Objective  To explore the willingness to participate in time bank mutual care program and its influencing factors among rural elderly in Xuzhou city for providing evidence to the improvement of mutual elderly care service system by relevant departments.

  Methods  An onsite self-administered or interviewer-assisted questionnaire survey was conducted among 950 elderly residents (60 years old and over) recruited with multistage random sampling from 38 rural villages in 5 prefectures/counties of Xuzhou municipality, Jiangsu province during July – September 2021. Unconditional multivariate logistic regression model and the random forest model were adopted in analyses on factors influencing the participants′ willingness to participate in the time bank mutual care.

  Results  Of the 925 participants with valid responses, 599 (64.8%) reported the wiliness to participate in the time bank mutual pension. The results of logistic regression analysis showed that the participants with following characteristics were more likely to have a higher willingness of the participation: being usually visited by their children once per month, being aware of the time bank mutual support for the elderly, with the preference for mutual elderly care system, and considering the time bank mutual pension having a good prospect or being worth to have the service; while, living with a cohabitant, being not optimistic about the prospect of the mutual assistant program, and being visited by their children once per week and more were factors against the participants′ willingness. The results of random forest model analysis demonstrated that the frequency of children's visit, the satisfaction to economic conditions and the living conditions were the top three important influential factors for the participants′ participation willingness, followed by the preference for mutual pension system, the awareness on the time bank mutual assistance program, and the prospect for the development of the mutual assistance elderly care system.

  Conclusion  The willingness to participate in the time bank mutual pension is high among rural elderly in Jiangsu province, especially among those living alone, being visited by their children not frequently, and with positive attitude towards the time bank mutual pension system.