Introduction
Place attachment refers to the emotional and cultural bond of one place with individuals [1]. In the old age, the living environment is more important due to the decrease in their activity and the increase in the risk of losing functional capacity. Although there are some conceptual discussions about the basic components of place attachment for elderly people [2, 3], there is no suitable multidimensional model of place attachment for use in the elderly living in urban areas. Few models of place attachment that have been provided for the elderly are not suitable for the Iranian population. In this regard, this study aims to survey the perception of the elderly in Aran & Bidgol city, Iran about this concept and its dimensions in order to design a suitable tool and examine its psychometric properties.
Methods
This is a sequential exploratory mixed method study that was conducted in Aran & Bidgol city in 2018-2019 in two qualitative and quantitative phases. In the first step of the first phase, the concept and different dimensions of place attachment models were searched in databases [4]. In the second step of the first phase, to understand and explain the dimensions of place attachment, interview questions were designed based on the matrix obtained from the findings of the reviewed studies. Then, after semi-structured interviewing 14 people over the age of 60 who were selected using a purposive sampling method, the data were analyzed using the directed content analysis method in MAXQDA version 10 software. In the last step of the first phase, based on the findings of the first and second steps, the themes and sub-themes of place attachment were determined and the conceptual model of place attachment was designed.
In the first step of the second phase, based on the conceptual model, the items were formulated and the formal and content validity of the initial draft of the tool were examined by a panel of experts and seniors. In the second step of the second step, after a survey study on 414 community-dwelling elderly people who were selected by a cluster sampling method and based on the entry criteria, construct validity the tool was determined using exploratory and confirmatory factor analyses. The internal consistency and test-retest reliability of the questionnaire were also evaluated. Statistical analysis was done in SPSS software, version 24 and AMOS version 24 applications.
Results
Based on the final model of the place attachment of the elderly resulting from the results of two stages of resource review [4] and interviews [6], the initial draft of the tool was designed with 86 items. The duplicate and irrelevant items were removed, and finally 67 items were determined and underwent face validity assessment and modification by the panel of experts and seniors. In the content validity assessment, S-CVI was calculated as 0.89. Most of the items had CVR>0.7 and CVI>0.79; those with low scores or Kappa value<0.74 were removed or modified and the number of items was reduced to 49. Based on the initial reliability check, two items were removed due to low Cronbach’s alpha value. The revised version of the questionnaire with 47 items was field tested for quantitative validation.
To identify the number of factors in the questionnaire, exploratory factor analysis for two areas of attachment to home and attachment to neighborhood was conducted separately. It was found that the sample size was adequate in the areas of home (KMO=0.893) and neighborhood (KMO=0.889) and the factor analysis was able to be conducted in both areas (P<0.001). The items were placed on 3 factors in each area; 2 items in the area of attachment to home and 3 items in the area of attachment to neighborhood were removed. The six extracted factors explained 61.75 and 50.06% of the variance of the total items in the areas of attachment to home and neighborhood, respectively. The fit indices obtained from the confirmatory factor analysis in the areas of attachment to home (GFI=0.877, CFI=0.916, RMSEA=0.080) and neighborhood (GFI=0.809, CFI=0.860, RMSEA=0.077) showed that the designed questionnaire with two subscales of attachment to home (16 items) and attachment to neighborhood (26 items) had an acceptable construct validity. The factors obtained in exploratory factor analysis, number of items, Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) related to each factor in both areas are presented in Table 1.


Finally, a 42-item questionnaire named Place Attachment Scale-Older Adults (PAS-OA) was designed using a 5-point Likert scale from 1 (completely disagree) to 5 (completely agree). For item number 22, the scoring was reversed. Total score for the subscales of attachment to home and neighborhood ranges 16-80 and 26-130, respectively. A higher score indicates more attachment of the elderly to home or neighborhood.
Discussion
The PAS-OA developed in Persian has acceptable face validity, content validity, construct validity, and reliability. This scale can be used to evaluate the place attachment of the elderly in Iran and examine their attachment to home (emotional bond, physical bond and dependency) and neighborhood (emotional, social and physical bonds), and the results be used in urban studies promote place attachment to the elderly living in urban areas. Examining the place attachment model proposed in this study in future studies can help to improve the fit indices of the model.

Ethical Considerations
Compliance with ethical guidelines
This study has an ethical approval (Code: IR.USWR.REC.1398.066). All ethical principles are considered in this article. The participants were informed about the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them

Funding
This study was extracted from a PhD. dissertation of the first author at the Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran.

Authors' contributions
Conceptualization: Zahra Aliakbarzadeh Arani, Nasibeh Zanjari; Methodology: Zahra Aliakbarzadeh Arani, Nasibeh Zanjari, Mahshid Foroughan, Gholamreza Ghaedamini Harouni; Investigation and writing-original draft: Zahra Aliakbarzadeh Arani; Writing-review & editing: Zahra Aliakbarzadeh Arani, Nasibeh Zanjari, Ahmad Delbari; Supervision: Nasibeh Zanjari, Ahmad Delbari; Review and finalization of the article: All authors.

Conflicts of interest
The authors declared no conflict of interest.



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