EASY-Care program in Iran Dr Reza Fadayevatan, MD, MPH, PhD Head of Ageing Department, The University of Social welfare and Rehabilitation Sciences

Outlines- I  Current 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 provinc e: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 The number of older peopleAge groups Total

Ageing index The ratio of the population of people over 60 years of age to under %10.93%6.68%Ageing Index

Iran Ministry of Health Program for Older People Start date: 2005 Setting : 30 cities in Iran Domains of the package: Cardiovascular diseaseNutritional disease DiabetesHearing and seeing Mental disordersOsteoporosis IncontinenceDementia FallsAcute 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 International Research 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 International Research 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 (1 st ongoing project)  Translation Forward Translation Review and assessment Backward Translation  Pilot Study  Main Study

Pilot Study Aims: 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) Aims Investigating of validity and reliability, item and test parameters of Persian version of the EASY-Care standard instrument. Target Population 500 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 (2 nd 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.(3 rd 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