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Mohammadi E, Allahyari T, Darvishpoor Kakhaki A, Saraei H. Determining Psychometric Properties of Iranian Active Aging Measurement Instrument. Salmand: Iranian Journal of Ageing 2018; 12 (4) :414-429
URL: http://salmandj.uswr.ac.ir/article-1-1287-en.html
1- Department of Social Work, Faculty of Social Sciences, Allame Tabataba'i University, Tehran, Iran. , e.mohammadi1986@gmail.com
2- Department of Social Work, Faculty of Social Sciences, Allame Tabataba'i University, Tehran, Iran.
3- Department of Internal Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
4- Department of Sociology, Faculty of Social Sciences, Allame Tabataba’i University, Tehran, Iran. 
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Extended Abstract
1. Objectives

Following the paradigm shift in the conception of aging experience, i.e. from the concept of “being alive” in the twentieth century to “ensuring the quality of life of elderly people” in the twenty-first century, active aging as a positive approach to aging has drawn the attention of policymakers and gerontologists [1]
Understanding of active aging, which is influenced by the culture and conditions of each community, has been largely based on Western studies, not applicable to the culturally-diverse communities in Asian countries [3]. Therefore, due to inappropriate measures of active aging in Iran, the present study aimed to design and determine the psychometric characteristics of active aging measures according to the cultural criteria of the Iranian aging society.
2. Methods & Materials 
The present study was a methodological research and is a part of a larger study entitled “Understanding active aging and constructing its measure” carried out by a combined research method in two stages using the steps proposed by Ingramsal-Dayton [4]. In the first step of the first stage, the study was based on the grounded theory of qualitative research aimed at achieving the native theoretical model of active aging [5]. The data were saturated and codified in the semi-structured interviews with 35 elderly people aged 60 to 85 years (who referred to the elderly centers and parks in Tehran) using theoretical sampling. Then, active aging and its dimensions were used as a part of this theoretical model for designing the tool, and the initial expressions were extracted from this section. In the second step, based on the concepts and dimensions obtained from the previous step, all psychometric measures related to active aging and their dimensions were collected, and the appropriate expressions were extracted to complete the qualitative section. Finally, in the third step, the expressions obtained from the previous steps were designed as an initial measure of active aging, with a format tailored to the elderly community.
In the second stage, the psychometric characteristics of the measure (reliability and validity) were checked. In the first step, the content validity of the measure was examined according to the opinions of 10 experts based on Waltz and Bausell content validity index and Lawshe content validity ratio [20]. The formal validity of the measure was examined according to the opinions of experts and the elderly group (15 people). In the second step, a sample of 350 old people aged over 60 years who were referred to the health centers of Tehran municipality was selected in a survey using three-stage cluster sampling. The mean (SD) age of the sample was 69 (78.6) years. Also, 52% of them were female (n=182) and 48% were male (n=168). In this survey, after analyzing the expressions, the psychometric characteristics of the measure, including the validity, were examined using exploratory factor analysis. The reliability was investigated based on internal consistency and test-retest method using Cronbach's α. The intra-cluster correlation coefficient and Pearson correlation coefficient were analyzed using SPSS16. It should be noted that the approval of the Chancellor of the Faculty of Social Sciences of Allameh Tabataba’i University was obtained to carry out the research.
3. Results 
In the first step of the first stage, the existential functionalism, the management of home affairs, the initial strategies of isolation aversion (interaction and lack of isolation), social participation (professional role-playing, voluntary activities, institutional social participation), physical dynamics, and insight-learning dynamics were revealed as active aging components that indicated the existence of mental, behavioral, and objective dimensions of active aging. According to the characteristics and dimensions of the data pertaining to those components, 96 expressions were extracted for the initial active aging measure. 
Due to overlapping and conceptual affinity, the number of expressions reduced to 56. In the second step, all psychometric questionnaires were searched in internal and external databases using the keywords related to active aging components. A total of 16 out of 40 searched measures had 27 appropriate expressions for designing the research tools. In the third step, all 83 expressions extracted from the previous two steps were re-examined in terms of conceptual affinity. Thus, the number of expressions reduced to 61 after eliminating the duplicate expressions. The expressions were designed scale-like in four formats. After examining all four formats of active aging measure expressions among a small sample of the elderly, the relevant form of questionnaire for the older adults was selected.
In the first step of the second stage, the content and formal validity of the initial active aging measure (including 61 items) were assessed in the expert group, and a preliminary investigation along with an interview was conducted in a small sample of the elderly. Based on the results of the Content Validity Index (CVI) and Content Validity Ratio (CVR), and formal validity, a total of six questions were eliminated. As a result, the number of active aging measure expressions reached 55. The mean content validity index was 0.906. In the second step, in a survey to check the psychometric properties of the measure, the expressions were further analyzed, which led to the elimination of 11 expressions. The results of structural validity using exploratory factor analysis with ecomax turning indicated the ultimate measure containing 40 questions with six factors (socialization (social-institutional participation), mind-exercise, interactivity, active insight, role-playing and physical-functional dynamics) with the ability to explain 56% of the total active aging variance. Finally, the reliability based on internal consistency and test-retest method indicated that the Cronbach's α coefficient, Pearson correlation coefficient, and the inter-cluster correlation coefficient were 0.876, 0.951, and 0.996, respectively (P<0.01).
4. Conclusion 
The active aging measure in the present study was designed based on the native understanding of active aging in the context of Iranian culture alongside the relevant texts. This indicates that active aging has objective and mental dimensions. This native understanding in the objectification and benchmarking of the external experience has led to the active aging measure including 40 expressions and 6 factors that have a good validity and reliability. In contrast to other existing aging measures that have only emphasized the existence of objective and behavioral dimensions in active aging [6, 7] and ignored the mental dimension, our measure is not only appropriate for the Iranian elderly community but also acknowledges the existence of the mental dimension of active aging, along with the objective-behavioral dimension.
Acknowledgments
This research was extracted from the first author's PhD thesis in Department of Social Work, Faculty of Social Sciences, Allame Tabataba'i University.
Conflict of Interest
The authors declared no conflicts of interest.
 
References
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  9. Mouleart T, Paris M. Social policy on aging: The case of active aging as a theatrical metaphor. International Journal of Social Science Studies. 2013; 1(2):113-123. doi:10.11114/ijsss.v1i2.141.
  10. World Health Organization. Active aging: A policy framework. Geneva: World Health Organization; 2002.
  11. Thanakwang K, Isaramalai S, Hattkhakit U. Development and psychometric testing of the active aging scale for Thai adults. Journal of Clinical Interventions in Aging. 2014; 1211. doi: 10.2147/cia.s66069
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  15. Stromborg M, Olsen S. Instrument for clinical health care. Boston: Jones & Bartlett Learning; 2004.
  16. Ingersoll-Dayton B. The development of culturally sensitive measures for research on ageing. Ageing and Society. 2011; 31(3):355-70. doi: 10.1017/S0144686X10000917.
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  22. MacCallum R, Widaman K, Zhang S, Hong S. Sample size in factor analysis. Psychological Methods. 1999; 4(1):84-99. doi: 10.1037//1082-989x.4.1.84
  23. Callaway L, Winkler D, Tippett A, Migliorini C, Herd N, Willer B. The community integration questionnaire-revised (CIQ-R). Melbourne: Summer Foundation Ltd; 2014.
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  28. Soltanmohamadi Y, Hassani Mehraban A, Taghizade G, Akbarfahimi M, Alahyari F. [Validity and reliability of the Persian version of Lawton instrumental activities of daily living scale among patients with dementia (Persian)]. Iranian Journal of Ageing. 2014; 9(2):160-167.
  29. Stewart A, Mills K, King A, Haskell W, Gillis D, Ritter P. CHAMPS physical activity questionnaire for older adults: Outcome for interventions. Medicine and Science in Sports and Exercise. 2001; 33(7):1126-41. doi: 10.1097/00005768-200107000-00010
  30. Yasunaga A, Park H, Watanabe E, Togo F, Park S, Shephard R, et al. Development and evaluation of the physical activity questionnaire for elderly Japanese: The Nakanojo Study. Journal of Aging and Physical Activity. 2007; 15(4):398-411. doi: 10.1123/japa.15.4.398
  31. Deng H, Macfarlane D, Thomas C, Lao Z, Jiang C, Cheng K, et al. Reliability and validity of the IPAQ Chinese: The Guangzhou Biobank cohort study. Medicine & Sciences in Sports and Exercise. 2008; 40(2):303-7. doi: 10.1249/mss.0b013e31815b0db5.
  32. Meyer AM, Evenson R, Morimoto L, Sisocovick D, White E. Test-retest reliability of the women's health initiative physical activity questionnaire. Medicine & Science in Sports & Exercise. 2009; 41(3):530-538. doi: 10.1249/MSS.0b013e31818ace55.
  33. Voorips L, Ravelli A, Dongelmans P, Deurenberg P, Van Straveren W. A physical activity questionnaire for the elderly. Medicine & Science in Sports & Exercise. 1991; 23(8):974-79. doi: 10.1249/00005768-199108000-00015
  34. Pretson C, Gudisken K. A measure of self perception among older people. Journal of Gerontologist. 1966; 21(1):63-71. doi: 10.1093/geronj/21.1.63
  35. Thiamwong L, Stewart A, Warahut J. Development, reliability and validity of Thai healthy aging survey. Walailak Journal of Science and Technology. 2009; 6(2):167-188.
  36. Troutman M, Nies M, Small S, Bates A. The development and testing of an instrument to measure successful aging. Research in Gerontological Nursing. 2011; 4(3):221-32. doi: 10.3928/19404921-20110106-02.
  37. Thanakwang T, Isaramalai S, Hattkhakit U. Thai cultural understandings of active ageing from perspective of older adults: A qualitative study. Pacific Rim International Journal of Nursing Research. 2014; 18(2):152-165.
  38. Polit D, Beck C. The content validity index: Are you sure you know what’s being reported? Critique and recommendations. Research in Nursing and Health. 2006; 29(5):489-497. doi: 10.1002/nur.20147.
  39. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. Berlin: Springer Publishing; 2005.
  40. Kim JH. Productive aging of elderly in Japan. Korean Social Science Journal. 2010; 1:1-26.
  41. Morrow-Howell N, Hinterlong J, Sherraden M. Productive aging (concepts and challanges). Baltomore: John Hopkins University Press; 2001.
  42. Stenner P, McFarquhar T, Bowling A. Older people and active aging: Subjective aspects of aging actively and becoming old. Journal of Health Psychology. 2011; 16(3):467-77. doi: 10.1177/1359105310384298.
  43. Ferreria OG L, Carnerio Maciel S, Oliveira Silva A, Dos Santos WS, Moreira MAS. Active aging from the perspective of aged individuals who are functionally independent. Revista da Escola de Enfermagem da USP. 2010; 44(4):1065-69. doi: 10.1590/s0080- 62342010000400030.
  44. Mohammadi E, Allahyari T, Darvishpoor Kakhki A, Saraei H, Fereshtehnejad SM. Analysis of being active based on community dwelling older adults’ experience: Qualitative study of active aging strategies (Persian). Iranian Journal of Ageing. 2017; 11(4):504-17.
  45. Mohammadi E. [Understanding active aging and constructing its psychometric instrument (Persian)] [PhD thesis]. Tehran: Allameh Tabataba'i University; 2016.
  46. Rafiey H. [Qualitative and quantitative interdisciplinary methods for research on addiction (Persian)]. Tehran: Danjeh Publication; 2008.
  47. Burns N, Grove S. The Practice of Nursing Research: conduct, critique & utilization. Philadelphia: Saunders; 2001.
Type of Study: Research | Subject: gerontology
Received: 2017/07/05 | Accepted: 2017/09/27 | Published: 2018/01/01

References
1. Crampton A. Population ageing and social work practice with older adults: Demographic and policy challenges. International Social Work. 2011; 54(3):313-329. doi: 10.1177/0020872810396257 [DOI:10.1177/0020872810396257]
2. Fernandez-Ballestros E, Robine J, Walker A, Kalache A. Active aging: A global goal. Current Gerontology and Geriatric Research. 2013; 1-4. doi:10.1155/2013/298012 [DOI:10.1155/2013/298012]
3. Paltasingh T, & Tyagi R. Demographic transition and population ageing: Building an inclusive culture. Social Change. 2013; 42(3), 391-409. doi: 10.1177/0049085712454053 [DOI:10.1177/0049085712454053]
4. Joghataei MT, Nejati V. [Assessment of health status of elderly people in the city of Kashan (Persian)]. Iranian Journal of Ageing. 2006; 1(1):3-10.
5. Mirzaei M, Shams Ghahfarokhi M. [Demography of elder population in Iran over the period 1956 To 2006 (Persian)]. Iranian Journal of Ageing. 2007; 2(3):326-331.
6. Saraie H. [Population window of Iran (Persian)]. Social Development and Welfare Planning. 2010; 1(1):33-45.
7. Saraie H. [Demoghraphy: Basics and principles (Persian)]. Tehran: SAMT; 2010.
8. Buys L, Miller E. The meaning of active aging to older Australian: Exploring the relative importance of health, participation and security. Paper presented at: The 39th Australian Association of Gerontology Conference. 6 August 2006; Sydney, Australia.
9. Mouleart T, Paris M. Social policy on aging: The case of active aging as a theatrical metaphor. International Journal of Social Science Studies. 2013; 1(2):113-123. doi:10.11114/ijsss.v1i2.141. [DOI:10.11114/ijsss.v1i2.141]
10. World Health Organization. Active aging: A policy framework. Geneva: World Health Organization; 2002.
11. Thanakwang K, Isaramalai S, Hattkhakit U. Development and psychometric testing of the active aging scale for Thai adults. Journal of Clinical Interven-tions in Aging. 2014; 1211. doi: 10.2147/cia.s66069 [DOI:10.2147/CIA.S66069]
12. Tareque I, Hoque N, Mahfuza Islam R, Kawahara K, Sugawa M. Relationships between the active aging index and disability free life expectancy: A case study in Rajshahi district of Bangladesh. Canadian Journal of Aging. 2012; 32(4):417-432. doi: 10.1017/S0714980813000494. [DOI:10.1017/S0714980813000494]
13. Zasimova L, Sheluntcova M. Measuring active aging government policy planning: A case of Russia. Moscow: National Research University Higher school of Economics (HSE); 2014.
14. Ziadi A, Gasior K, Hofmarcher M, Lelkes O, Marin B, Rodriques R, et al. Active ageing index, concept, methodology and final results: Project active age-ing index (AAI). Vienna: European Centre for Social Welfare Policy and Research; 2013. [PMCID]
15. Stromborg M, Olsen S. Instrument for clinical health care. Boston: Jones & Bartlett Learning; 2004.
16. Ingersoll-Dayton B. The development of culturally sensitive measures for research on ageing. Ageing and Society. 2011; 31(3):355-70. doi: 10.1017/S0144686X10000917. [DOI:10.1017/S0144686X10000917]
17. LoBiondo-Wood G, Haber J. Nursing research: Methods, clinical appraisal, and utilization. St.Louis: Mosby; 2013. [PMID] [PMCID]
18. Strauss A, Corbin J. Basics of qualitative research: Techniquesand procedures for developing grounded theory. Thousand Oaks, California: SAGE Publica-tions; 1998.
19. Schwandt TA, Lincoln YS, Guba EG. Judging interpretations: but is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Direc-tions for Evaluation. 2007; 114:11-25. doi: 10.1002/ev.223 [DOI:10.1002/ev.223]
20. Waltz CF. Nursing research: Design, statistics and computer analysis. Philadelphia: FA Davis Company; 1981.
21. Lawshe C. A quantitative approach to content validity. Personal Psychology. 1975; 28(4):563-75. doi: 10.1111/j.1744-6570.1975.tb01393.x [DOI:10.1111/j.1744-6570.1975.tb01393.x]
22. MacCallum R, Widaman K, Zhang S, Hong S. Sample size in factor analysis. Psychological Methods. 1999; 4(1):84-99. doi: 10.1037//1082-989x.4.1.84 [DOI:10.1037//1082-989X.4.1.84]
23. Callaway L, Winkler D, Tippett A, Migliorini C, Herd N, Willer B. The community integration questionnaire-revised (CIQ-R). Melbourne: Summer Foun-dation Ltd; 2014.
24. McColl M, Davies S, Carlson P, Johnston J, Minnes P. The community integration measure (CIM): Development and preliminary validation. Archives of Physical Medicine and Rehabilitation. 2001; 2001; 82(4):429–34. doi: 10.1053/apmr.2001.22195 [DOI:10.1053/apmr.2001.22195]
25. Van Brakel W, Anderson A, Mutatkar R, Bakirtzeif Z, Nicholls P, Raju M, et al. The participation scale: Measuring a key concept in public health. Journal of Disability and Rehabilitation. 2006; 28(4):193-203. doi: 10.1080/09638280500192785. [DOI:10.1080/09638280500192785]
26. Tate R. Manual for the Sydney psychosocial scale version 2 (SPRS-2). Unpublished manuscript. Sydney: University of Sydney; 2011.
27. Harwood R, Rogers A, Dickinson E, Ebrahim S. Measuring handicap: The London handicap scale, a new outcome measure for chronic disease. Quality and Safety in Health Care. 1994; 3(1):11–6. doi: 10.1136/qshc.3.1.11 [DOI:10.1136/qshc.3.1.11]
28. Soltanmohamadi Y, Hassani Mehraban A, Taghizade G, Akbarfahimi M, Alahyari F. [Validity and reliability of the Persian version of Lawton instrumen-tal activities of daily living scale among patients with dementia (Persian)]. Iranian Journal of Ageing. 2014; 9(2):160-167.
29. Stewart A, Mills K, King A, Haskell W, Gillis D, Ritter P. CHAMPS physical activity questionnaire for older adults: Outcome for interventions. Medicine and Science in Sports and Exercise. 2001; 33(7):1126-41. doi: 10.1097/00005768-200107000-00010 [DOI:10.1097/00005768-200107000-00010]
30. Yasunaga A, Park H, Watanabe E, Togo F, Park S, Shephard R, et al. Development and evaluation of the physical activity questionnaire for elderly Japa-nese: The Nakanojo Study. Journal of Aging and Physical Activity. 2007; 15(4):398-411. doi: 10.1123/japa.15.4.398 [DOI:10.1123/japa.15.4.398]
31. Deng H, Macfarlane D, Thomas C, Lao Z, Jiang C, Cheng K, et al. Reliability and validity of the IPAQ Chinese: The Guangzhou Biobank cohort study. Medicine & Sciences in Sports and Exercise. 2008; 40(2):303-7. doi: 10.1249/mss.0b013e31815b0db5. [DOI:10.1249/mss.0b013e31815b0db5]
32. Meyer AM, Evenson R, Morimoto L, Sisocovick D, White E. Test-retest reliability of the women's health initiative physical activity questionnaire. Medicine & Science in Sports & Exercise. 2009; 41(3):530-538. doi: 10.1249/MSS.0b013e31818ace55. [DOI:10.1249/MSS.0b013e31818ace55]
33. Voorips L, Ravelli A, Dongelmans P, Deurenberg P, Van Straveren W. A physical activity questionnaire for the elderly. Medicine & Science in Sports & Exercise. 1991; 23(8):974-79. doi: 10.1249/00005768-199108000-00015 [DOI:10.1249/00005768-199108000-00015]
34. Pretson C, Gudisken K. A measure of self perception among older people. Journal of Gerontologist. 1966; 21(1):63-71. doi: 10.1093/geronj/21.1.63 [DOI:10.1093/geronj/21.1.63]
35. Thiamwong L, Stewart A, Warahut J. Development, reliability and validity of Thai healthy aging survey. Walailak Journal of Science and Technology. 2009; 6(2):167-188.
36. Troutman M, Nies M, Small S, Bates A. The development and testing of an instrument to measure successful aging. Research in Gerontological Nursing. 2011; 4(3):221-32. doi: 10.3928/19404921-20110106-02. [DOI:10.3928/19404921-20110106-02]
37. Thanakwang T, Isaramalai S, Hattkhakit U. Thai cultural understandings of active ageing from perspective of older adults: A qualitative study. Pacific Rim International Journal of Nursing Research. 2014; 18(2):152-165.
38. Polit D, Beck C. The content validity index: Are you sure you know what's being reported? Critique and recommendations. Research in Nursing and Health. 2006; 29(5):489-497. doi: 10.1002/nur.20147. [DOI:10.1002/nur.20147]
39. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. Berlin: Springer Publishing; 2005.
40. Kim JH. Productive aging of elderly in Japan. Korean Social Science Journal. 2010; 1:1-26.
41. Morrow-Howell N, Hinterlong J, Sherraden M. Productive aging (concepts and challanges). Baltomore: John Hopkins University Press; 2001. [PMID]
42. Stenner P, McFarquhar T, Bowling A. Older people and active aging: Subjective aspects of aging actively and becoming old. Journal of Health Psychology. 2011; 16(3):467-77. doi: 10.1177/1359105310384298. [DOI:10.1177/1359105310384298]
43. Ferreria OG L, Carnerio Maciel S, Oliveira Silva A, Dos Santos WS, Moreira MAS. Active aging from the perspective of aged individuals who are func-tionally independent. Revista da Escola de Enfermagem da USP. 2010; 44(4):1065-69. doi: 10.1590/s0080- 62342010000400030.
44. Mohammadi E, Allahyari T, Darvishpoor Kakhki A, Saraei H, Fereshtehnejad SM. Analysis of being active based on community dwelling older adults' experience: Qualitative study of active aging strategies (Persian). Iranian Journal of Ageing. 2017; 11(4):504-17.
45. Mohammadi E. [Understanding active aging and constructing its psychometric instrument (Persian)] [PhD thesis]. Tehran: Allameh Tabataba'i University; 2016.
46. Rafiey H. [Qualitative and quantitative interdisciplinary methods for research on addiction (Persian)]. Tehran: Danjeh Publication; 2008.
47. Burns N, Grove S. The Practice of Nursing Research: conduct, critique & utilization. Philadelphia: Saunders; 2001.

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