Construction Of Indigenous Tool Based On The Evaluation Of Active Ageing Measurement Tools Worldwide

Objective To obtain a referenceable theoretical framework and indicators pool by systematically evaluating the existing original measurement tools of active ageing worldwidely,and to explore an active ageing index system which is compatible to the socio-economic development level,population and cultural background of the country’s western less developed inland areas,in order to enrich the scientific concept of active ageing and provide a scientific basis for the research on ageing in different regions.Methods We performed computer based online searches of the PubMed,Web of Science,CNKI,WanFang Data,VIP,websites of WHO,European Commission,and United Nations Economic Commission for Europe from April 2002 to November 2019.Two reviewers independently screened the literature and extracted data according to the inclusion and exclusion criteria,and conducted a qualitative analysis and comparison of the measurement tools obtained from these data.The importance,operability and sensitivity of indicators at all levels of tools were described by selected local experts in relevant fields.We determined the initial version of the index system of active ageing measurement tool according to the inclusion criteria of indicators,combined with the quantitative results and qualitative analysis of experts’consultation.In addition,the active ageing situation on convenient sample of senior citizens aged 60 and above in Gansu Province was measured through a questionnaire formed by the index system.The construct validity of the index system and the further revision of level-3 indicators were tested by exploratory factor analysis.We have obtained the proper weight coefficient at each level by Analytic Hierarchy Process,and calculated the Cronbach’s alpha coefficient of the internal consistency of the index system,and eventually completed the construction of measurement tool.Results 1.A total of 36 researches were included,which involved in 9 original active ageing quantitative measurement tools（3 in Thailand,2 in China,1 among the European Union,Russia,Australia,and Finland respectively）.There were 2 to 3dimensions of the tools,3 to 10 items of primary measurement targets,and 11 to 177items of measurement indicators.The construction of the dimensions and level-1measurement goals were mainly based on the three pillars of health,participation,and security which composed WHO’s policy framework of active ageing.Systematic review showed that the indicators of all tools had measured the health,participation,and security targets except for the AAQ-CHN（2012）and AAL-Thai（2016）.Five indicators with epoch characteristic as electronic information technology equipment,voluntary services,participation in political activities,access to health care services,and lifelong learning habits were presented in the EU tool.The application researches of EU original tool were widely applied in the researches in Europe,Asia,and the Americas with a total of 20 published researches.2.According to the evaluation results,the index system of active ageing measurement tool initially proposed 4 level-1 indicators including Health,Participation,Security and Supporting Environment,15 level-2 indicators including Physical Condition,Direct Social Contribution,Property Status,Family Environment,etc,and34 level-3 indicators.A total of 20 experts（Male&female:10&10）with an average age of 48.5±5.7 years old had participated in the consultation.The average working years was 24.3±5.5.Among the 20 experts,2 had intermediate title,18 persons had deputy senior professional and technical titles and above,accounting for 90%of the total.The positive coefficients of consultants in the two rounds were 87%and 100%,respectively.Experts’overall authority coefficient Cr_{First round}=0.77,Cr_{Second round}=0.82.The Kendall concordance coefficient of the experts for the first round of index scores were WImportance1=0.261（P=0.001）,WOperability1=0.147（P=0.001）,WSensitivity1=0.190（P=0.001）,the second round of index scores were W_Importance2=0.295（P=0.001）,W_Operability2=0.206（P=0.001）,W_Sensitivity2=0.217（P=0.001）.After two rounds of expert consultation,4 level-1 indicators,12 level-2 indicators and 30 level-3 indicators were established.3.The struction validity of the index system was verified through the sub-level exploratory factor analysis based on the questionnaire,and 23 level-3 indicators were retained,the internal consistency Cronbach’s alpha coefficient of the final measurement tool was 0.803.The weight coefficients of indicators at each levels of the final measurement tool were determined by AHP:4 level-1 indicators included"Health"（W=0.4574）,"Participation"（W=0.1478）,"Safety"（W=0.2771）,"Supporting Environment"（W=0.1177）;and 12 level-2 indicators included"Physical Condition"（W=0.2432）,"Psychological Condition"（W=0.1507）,"Social Adaptability"（W=0.0635）,"Direct Social Contribution"（W=0.0726）,"Indirect Social Contribution"（W=0.0752）,"Economic Income Status"（W=0.0586）,"Property Status"（W=0.0637）,"Personal Safety"（W=0.1192）,"Use of Communication Equipment"（W=0.0356）,"Family Environment"（W=0.0638）,"Community Environment"（W=0.0337）,"Social Environment"（W=0.0202）.Conclusion This study used the evaluation results of the framework design,index setting and construction methods of the global active ageing measurement tools references,and built a native active ageing measurement tool with a macro design concept keeping pace with international ageing policies,and developed some innovation in the index system.The reliability and validity of this tool were well verified and improved by consultation combined with factor analysis of field survey data.This measurement tool can be used as reference in the study of active ageing in the country’s western less developed inland areas.