Factors Influencing the Utilization of Community Cultural and Leisure Services for the Older Adults From The Perspective of Supply and Demand: Based on the Case of Shaanxi Province


 Background

Along with the increasing number of older adults in China, the demand for older adults services of China's aging population has been transformed and upgraded, and the demand for community cultural and leisure services of the older adults has become increasingly prominent. The research on the influencing factors of the utilization of community cultural and leisure services of the older adults can help improve the service effect and enhance the quality of life of the older adults. Based on Anderson's model, we constructed an analytical framework of the influencing factors of the utilization of community cultural and leisure services for the older adults from both the supply and demand sides, and then used Poisson regression method to empirically test the analytical framework based on the survey data of three cities in Shaanxi Province in 2019.
Results

The results found that supply-side factors significantly influenced the utilization of community cultural and leisure services by the older adults, mainly including service facility supply, service content supply, and service location accessibility; demand-side factors significantly influenced the utilization of community cultural and leisure services by the older adults, mainly including service acceptability, service satisfaction, and service need. The study also found that, unlike the results of previous studies, the use of community cultural and leisure services by older adults was not constrained by economic level.
Conclusions

Both supply-side factors and demand-side factors significantly affect the utilization of community spiritual culture services by the older adults. In strengthening and improving the supply of community cultural and leisure services, the previous "top-down" and "service-centered" approach should be changed to a "bottom-up" and "demand-centered" approach. In the past, the supply of community spiritual culture services should be changed from a "top-down" and "service-centered" approach to a "bottom-up" and "demand-centered" approach, and attention should be paid to the urban-rural differences in supply.


Background
By the end of 2019, China's older adults population aged 60 and above reached 253.88 million, accounting for 18.1% of the total population, much higher than the UN's statistical standard of 10% of the population aging [1]. Relevant data show that China's population aged 60 and above is expected to exceed 300 million in 2025, 400 million in 2033, and will reach a peak of 487 million in 2053 [2]. Along with the increasing number of older adults, the demand for older adults services is also expanding. At the same time, along with socialism with Chinese characteristics entering a new era, the demand for older adults services in China is constantly transforming and upgrading, showing a situation where basic physiological needs and spiritual and cultural needs are equally important [3]. As the older adults move from society to family after retirement, the change of environment and role has caused more and more older adults psychological quality to weaken and their demand for Cultural and Leisure Services to become more and more urgent [4]. The "Thirteenth Five-Year Plan" for the development of the national older adults and the construction of the older adults system points out that "to improve the older adults service system, enrich the spiritual and cultural life of the older adults, the development of older adults education, and the prosperity of older adults culture." In recent years, along with the accelerated development of population aging in China, community older adults care services have received more and more attention from the government and the society. Under the guidance of government policies and market promotion, community older adults services in China have been developed rapidly, and some urban communities have even achieved full coverage of community older adults service sites [5]. Community older adults services include life care, medical care, cultural entertainment, spiritual comfort, active aging, and rights protection, which are all urgently needed to be satis ed for the older adults. However, the utilization level of community older adults services for the older adults is generally low, and the imbalance between supply and demand is becoming more and more serious, and so is the utilization of community cultural and leisure services [6]. First, the mismatch between service content and demand has led to the dilemma of "poor supply" and "poor demand" at the same time, and the supply of community cultural and leisure services mainly focuses on the most basic services such as chess and card activities, calligraphy and painting activities, and lacks senior classes, knowledge lectures, intelligent recreational activities [7]. Secondly, the services lack specialization and are di cult to meet the needs of the older adults. At present, most studies on the factors affecting the utilization of community older adults services discuss demand-side factors such as economic level, health status, family support, and lack discussions on supply-side factors such as service supply and service price, while studies on the utilization of community cultural and leisure services mainly stay at the theoretical level, with a lack of empirical studies [8]. Service supply and service demand are the prerequisites for effective service utilization, and thus determine whether service effectiveness can be generated. In order to better break the imbalance between supply and demand, improve the effectiveness of community older adults services, and promote the healthy and sustainable development of community older adults services, it is necessary to investigate the factors in uencing the utilization of community cultural and leisure services from both the supply and demand sides [9].
Accordingly, this study draws on Anderson's model to construct an analytical framework for the factors in uencing the utilization of community cultural and leisure services for the older adults. Based on the questionnaire survey data in Shaanxi Province, the Poisson regression method is used to empirically analyze the key factors in uencing the utilization of community cultural and leisure services for the older adults from both the supply and demand sides, in order to draw insights for the future development of community cultural and leisure services.

literature review
Scholars have studied the factors in uencing the utilization of community-based senior care services for older adults, focusing on overall community-based senior care service utilization, or the utilization of medical care services among them. In terms of overall community older adults service utilization, the factors that in uence the utilization of older adults services are mainly gender, age, residence style, nancial status, receipt of Medicaid, and health status [10][11] [12][13] [14]. Meanwhile, related studies show that older adults who receive support from informal caregivers such as children are more likely to use community older adults care services [15]; the more adequate social capital (social participation, volunteering, sense of belonging, social trust, etc.), the more likely older adults are to use older adults care services[16]; perceived service need and service knowledge/perception are important factors in uencing older adults care service utilization [17][18]; service supply and service quality are the practical constraints for the elderly to use elderly care services [19]; socio-cultural factors may lead to urban-rural differences in the utilization of older adults care services, such as the perceptions of older adults towards communitybased older adults care services and formal support [20].  [24]; the more intergenerational support ( nancial support, caregiving support, emotional support from children), the more older adults use health care services [25][26]; the economic level constrains older adults' use of health care services [27][28] [29]; the type of health insurance has a signi cant impact on the level and frequency of health care services for older adults [30][31] [32]; the accessibility of community health care facilities is an important factor in uencing the use of health care services for older adults [33].
According to the literature, rst of all, few scholars have studied the factors in uencing the utilization of community-based Cultural and Leisure Services for the older adults. However, the demand for Cultural and Leisure Services of the older adults in China is becoming more and more prominent, and the demand for older adults services has changed from a single basic physical need to both basic physical needs and spiritual and cultural needs. Secondly, existing studies have focused on demand-side factors and relatively neglected the in uence of supply-side factors on the service utilization of the older adults.
Therefore, this study intends to focus on community cultural and leisure services and investigate the key factors affecting the utilization of community spiritual services for the older adults from both supply and demand side perspectives.

Analysis Framework
The Anderson model was created by American scholar Ronald Anderson in 1968 and was originally used to analyze the factors in uencing the utilization of home health services. The fourth revision of the Anderson model in 2000 renamed the "environment" dimension and the "demographic" dimension as the "situational characteristics" dimension and the "personal characteristics" dimension, respectively, and expanded the "situational characteristics" dimension to be the same as the "personal characteristics" dimension. The "situational characteristics" dimension is expanded into the same structure as the "personal characteristics" dimension, i.e., dispositional factors, enabling resources, and need factors [34] [35]. Thus, the Anderson model consists of four dimensions: situational characteristics, personal characteristics, medical behaviors, and medical outcomes, making the model more complex and complete. The situational characteristics dimension refers to the external environment. The personal characteristics dimension refers to the factors that predispose people to use medical services before the onset of disease, including demographic factors, social structural factors, and health beliefs; the enabling resources refer to the factors that ensure people's access to medical services, including personal resources, family resources, and community resources; and the need factors are the direct reasons for people to use medical services, including perceived health status and assessment of health status. Medical behavior dimension, including individual self-care, medical service process and medical service utilization. The medical outcome dimension, which includes perceived health status, assessed health status, and patient satisfaction, re ects the subjective evaluation of the individual's health care outcomes, and the health care outcomes have a negative impact on the individual's health care utilization behavior [35].
Anderson's model has become the most widely used theoretical model in health care utilization research [36] and is also applicable to analyze the in uencing factors of psycho-cultural service utilization. It has been pointed out that, as a bridge between supply and demand of services, health care utilization is mainly in uenced by supply-related and demand-related factors, in addition to individual characteristics [37][36]. This provides a more systematic approach to explore the determinants of health care service utilization and may overcome the shortcomings of Anderson's model. Therefore, this paper adopts this new perspective by reconstructing the Anderson model using the 2000 version of the Anderson model as the base model and considering only the individual characteristics, medical behavior, and medical outcome dimensions. In this study, the propensity factors are invariable and cannot be intervened[38] [34], which can be used as control variables in this study [39], including demographic characteristics such as age and gender and social structural characteristics such as education level and household registration; community resources in the enabling factors are used as supply-side factors, resources of Cultural and Leisure Services for the older adults provided by the community, and are appropriately re ned and extended, including service facility supply, service content; nally, the perceived service needs are used to measure the Cultural and Leisure Services needs of the older adults instead of the health status in the original model, and they are combined with the individual and family resources in the enabling factors and the satisfaction of the results in the "medical outcomes" in the original model as the demand-side factors, including Service need, service acceptability, economic level, and service satisfaction.
From the supply side, service supply is a prerequisite for the use of community cultural and leisure services for the older adults, including the supply of service facilities and the supply of service contents. On the basis of adequate service supply, scholars point out that the accessibility of service location and the reasonableness of service fees signi cantly affect the service utilization of the older adults [40][41] [42]. Therefore, this paper proposes the following research hypotheses.
H1: Supply-side factors signi cantly affect the utilization of community cultural and leisure services for the older adults.
H1a: The supply of service facilities signi cantly and positively affects the use of community cultural and leisure services for the older adults.
H1b: The supply of service content signi cantly and positively affects the use of community cultural and leisure services for the older adults.
H1c: Service location accessibility signi cantly and positively affects the utilization of community cultural and leisure services for the older adults.
H1d: Reasonableness of service fees signi cantly and positively affects the utilization of communitybased Cultural and Leisure Services for the older adults.
From the demand side, service need is the direct motivation for the older adults to utilize community cultural and leisure services, and at the same time, the conversion of this potential need into actual demand is also directly in uenced by factors such as service acceptability, economic level, and the feedback in uence of service satisfaction [43][44] [45][18]. Therefore, this paper proposes the following research hypothesis.
H2: Demand-side factors signi cantly affect the utilization of community-based Cultural and Leisure Services for the older adults.
H2a: Service acceptability signi cantly and positively affects the use of community cultural and leisure services for the older adults.
H2b: Service satisfaction signi cantly and positively affects the use of community cultural and leisure services for the older adults.
H2c: Service need signi cantly and positively in uences the utilization of community cultural and leisure services for the older adults.
H2d: Economic level signi cantly and positively in uences the utilization of community cultural and leisure services for the older adults.
In summary, the Anderson model of health care service utilization was reconstructed from both the supply and demand sides to establish an analytical framework of factors in uencing the utilization of community-based cultural and leisure services for the older adults, as shown in Fig. 1.

Data source
The data of this study come from the eld research data of the subject group, and this survey adopts strati ed random sampling method, according to the regional distribution of Shaanxi Province, Yan'an City, Baoji City and Hanzhong City are selected as the rst stratum, 2 counties (districts) in each city are randomly selected as the second stratum, a total of 6 counties (districts), then 2 street o ces (townships) are randomly selected from each county (district) as the third stratum, a total of 12 street o ces (townships), and nally 2 communities (village groups) are randomly selected from Each street o ce (township) randomly selected 2 communities (village groups) as the fourth layer, a total of 24 communities (village groups), to conduct the survey. The survey targets the older adults population aged 60 and above, and the survey covers many aspects such as old-age care, medical care, old-age service and old-age products, among which, old-age service covers the demand and supply of old-age service and evaluation of old-age service for the older adults, with a total of 948 valid questionnaires. In this paper, we select the data of cultural and recreational services part of the demand and supply of older adults services, eliminate the samples of institutional older adults care institutions services and key variables missing, and nally get 683 valid samples.
This study was approved by the Department of Social Sciences of the Ministry of Education, PRC and the Medical Ethics Committee of Health Science Center of Xi 'an Jiaotong University (Approval Number 2016 − 416). The ethics committee approves the procedure for the verbal consent, which is allowed for social investigation not involving any biological or medical experiment. Before data collection, we orally introduced the background, content and purpose of the study to respondents and assured them that the data did not involve any personal privacy information and were for research only. Only when the respondents con rmed that they were willing to participate in this survey, our investigators began the investigation. All questionnaires were completed anonymously and all procedures performed in the study were in accordance with the ethical standards.

Variables selection
(1) Dependent variable: community cultural and leisure services Utilization The utilization of community cultural and leisure services is de ned as the number of older adults who have used the cultural and recreational services provided by the community, which is measured by asking the older adults "the content of cultural and recreational services provided by the community (multiple choice)", including ve items of older adults interest groups, cultural performances, chess and card activities, knowledge lectures, and intelligent older adults recreational services, and the values are A value of 1 means that the older adults have used the service, and a value of 0 means that the older adults have not used the service. Finally, the scores of each service are summed up to obtain the spiritual cultural service utilization variable, with a value range of 0 ~ 5.
(2) Independent variables According to the analysis framework of the study, the independent variables include two main categories. The rst category is the supply side, which is mainly measured by service facility supply, service content supply, service location accessibility, and service fee reasonableness. The service facilities mainly include senior activity centers, chess and card rooms, reading rooms, painting and calligraphy rooms and senior tness rooms, and the service contents mainly include senior interest groups, cultural performances, chess and card activities, knowledge lectures and smart senior recreational activities. "The scores of each service facility/service content provided were summed up to obtain two variables, namely, service facility supply and service content supply, with the values ranging from 0 to 5. The second category is the demand side, mainly measured by service acceptability, service satisfaction, service need and economic level. The second category is the demand side, which is measured by service acceptability, service satisfaction, service need, and economic level, where service satisfaction indicates the feedback impact of service effect. Service acceptability refers to the psychological response of the older adults to the home community service provider's network and door-to-door service, and mainly measures the degree of acceptance of the service by the older adults [19], in this study, it mainly refers to the degree of acceptance of community cultural and leisure services by the older adults, and is measured by the older adults' "willingness to participate in these recreational activities". The results were expressed by Likert scale with values from 1 to 5; service satisfaction refers to the degree of satisfaction of the older adults with the community cultural and leisure services provided by the community, measured by Likert scale with values from 1 to 5; service need includes older adults interest groups, cultural performances, chess and card activities, knowledge lectures and intelligent recreational services for the older adults, 1 means the older adults have a need for the service, 0 means the older adults do not have a need, and nally the scores were The higher the score, the greater the need, and the range of values is 0 ~ 5. The economic level refers to the total annual income of the older adults in the previous year and is a continuous variable. (

3) Control variables
According to previous research literature, the control variables used in this paper include: age (continuous variable), gender (male, female), education level (elementary school and below, junior high school, high school/junior high school, college, undergraduate and above), type of marriage (unmarried, married, divorced, widowed), household registration (urban, rural), whether living alone, and ability to take care of oneself. The ability to take care of oneself is a composite of the respondents' scores on six indicators: eating, dressing, getting in and out of bed, going to the toilet, walking around indoors and bathing, with values from 0 to 6. The higher the score, the worse the ability to take care of oneself. The setting and description of the variables are shown in Table 1.

Analysis method
This study used Poisson regression model for analysis based on two main considerations: rst, the data distribution, like the service utilization behavior of all older adults with a Poisson distribution [3], the data on community cultural and leisure services utilization in this study also had a Poisson distribution; second, the data characteristics, the dependent variable community cultural and leisure services utilization has a range of values from 0 to 5, which is a count variable.
In order to analyze the direction and degree of in uence of supply side and demand side on the utilization of community cultural and leisure services, four models were constructed in this paper; model 1 incorporates only control variables, model 2 incorporates both control variables and supply side factors, model 3 incorporates both control variables and demand side factors, and model 4 is a full model, incorporating both control variables, supply side and demand side factors. The speci c models are as follows.

Demographic characteristics and overall service utilization
Among the surveyed older adults, the youngest was 60 years old and the oldest was 92 years old, with an average age of 70.41 years old; the ratio of men to women was about 0.6:1, with more female older adults than male older adults; in terms of education level, the percentage of older adults with elementary school education and below reached 43.48%, while those with college education and above only accounted for about 8%, and the overall education level of the surveyed older adults was low; in terms of household registration, the ratio between urban and rural households was 1.3:1, with slightly more older adults living in urban households than in rural households; in terms of self-care ability, the mean value of ADL was 0.05, meaning that the majority of older adults were not physically impaired; in terms of living alone, the ratio between older adults living alone and those not living alone was about 0.2:1, with most of the surveyed older adults living with their children and other family members; in terms of marriage type, the largest number of older adults were married, accounting for 71.5%. In terms of marriage type, the largest number of older adults are married, accounting for 71.60%, followed by widowed, accounting for 25.48%. Regarding the use of community cultural and leisure services, 39.39% of the older adults had not used community cultural and leisure services, 22.98% had used one, 22.98% had used two, and 14.65% had used three or more, so the overall use of community cultural and leisure services by the surveyed older adults was good, and more than half of the older adults had used the services. Descriptive statistics are shown in Table 2.  Table 3 shows the results of the Poisson regression analysis, where the dependent variable is the utilization of community cultural and leisure services, model 1 incorporates only the control variables, models 2 and 3 are the results of incorporating supply-side and demand-side factors, respectively, based on the control variables, and model 4 is the full model. Although there may be covariance among the variables, the statistics show that the four models do not have serious covariance problems (see the notes to Table 3), which can be used as the basis for analysis.

Analysis of regression results
(1) Test of the impact of supply-side factors on the utilization of community cultural and leisure services for the older adults . This indicates that the more adequate the supply of service facilities, the more helpful it is for the older adults to use community cultural and leisure services; the more adequate the supply of service contents, the more likely the older adults will use community cultural and leisure services; the more convenient and accessible the location of services, the more likely the older adults will use community cultural and leisure services. This veri es the hypothesis 1 of this paper: supply-side factors signi cantly affect the use of spiritual culture services by the older adults, further verifying hypotheses H1a, H1b and H1c, and hypothesis H1d does not pass the veri cation.
(2) Test of the in uence of demand-side factors on the utilization of community cultural and leisure services for the older adults . This indicates that the more receptive the older adults are to the service, the more likely they are to utilize the cultural and leisure services; the more satis ed the older adults are with the service, the more likely they are to utilize the cultural and leisure services; and the greater the need for the cultural and leisure services, the more likely they are to utilize the service. This veri es the hypothesis 2 of this paper: demand-side factors signi cantly affect the utilization of spiritual culture services by the older adults, and further veri es hypotheses H2a, H2b, and H2c, and hypothesis H2d does not pass the veri cation. Note: (1) Signi cance, * P < 0.05, ** P < 0.01, *** P < 0.001; (2) Tolerance (Tolerance) and variance in ation factor (VIF) are both tests of covariance of independent variables, and the tolerance of the above six models are all much larger than 0.10, and the variance in ation factor is much smaller than 10, indicating that there is no serious covariance between the independent variables.

Discussion
This study analyzed the factors in uencing the use of community cultural and leisure services for the older adults from both the supply and demand sides through eld research data, and the ndings veri ed two research hypotheses that supply and demand signi cantly affect the use of community cultural and leisure services for the older adults.
First, the utilization of community cultural and leisure services is signi cantly in uenced by literacy level.
Among all the control variables, literacy level is highly signi cant in models 1 to 4, i.e., the higher the literacy level, the more likely the older adults are to use community cultural and leisure services, and to some extent, it can be considered that the current utilization of community cultural and leisure services in China has a "pro-intellectual" tendency. On the one hand, education can improve the income level and economic independence of the older adults and enhance their purchasing power, thus promoting their use of community cultural and leisure services; on the other hand, the improvement of education can expand the interpersonal circle of the older adults and broaden their information access.
Second, the utilization of community cultural and leisure services is not bound by the economic level. The research results show that the effect of economic level on the utilization of community cultural and leisure services for the older adults is insigni cant, and this research result is contrary to the results of previous studies on the utilization of social older adults services. On the one hand, the supply cost of community cultural and leisure services for the older adults is low, and on the other hand, the consumption ability of the older adults gradually increases with the improvement of the economic level. Further divided into urban and rural areas, among the rural older adults, those with an annual income of less than 10,000 RMB accounted for more than 50% of the surveyed rural older adults, and the economic level remains a factor affecting the utilization of community cultural and leisure services among the rural older adults because they have less savings and are still engaged in agricultural labor in their later years.
The government should pay attention to the spiritual and cultural needs of the older adults in need, while ensuring their basic material needs, as spiritual culture affects their psychological health, which in turn affects their physical health. The government should play a bottom-up role to provide community cultural and leisure services for the older adults who are affected by the economic level.
Third, the utilization of spiritual culture services is signi cantly in uenced by supply-side factors.
Research shows that the more service facilities are supplied, the more service content is supplied, and the higher the accessibility of service location, the higher the level of spiritual cultural service utilization of the older adults. The supply of cultural and leisure services for the older adults in cities is more adequate, and the service location is mainly in the community, while the village group in rural areas contains a larger area, and often there is only one activity point in a village group, and the facilities are simple and far away. As mentioned above, the supply-side factor of the reasonableness of service charges does not have a signi cant impact on the utilization of cultural and leisure services for the older adults. As mentioned above, the supply cost of cultural and leisure services for the older adults is low, and the consumption ability of the older adults is increasing, so the economy no longer constrains the utilization behavior of cultural and leisure services for the older adults [46]. The supply of cultural and leisure services in the community is far from meeting the needs of the elderly, and the inequality in the supply of cultural and leisure services in urban and rural communities is very seriously [47]. At the same time, related studies show that the more specialized and space and equipment required, the lower the coverage rate of home community older adults service programs [48]. The eld research of the research group found that the supply of community cultural and leisure services is limited to simple services such as chess and card activities, and some even only provide venues for activities, lacking higher-level services such as knowledge lectures, senior classes and senior universities. Meanwhile, the quantity and quality of spiritual cultural service supply in rural areas are lower than those in urban areas, and the remote location of services often hinders rural older adults from using spiritual cultural service facilities.
Fourth, the use of cultural and leisure services is signi cantly in uenced by demand-side factors. The results of the study show that the higher the acceptance of cultural and leisure services by the older adults, the more satis ed they are with the services, the greater the service need, and the greater the possibility of their using the services. Further research on service need factors by urban and rural areas shows that among urban older adults, those with cultural and leisure services needs account for 64% of the urban older adults surveyed, and among rural older adults, those with service needs account for 58% of the rural older adults surveyed, which shows that the spiritual and cultural needs of rural older adults are similar to those of urban older adults, and the spiritual and cultural needs of rural older adults may explode in the future The demand side factors The effect of economic level among the demand side factors is not signi cant, but negative, which indicates to some extent that the higher the economic level of the older adults, the more they may tend to choose professional market-based services. A large number of studies have shown that the mismatch between demand and supply is the main reason for the low utilization of community older adults services in China [49], and also the main reason for the low utilization of community cultural and leisure services in China. This indicates that on the one hand, the spiritual needs of the older adults are not met, and on the other hand, a part of the current supply of community cultural and leisure services is "idle", i.e., there is a general oversupply of services in a low supply ratio. In our eld research, the older adults generally report that the community spiritual and cultural facilities are single, the services are simple, and there is a lack of professional teachers to guide them, which makes it di cult to meet their needs. Therefore, the supply of community cultural and leisure services should consider the individual needs of different levels of older adults, and provide the most basic community cultural and leisure services while considering the specialized needs of higher-level older adults.

Conclusions
Based on the improved Anderson model, this paper constructs an analytical framework for the factors in uencing the utilization of community cultural and leisure services for the older adults from both the supply and demand sides. Using questionnaire survey data in Shaanxi Province in 2019, Poisson regression method is applied to empirically test the analytical framework. It was found that both supplyside and demand-side factors signi cantly affect the utilization of community cultural and leisure services for the older adults. Speci cally, the supply-side factors of service facility supply, service content supply, and service location accessibility had signi cant effects, while the demand-side factors of service acceptability, service satisfaction, and service need had signi cant effects. The study also found that, unlike the results of previous studies, the utilization of community cultural and leisure services for the older adults was not constrained by economic level.
The article suggests to improve the supply level and quality of community cultural and leisure services for the older adults. First, adhere to the concept of demand-oriented service supply. In strengthening and improving the supply of community cultural and leisure services for the older adults, we should change the previous "top-down" and "service-centered" thinking to "bottom-up" and "demand-centered". "When carrying out cultural and leisure services, we should conduct demand surveys and assessments, and strive to supply services from the perspective of the actual needs of the older adults, so as to improve the e ciency of service utilization. Second, the supply of cultural and leisure services should be different between urban and rural areas. The supply of spiritual culture services for the urban older adults is in place, so we should focus on the specialization of service supply, i.e., from "available" to "excellent"; the lack of spiritual culture services for the rural older adults, and the future demand for spiritual culture for the rural older adults may grow explosively, so we should focus on At the same time, the accessibility of services is also an important factor affecting the use of spiritual culture services for rural older adults.
Finally, we should improve the subsidy system and expand the scope of services purchased by the government. On the one hand, for some older adults with low income and insu cient ability to pay, reasonable subsidy standards should be set according to their health and income levels, so that lowincome older adults can also use community cultural and leisure services; on the other hand, the scope of government purchased services should be expanded to include community cultural and leisure services, so as to improve the utilization rate of services.

Limitations
The limitations of this study are, rstly, con ned to data limitations, which only focus on the in uencing factors of spiritual culture service utilization in Shaanxi Province and lack of typicality; secondly, the inclusion of explanatory variables is not su cient and the explanatory power of the model is not high.
The future study can work on 2 aspects: (1) further expand the scope of the study, eld research in developed eastern regions to verify and enrich the existing study; (2) on the selection of indicators for the utilization of community cultural and leisure services of the older adults, the indicators will be continuously adjusted and improved through more detailed interview research in the future to provide a theoretical basis for enriching the analytical framework for the utilization of community cultural and leisure services of the older adults. bodies had no further involvement in the research process, and they will continue to fund follow-up research.
Availability of data and materials The datasets used during the current study are available from the corresponding author on reasonable request.
Statement for guidelines: all methods were performed in accordance with the relevant guidelines and regulations.
Ethics approval and consent to participate This study was approved by the Department of Social Sciences of the Ministry of Education, PRC and the Medical Ethics Committee of Health Science Center of Xi 'an Jiaotong University (Approval Number 2016-416). The ethics committee approves the procedure for the verbal consent, which is allowed for social investigation not involving any biological or medical experiment. Before data collection, we orally introduced the background, content and purpose of the study to respondents and assured them that the data did not involve any personal privacy information and were for research only. Only when the respondents con rmed that they were willing to participate in this survey, our investigators began the investigation. All questionnaires were completed anonymously and all procedures performed in the study were in accordance with the ethical standards.
Consent for publication "Not applicable".
Competing interests The authors declare that they have no competing interests.