EASY-Care program in Iran

Dr Reza Fadayevatan, MD, MPH, PhD

Head of Ageing Department,

The University of Social welfare and Rehabilitation Sciences

Outlines- ICurrent status of older people population in Iran

and Tehran

Iran Ministry of Health Program for older people

Elderly health service package

Outlines- II

EASY-Care in Iran

Undertaken programs

On-going projects

Up-coming programs

Current Status of older people population in Iran (latest census)

Total number of population: 70,495,782

Number of older people population: 5,121,043

Percentage of older people: 7.26%

Number of people aged 100+ in Tehran province:1891

Population of Older people in Tehran

Tehran province:

Total number of population : 13,422,366

Number of older people: 973,183

Different age groups living alone in Tehran

Age groups The number of older people

60-64 14561

65-69 18217

70-74 22043

+ 75 34685

Total 89506

Ageing index The ratio of the population of people over 60 years of age

to under 15

1986 1996 2006Ageing Index

6.68% 10.93% 20.68%

Iran Ministry of Health Program for Older People

Start date: 2005 Setting: 30 cities in Iran

Domains of the package:

Cardiovascular disease Nutritional disease

Diabetes Hearing and seeing

Mental disorders Osteoporosis

Incontinence Dementia

Falls Acute lung tuberculosis

Immunization

Questionnaires of Iran Ministry of Health Program for older people

Questionnaire at first admission

Periodic care forms

Referral forms

Follow up forms

EASY-Care, Mission

“To improve the life of older people through

better assessment and response to their health

and care needs.”

EASY-Care Standard: Domains Biography & Reason for Assessment Seeing, Hearing & Communicating Looking After Yourself Mobility Safety Accommodation & Finance Staying Healthy Mental Health and Well-Being Other Information

Risk of break down in care

Independence Score

Risk of falls

EASY-Care InternationalResearch Network Europe

Belgium

Czech Republic

England

Finland

France

Germany

Greece

Italy

Latvia

Lithuania

Netherlands

Poland

Portugal

Russia

Scotland

Sweden

Switzerland

Turkey

© The University of Sheffield

EASY-Care InternationalResearch Network

Australia

Brazil

Canada

Colombia

Hong Kong

Iran

Malaysia

Taiwan

USA

EASY-Care, Undertaken programs in Iran

2008

Signing the contract with The University of Sheffield

to start the work

2009

Preparatory work;

•Setting, budget, team members, professions

empowerment etc.

To set up a research team

To attend EASY-Care symposium, IAGG, Paris

To attend training course at The University of

Sheffield, University of Warwick and Turkey

2010

Providing project budget

Allocating the office for EASY-Care project at Tehran

University of Medical Sciences (TUMS)

To carry out review of literature

Some courses in methodology of validation studies

1 PhD student on Easy Care (Warwick)

2011 Developing a care-plan for approaching at-risk people

Digitalization EASY-Care

Care plan

CGA

Developing a protocol for translation and cross-cultural adaptation using three protocols including:

• IQOLA (International Quality of Life Assessment)

• IPAQ (International Physical Activity Questionnaire)

• WHO recommendations

Psychometric properties of Farsi version of the EASY-Care

instrument (1st ongoing project) Translation

• Forward Translation

• Review and assessment

• Backward Translation

Pilot Study

Main Study

Pilot StudyAims:

1. To assess acceptability of the EASY-Care instrument from perspective of older people

2. To assess acceptability of the EASY-Care instrument from perspective of specialists

Main Study (ongoing project)

AimsInvestigating of validity and reliability, item and test

parameters of Persian version of the EASY-Care standard instrument.

Target Population500 male and female aged 60 and over

Inclusion Criteria: aged 60 and above; having consent to

participate in the study. Exclusion criteria : having significant cognitive impairment

(Abbreviated Mental Test (AMT) <7) and having a diagnosis of psychotic disorders.

Data Analysis

Data analysis will be done based on Classic Test Theory

(CTT) and Item-Response Theory (IRT).

Validation process based on CTT

Assessing reliability

Test-retest conducted as reproducibility measure after a two week interval.

Internal consistency was measured with Cronbach’s alpha. Inter-rater reliability was estimated based on the correlation

of scores between two raters who rate the EASY-Care.

Investigating validity Content validity assessed in an expert panel

Construct-related validity

Confirmatory Factor Analysis

Exploratory Factor Analysis

• Concurrent validity will be assessed using correlation

with SF-36 and AMT.

Ethical Considerations

The study was approved by Research Ethics

Committee of the University of Social Welfare and

Rehabilitation Sciences on 20/05/2010 and all

participants gave a written consent form and an

information sheet inviting them to take part in the

study which included coverage of the aim of the

study. Participation in this study is voluntary. Study

Comparison of independency score of EASY-Care between Iranian and Portuguese older people: A cross-cultural study (2nd ongoing project)

Aims:

Psychometric properties of independency score of EASY-care

Comparison of classic Test Theory (CTT) and Item Response Theory (IRT)

Cultural differences in Iran and portugal

Methods-II Sampling:

The participants recruited through a random sampling, sample of convenience, only consented participants

Sample size:799 (319 Iranian and 460 Portuguese older people)

Methods-III Method

A sample of 319 Iranian and 460 Portuguese older people

were measured using the 18-items independence scale of

the EASY-Care. The data were analyzed using Rasch

rating Scale Model (RSM) by WINSTEPS 3.49 (Linacre,

2004) software program.

Psychometric properties of the EASY-Care standard instrument as a global

instrument.(3rd ongoing project)Aim:

Developing a global assessment instrument for older people is currently being carried out worldwide.

Developing a global instrument through Analyzing data from all countries using IRT

Upcoming programs

Clinical outcome evaluation

Cost effectiveness

Forming the National Advisory Board

Presenting the whole work in the 20 th IAGG

conference, Seoul 2013

32

Thank you for listening