3 fadayvatan-easy care in iran, prague 2012

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  • 1. EASY-Care program in Iran Dr Reza Fadayevatan, MD, MPH, PhD Head of Ageing Department,The University of Social welfare and Rehabilitation Sciences
  • 2. Outlines- I Current status of older people population in Iran and Tehran Iran Ministry of Health Program for older people  Elderly health service package
  • 3. Outlines- II EASY-Care in Iran  Undertaken programs  On-going projects  Up-coming programs
  • 4. Current Status of older peoplepopulation 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
  • 5. Population of Older people in Tehran Tehran province:  Total number of population : 13,422,366  Number of older people: 973,183
  • 6. 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
  • 7. Ageing index The ratio of the population of people over 60 years of age to under 15 1986 1996 2006 Ageing 6.68% 10.93% 20.68% Index
  • 8. Iran Ministry of Health Program for Older PeopleStart date: 2005Setting: 30 cities in IranDomains of the package:Cardiovascular disease Nutritional diseaseDiabetes Hearing and seeingMental disorders OsteoporosisIncontinence DementiaFalls Acute lung tuberculosisImmunization
  • 9. Questionnaires of Iran Ministry of Health Program for older people Questionnaire at first admission Periodic care forms Referral forms Follow up forms
  • 10. EASY-Care, Mission“To improve the life of older people throughbetter assessment and response to their health and care needs.”
  • 11. EASY-Care Standard: Domains Biography & Reason for Assessment Seeing, Hearing & Communicating c a re Looking After Yourself in wn Mobility do eak o re br Sc Safety of nc e Accommodation & Finance R isk nd e  e dep all s Staying Healthy In ff  s ko Mental Health and Well-Being  Ri Other Information
  • 12. EASY-Care International Research Network EuropeBelgium Latvia LithuaniaCzech Republic NetherlandsEngland PolandFinland PortugalFrance RussiaGermany ScotlandGreece SwedenItaly Switzerland Turkey
  • 13. EASY-Care International Research NetworkAustraliaBrazilCanadaColombiaHong KongIranMalaysiaTaiwanUSA © The University of Sheffield
  • 14. EASY-Care, Undertaken programs in Iran2008 Signing the contract with The University of Sheffield to start the work
  • 15. 2009 Preparatory work;•Setting, budget, team members, professionsempowerment etc. To set up a research team To attend EASY-Care symposium, IAGG, Paris To attend training course at The University ofSheffield, University of Warwick and Turkey
  • 16. 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)
  • 17. 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
  • 18. 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
  • 19. 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
  • 20. 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
  • 21.  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.
  • 22.  Data AnalysisData analysis will be done based on Classic Test Theory (CTT) and Item-Response Theory (IRT).
  • 23. 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.
  • 24.  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.
  • 25.  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
  • 26. Comparison of independency score ofEASY-Care between Iranian and Portugueseolder people: A cross-cultural study (2nd ongoing project)
  • 27. 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
  • 28. 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)
  • 29. 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.
  • 30. Psychometric properties of the EASY-Care standard instrument as a global instrument.(3rd ongoing project) Aim: Developing aglobal assessment instrument for older people is currently beingcarried out worldwide. Developing aglobal instrument through Analyzing data from all countries using IRT
  • 31. 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 32