.0	3.0	1.0	100
Lifelong learning	39.3	4.9	24.6	3.3	16.4	6.6	1.6	3.3	61
Informal caregiving	53.4	10.0	1.6	6.7	13.3	6.7	6.7	1.6	60
Culture	45.0	9.8	29.4	2.0	7.8	2.0	2.0	2.0	51
Sport	41.6	12.5	16.7	20.8	-	-	4.2	4.2	24
Tourism	15.0	45.0	20.0	-	15.0	-	-	5.0	20
Agriculture and gardening	40.0	13.3	6.7	20.0	-	6.7	13.3	-	15
Grandparenting	30.0	40.0	-	-	20.0	-	10.0	-	10
Co-housing	33.3	-	-	-	16.7	33.3	16.7	-	6
Labour market	-	-	-	-	-	33.3	33.3	33.3	3

shows the AA domains interested in the initiatives implemented by the surveyed organisations. The most widespread domains interested in the initiatives were volunteering/civic engagement (101) and leisure activities (100), followed by lifelong learning (61) and informal caregiving (60). Volunteering initiatives were mostly implemented by associations (46.5%), with fewer initiatives by municipalities (17.8%) or other types of organisations (less than 11%).

The domain of leisure activity was mostly covered by associations and municipalities (35% and 32%, respectively), while lifelong learning was still mostly covered by associations (39.3%), followed by U3A (24.6%). The domain of culture shows a similar pattern, with associations covering 45% of the initiatives and U3A 29.4%.

Initiatives in the field of informal caregiving were guaranteed by associations, which carried out more than half of the initiatives in this domain. The same pattern concerns the sport domain (41.6% and 20.8% of initiatives covered by associations and ATSs, respectively).

The domain of tourism was mostly a prerogative of municipalities, with almost half of cases (45%), but also U3A were quite active in this sector (20%), followed by associations and unions (15% each).

Both agriculture/gardening and grandparenting were mostly covered, respectively, by associations and municipalities (40% each).

3.2. Policy Needs

Out of the 192 initiatives, 107 (56%) reported weaknesses and criticalities. The 107 answers to the open-ended question were recoded into six macro-categories of policy needs, as described in

Table 3. Categories of policy needs (%, multiple answers).

Policy Need	N = 107
Help in planning and sustainability	45.8
Need of economic and human resources	42.1
More institutional support	23.4
Help in promotion	17.8
Need of improving ICT competences	9.3
Help in networking	4.7

.

Of the 107 initiatives, 45.8% reported a main policy need for help in planning and making the initiative sustainable due to a lack of design or planning. Sustainability problems were identified, particularly in specific geographic areas, such as small villages in the hinterland.

Additional economic and human resources were required for 42.1% of the concerned initiatives. This was not directly related to jeopardising the initiative in terms of sustainability (i.e., the previous policy need described); however, help was strongly requested to improve the situation. The issues included not only financial aspects but also difficulties related to the availability/adequacy of premises. Regarding human resources, organisations reported a shortage of available volunteers (which often may result in a loss of them) and also a scarcity of time devoted to volunteering for the initiative.

A total of 23.4% of the initiatives required more institutional support. This involves preventing a top-down policy approach by using co-decisional tools. Organisations often struggle to provide the administrative documentation requested due to excessive bureaucracy. As a result, they are often forced to hire professionals to produce these documents.

Organisations also highlighted the need for assistance in promotion (17.8%). This referred to reported difficulties in accessing the target audiences of the initiatives, with a related need to improve promotional and communication aspects and to generate more interest and commitment in the community.

Although less frequently reported, it is still important to underline the need for improving information and communication technology (ICT) competences (9.3%) and networking capacities (4.7%). The first refers to a gap to be covered between those older people who have access to (and can use) ICTs and those who have no or limited access to them or inadequate ICT skills. The second refers to coordination and collaboration issues with other entities as well as difficulties in involving other organisations.

To determine whether policy needs are interrelated, we tested the correlation between them (

Table 4. Pearson correlations of policy needs.

	Help in Planning and Sustainability	Need of Economic and Human Resources	More Institutional Support	Help in Promotion	Need of Improving ICT Competences	Help in Networking
Help in planning and sustainability	1	−0.126	−0.049	0.126	0.132	−0.021
Need of economic and human resources		1	0.297 **	−0.142 *	−0.019	0.064
More institutional support			1	−0.025	0.049	0.131
Help in promotion				1	0.079	0.055
Need of improving ICT competences					1	−0.038
Help in networking						1

* p < 0.05, ** p < 0.01.

).

We identified a weak (the value of the coefficient being less than 0.3) but statistically significant correlation in two cases. The need for resources is positively correlated to the need for institutional support, while it is negatively correlated with the need for help in promotion (i.e., the fewer resources needed, the more help is required for promotion, and vice versa).

When analysing the needs of the initiatives by type of organisation (

Table 5. Policy needs by type of organisation (row%; multiple answers) *.

Type of Organisation	Type of Policy Needs
	Help in Planning and Sustainability	Need of Economic and Human Resources	More Institutional Support	Help in Promotion	Need of Improving ICT Competences	Help in Networking	N
Association	41.5	37.7	17.0	22.6	9.4	5.7	53
Municipality	64.3	35.7	7.1	-	-	-	14
U3A	42.9	78.6	57.1	28.6	14.3	7.1	14
ATS	33.3	33.3	44.4	-	11.1	-	9
Company	40.0	40.0	20.0	-	20.0	-	5
Social Coop.	80.0	20.0	20.0	-	20.0	20.0	5
Academia	75.0	25.0	25.0	50.0	-	-	4
Union	-	66.7	-	33.3	-	-	3

* Percentages are calculated within initiatives reporting needs.

), it is noticeable that for associations and municipalities, the more reported needs are help in planning and sustainability and the need for economic and human resources. Regarding the request for help in planning and sustainability, concerning associations, an example of this is provided by the criticality of the initiative of organisation 117_1, which was largely influenced by the pandemic: “The impossibility of organising smartphone courses in presence, an essential condition for members who were new to the project, has severely limited the results in the first phase” [Association 117_1]. Perhaps surprisingly, despite involving the public administration, this is also the most reported need among municipalities. One of the most frequently cited reasons concerns the difficulty of guaranteeing adequate means of transportation to older people involved in the initiatives (e.g., Municipalities 243_1 and 298_1).

The need for economic and human resources (especially) and more institutional support scored quite high among U3A (78.6 and 57.1%, respectively). Regarding the first need, U3A reported, for example, the following problem: “There is scarce availability of adequate classrooms, in relation to anti-COVID-19 provisions. There are also difficulties in finding funds, especially during periods of low enrolments, and this makes it difficult to carry out the planned activities” [U3A 441_1]. An example of complaints about the inadequate institutional support concerned the initiative of U3A 416_1: “There is a lack of sensitivity by the municipality towards our activities. The municipality contacts us when it needs help to organise events or activities, or to implement services for free, however, when we ask for something, there is nothing for us… We have to do as we can” [U3A 416_1]. It should be noted that some public sector organisations, such as municipalities and ATSs, reported needs in terms of planning, resources, and institutional support. An example of the latter is provided by the initiative of ATS 213_1: “The biggest problems derive from the management of the dedicated funds and the stringent parameters adopted by the regional government, with little awareness of the characteristics of the area, thus discouraging participation and the creation of further opportunities” [ATS 213_1].

Criticalities and needs were also analysed in relation to the type of AA domain(s) concerned by the initiatives (

Table 6. Policy needs by AA domains (row %; multiple answers) *.

AA Domains	Type of Policy Needs
	Help in Planning and Sustainability	Need of Economic and Human Resources	More Institutional Support	Help in Promotion	Need of Improving ICT Competences	Help in Networking	N
Volunteering and Civic engagement	42.2	48.4	21.9	20.3	7.8	3.1	64
Leisure activities	52.8	43.4	30.2	17.0	3.8	5.7	53
Lifelong learning	52.4	47.6	21.4	23.8	14.3	7.1	42
Informal caregiving	43.6	38.5	17.9	17.9	17.9	10.3	39
Culture	58.8	50.0	29.4	14.7	5.9	5.9	34
Sport	53.8	38.5	38.5	23.1	-	-	13
Agriculture and gardening	50.0	33.3	16.7	16.7	-	-	12
Tourism	33.3	55.6	33.3	11.1	-	11.1	9
Grandparenting	66.7	33.3	16.7	50.0	-	16.7	6
Co-housing	50.0	50.0	50.0	-	-	25.0	4
Labour market	66.7	-	-	33.3	33.3	-	3

* Percentages are calculated within initiatives reporting needs.

).

Help with planning and sustainability seems to be the most experienced need across AA domains transversally, even more so than the request for resources. One of the few exceptions to this concerns the AA domain of volunteering and civic engagement, where the need for economic and human resources (48.8% of the initiatives reporting needs) is greater than the need for help in planning and sustainability (42.2% of the initiatives reporting needs).

Moving the analyses on the presence or absence of policy needs at a more general level (Y/N) among the 192 initiatives surveyed globally in order to determine whether there is a link between the type of inequality addressed by the AA initiative and the presence of a policy need. Bivariate analyses were carried out (

Table 7. Type of inequality addressed by the initiative and presence or absence of policy needs (%).

Inequality Addressed (Yes) ^	Policy Need Yes (N = 107)	Policy Need No (N = 85)	p
Health conditions	72.9	67.9	0.448
Gender and/or equal opportunity aspects	15.0	17.9	0.589
Ethnic background	8.4	4.8	0.320
Socio-economic status	9.3	11.9	0.566
Educational qualification/level of education	10.3	6.0	0.284
Intergenerationality	58.9	31.0	<0.001 ***
Area of residence	16.8	13.1	0.476
Transport and accessibility	26.2	17.9	0.172
Life course	29.0	23.8	0.423
Environmental sustainability	17.8	13.1	0.379
Digitalisation	29.0	8.3	<0.001 ***

^ Percentages are shown in relation to: Inequality addressed (No); *** p < 0.001.

).

The analysis showed significant associations regarding inequalities in terms of age divide (initiatives aimed to reduce the intergenerational divide) and digital divide (initiatives aimed to increase the digital competences of older people).

According to the results, among all initiatives reporting policy needs, 58.9% addressed the topic of intergenerational aspects (instead, among all initiatives that did not report policy needs, 31% addressed the same topic). For example, initiative 235_1 (Company) aimed to develop innovative models to manage agricultural holdings by promoting their multi-functionality. Among the activities planned, one involved organising workshops to promote interaction between older people and children. However, the initiative faced difficulties in obtaining support from local authorities for planning issues, both in the short and long term.

For initiatives aimed at improving the digital competence of older people, the percentages were 29% and 8.3%, respectively. Among the 29% of initiatives reporting needs, case 340_2 (Association) had the general aim of providing informal caregivers of older people with tools and skills to support them in their care tasks. The activities concerned organising four online meetings, one of which was focused on how to find useful information by using online resources. The need for this initiative concerned improving participants’ basic ICT competences, as many of them had difficulties managing online meetings.

The policy needs have also been related to the different AA domains concerned by the initiative (

Table 8. Type of AA domain addressed by the initiative and presence or absence of policy needs (%).

AA Domain Addressed (Yes) ^	Policy Need Yes (N = 107)	Policy Need No (N = 85)	p
Volunteering and civic engagement	59.8	43.5	0.025 *
Leisure activities	49.5	55.3	0.427
Lifelong learning	39.3	22.4	0.012 *
Informal caregiving	36.4	24.7	0.081
Culture	31.8	20.0	0.067
Sport	12.1	12.9	0.869
Tourism	8.4	12.9	0.307
Agriculture and gardening	11.2	3.5	0.049 *
Grandparenting	5.6	4.7	0.780
Cohousing	3.7	2.4	0.584
Labour market	2.8	-	0.120

^ Percentages are shown in relation to: AA domain addressed (No); * p < 0.05.

).

Significant associations were found in the AA domains of volunteering/civic engagement, lifelong learning, agriculture and gardening.

Specifically, 59.8% of initiatives reporting policy needs were in the domain of volunteering/civic engagement. As an exemplary finding, initiative 200_1 aims to transport and support older people in need (transportation needs; help in booking medical examinations, etc.). The initiative has requested resources, especially human resources, due to the difficulty of involving volunteers. When considering all initiatives that did not report policy needs, 43.5% of them have been implemented in this same field.

In the lifelong learning domain, these percentages were 39.3% and 22.4%, respectively. An example of initiative reporting needs in this domain is that of 450_1. In this case, the aim concerned the cultural and social training of older people through the organisation of meetings, courses, and workshops on specific topics. Activities also involved planning and implementing initiatives to protect and safeguard the cultural heritage. The policy need of this organisation to improve participants’ ICT competences, was linked to the specific event of the pandemic. In particular, when the initiative was forced to move the lessons fully online, there has been a progressive loss of participants due to poor knowledge of ICT.

Additionally, in the agriculture and gardening domain, which concerned fewer initiatives, 11.2% reported needs, while 3.5% did not report policy needs.

The variables that demonstrated significant associations in the previous bivariate analyses testing the relationship with policy needs of the types of inequalities and of the AA domains have been included in a logistic regression as independent variables. As an exception to the latter, the domain of agriculture and gardening was not included due to its low numerosity. Additionally, the geographical scope of the initiative (municipality vs. broader area) was included as a control variable. The results are shown in

Table 9. Explanatory variables for policy needs (Y). Logistic regression, N = 192.

	B	OR	p
Inequality addressed: intergenerationality	1.115	3.051	0.001 **
Inequality addressed: digitalization	1.035	2.816	0.036 *
AA domain: volunteering and civic engagement	0.674	1.962	0.044 *
AA domain: lifelong learning	0.442	1.556	0.233
Geographical area: (reference: broader than municipality)
Municipality	−1.041	0.353	0.017 *
Nagelkerke R2 = 0.234

* p < 0.05, ** p ≤ 0.01.

.

The significant association between the presence of policy needs and the two types of inequalities analysed was confirmed by the multivariate analyses. Specifically, the presence of initiatives aimed at reducing the intergenerational divide increases the probability of having policy needs by three times (Odds Ratio, approximately 3). Similarly, initiatives aimed at increasing the digital competence of older people were almost three times (OR 2.816) more likely to experience policy needs.

Multivariate analyses confirmed significant levels of the AA domain volunteering/civic engagement, but not for the lifelong learning domain. Specifically, initiatives covering the AA domain of volunteering/civic engagement, have almost twice the probability (OR 1.962) of experiencing policy needs.

Finally, the geographical scope of the initiative seems to play a role in relation to policy needs, as initiatives at the municipal level have a 65% lower probability of experiencing policy needs compared to initiatives implemented at a broader level (35%).

4. Discussion and Conclusions

The primary objective of this paper is to study the policy needs of meso-level organisations that provide AA initiatives. This aim is motivated by various reasons. Firstly, due to its recognised benefits at all levels [22,23], there is a need to promote and favour the transition towards the AA perspective, which is still not fully considered at the policy level, as opposed to the traditional healthcare-related perspective [24]. Another reason is that, while a considerable number of studies have addressed this issue at the micro and at the macro levels [25,26], the needs of meso-level organisations have rarely been explored. Moreover, meso-level organisations play a crucial role in connecting public policy opportunities to older individuals [27].

Among the various types of policy needs identified, we found that the two main ones occurring in meso-level organisations dealing with AA were help in planning to make the initiatives sustainable and the need for economic and human resources. Maybe not surprisingly, the latter need resulted in a positive correlation with the need for more institutional support. Instead, the need for assistance in promoting the initiative is more prevalent when there is less need for resources. This could mean that when AA initiatives have adequate resources, the policy of promoting them arises as a “second level” need.

When considering the institutional governmental level as the recipient of these messages, it is important to address planning issues in order to guarantee the sustainability of the initiatives. This may require greater involvement of (representatives of) meso-level organisations in programming AA policies through co-decisional tools [11]. AA policies are often implemented using a top-down approach [28], which may result in the perspective of meso-level organisations being neglected. This criticality is particularly visible when planning issues are concerned, even if the adoption of “hybrid” (i.e., involving both top/institutional and bottom/meso-level organisations) co-decisional participative tools may be helpful regardless of the policy need [21]. This is also suggested by Carter and Beresford [29], who, examining models of involvement for older people in policy making in the UK context, observed that co-decisional approaches (over consultative ones) may really set the conditions for a deliberative dialogue. Interestingly, the present study has been conducted in an Italian region where such a tool exists, and it is represented by a formalised permanent table on AA for the governance and planning of AA policies. The “Regional permanent table on active ageing”, was established through Art. 4 of Regional Law 1/2019, “Promotion of active ageing”, and it comprises both regional policy makers/officers, and key stakeholders from civil society, including representatives of meso-level organisations [30]. Their joint work resulted in the production of the first “Annual regional plan for AA” in 2022 [31], as envisaged by the above-mentioned regional law. Therefore, as a future research step, it would be very interesting to follow up on the policy needs of meso-level organisations in this region in order to understand whether the work of this co-decisional tool has effectively addressed their policy needs.

Regarding the other most significant policy need identified, which is the need for resources, it is important to underline that the need for economic resources by meso-level organisations in general (i.e., not necessarily those providing AA initiatives) is very commonly mentioned [32]. However, in this case, resources also refer to human resources. It is not surprising that this need is particularly relevant for U3A, which represent less structured organisations with less potential for involving people, many of whom are older volunteers. This view is consistent with the other finding that the need for resources is mostly experienced by initiatives in the domain of volunteering. In the volunteering sector, this kind of need lasts over time, and it is not limited to the Italian regional or national level, but rather it seems to be an international phenomenon, as suggested by a study conducted in eight European countries [19]. This implies that recruitment campaigns for voluntary organisations should receive better institutional support, with a particular focus on socially disadvantaged older people and/or those with limited access to information on AA opportunities, e.g., by ad hoc campaigns.

Partly in line with the above results, when we examined the factors associated with the presence or absence of policy needs in meso-level organisations in relation to various AA domains, we found that the volunteering domain may be the most critical, with a higher probability of requiring supporting policies. This is a crucial message for policy makers, as it underlines the need to improve the operalisation of AA multidimensionality in policy to ensure that no domain is left behind. This should be done considering that in Italy, voluntary work is mainly concentrated on complementing the public administration in delivering social and care services, so this sector acts as an essential service provider, despite the need to recruit more volunteers. In line with this, the voluntary sector in Italy appears to be underdeveloped when compared to other European countries, especially those in Northern Europe [19].

An additional objective of this study was to examine the presence of organisational policy needs in relation to the attempt to reduce inequalities through the AA initiatives implemented. The reduction of inequalities is a specific sustainable development goal of the 2030 agenda for sustainable development (SDG 10) [20]. There are many types of possible inequalities, such as those based on income, gender, age, disability, sexual orientation, race, class, ethnicity, and more. Outcomes of inequalities may be a missed sense of fulfilment and of self-worth. Regarding older people, the UN has specified that they face a lack of opportunities and discrimination (e.g., due to ageism). It also underlined that it is important to pay attention to the needs of disadvantaged and marginalised communities and promote inclusive social growth [33]. This aim must also be pursued by providing opportunities for all older people, including those with fewer resources, to access AA opportunities.

Among the various types of inequalities tested through our study, the results highlighted a higher probability of reporting policy needs when attempting to reduce the generational gap and the digital divide. In some way, these two results may be linked, since in many cases, initiatives addressing ICT literacy are carried out involving both older people (as learners) and younger people (as teachers) [34]. The reason why these kinds of AA initiatives seem to encounter more problems may be the difficulty of recruiting individuals from different generations. This may be due to a lack of interest from both sides in interacting with each other [35], as well as a lack of promotion of the few opportunities/programs that favour such “contaminations”, e.g., intergenerational learning programs [36,37]. This may also pose problems in terms of intergenerational team building, within the initiative [38]. In spite of this, the policy level should provide greater support to meso-level organisations that offer this kind of initiative. Indeed, research has shown that on the one hand, initiatives that involve intergenerational exchange are beneficial both to older and younger people, and on the other hand, they are beneficial to overcoming age stereotypes [39].

The results also highlighted that AA initiatives implemented by meso-level organisations at the local level (municipality level) may be less likely to experience policy needs compared to initiatives with a larger geographical scope. This may be due to the fact that the implementation process would be more straightforward if the initiative was small and aimed at early wins to encourage future investments of time or other resources [40].

This study also has some limitations. An important limitation is that it cannot be considered representative of the regional territory investigated; therefore, the results cannot be generalised to the regional context. Instead, this study should be treated as exploratory. Moreover, due to the low numbers, it was not possible to investigate each of the six types of policy needs identified through multivariate analyses. Such analysis would have allowed us to deliver more specific policy implications. Another limitation is that some of the policy needs may have been influenced by the pandemic, so it is unclear whether there has been an increase or decrease in organisational policy needs as a result. In addition, the pandemic may have limited the institutional capacity to address meso-level policy needs.

Despite those limitations, the study also has some strengths. Its main advantage is that, in light of a considerable paucity of studies on the matter, it fills an evident gap in knowledge regarding policy needs in meso-level organisations that implement AA initiatives, while studies on the same matter carried out at the micro and macro levels are largely available [12,26]. A further strength is that while most studies on the topic of AA concentrate on one specific AA domain (work for the labour market, volunteering, lifelong learning, etc.), e.g., [41], this study covers all of the main AA domains, thus acknowledging its multidimensionality.