The World Health Organization engages cities and communities all over the world in becoming age-friendly. There is a need for assessing the age-friendliness of cities and communities by means of a transparently constructed and validated tool which measures the construct as a whole. The aim of this study was to develop a questionnaire measuring age-friendliness, providing full transparency and reproducibility. The development and validation of the Age Friendly Cities and Communities Questionnaire (AFCCQ) followed the criteria of the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN). Four phases were followed: (1) development of the conceptual model, themes and items; (2) initial (qualitative) validation; (3) psychometric validation, and (4) translating the instrument using the forward-backward translation method. This rigorous process of development and validation resulted in a valid, psychometrically sound, comprehensive 23-item questionnaire. This questionnaire can be used to measure older people’s experiences regarding the eight domains of the WHO Age-Friendly Cities model, and an additional financial domain. The AFCCQ allows practitioners and researchers to capture the age-friendliness of a city or community in a numerical fashion, which helps monitor the age-friendliness and the potential impact of policies or social programmes. The AFCCQ was created in Dutch and translated into British-English. CC-BY Original article: https://doi.org/10.3390/ijerph17186867 (This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives") https://www.dehaagsehogeschool.nl/onderzoek/lectoraten/details/urban-ageing#over-het-lectoraat Extra: Vragenlijst bijlage / Questionnaire attachement
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Hundreds of cities and communities in the world have joined the WHO’s Global Network for AgeFriendly Cities and Communities since 2010. In order to do quantitative assessments of the age friendliness of cities, the Age-Friendly Cities and Communities Questionnaire (AFCCQ) was developed for the Dutch municipality of The Hague. The purpose of this study was first to translate and test the validity and reliability of the AFCCQ for use in North Macedonia and second to explore perceptions on age-friendliness of the bicultural and bilingual City of Skopje. The AFCCQ proved valid for use in North Macedonia. Overall, older adults in Skopje experience the age-friendliness of the city as neutral (in seven out of nine domains). The best score (“slightly satisfied”) was found in the domain of Housing, which was rated positive in all ten municipalities. The lowest total score (“slightly dissatisfied”) was found in the domain of Outdoor spaces and buildings, which received negative scores in eight out of ten municipalities. In five out of nine domains differences were observed between the Albanian and Macedonian communities. The Albanian sample has slightly higher scores in two domains: 1) Housing and 2) Civic Participation and Employment, while the Macedonian sample scored higher in three domains: 1) Communication and Information; 2) Outdoor Spaces and Buildings and 3) Transportation. A hierarchical cluster analysis further revealed the presence of six distinct age-friendly typologies that can be used for a better understanding of subpopulations in the city and draft policies and action programs on the city level.
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The municipality of The Hague has been a member of the WHO's Global Network for Age-Friendly Cities and Communities since 2015. The municipality commissioned a survey to investigate how older citizens view the age-friendliness of their city. A cross-sectional survey was conducted among a diverse sample of 393 community-dwelling older citizens. The survey made use of the Age Friendly Cities and Communities Questionnaire (AFCCQ), and multilevel regression techniques to investigate how social groups differ on the domains of the AFCCQ. The Hague scored a satisfied as an overall score (16.9 ± 8.87), and a satisfied on social participation (2.6 ± 2.46), civic participation and employment (1.4 ± 1.34), communication and information (1.4 ± 1.32), respect and social inclusion (1.6 ± 1.59), community support and health services (2.7 ± 2.79), transportation (1.7 ± 1.26) and financial situation (1.9 ± 1.26). The Hague has an above-average score in the field of housing (2.4 ± 1.06). For Outdoor spaces and buildings, the municipality scores a moderate positive score (0.9 ± 1.41). Significant differences were found for sex, age, socio-economic position, receiving care support, and use of mobility aids. The findings show that older people have different perceptions regarding their city's age-friendliness. Policy makers must acknowledge this heterogeneity among their older citizens and adapt city policies accordingly. CC-BY Original article: https://doi.org/10.1016/j.cities.2022.103568 https://www.dehaagsehogeschool.nl/onderzoek/lectoraten/details/urban-ageing#over-het-lectoraat
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Numerous cities in the Russian Federation have joined the World Health Organization's (WHO) Global Network for Age-Friendly Cities and Communities since 2011. In order to do quantitative evaluations of the age-friendliness of cities, the Age-Friendly Cities and Communities Questionnaire (AFCCQ) was developed in the Netherlands. The purpose of this study was to translate and test the validity and reliability of the AFCCQ for use in the Russian Federation, and to study the views on the age-friendliness of the city of Kazan in the Republic of Tatarstan from an intergenerational perspective. Data were collected in a survey. In total, 208 people from various age cohorts met the inclusion criteria to assess the psychometric validity. Confirmatory factor analysis supported the structure with nine factors. Overall, the people in Kazan experience the age-friendliness of their city as positive. The youngest and oldest generations demonstrated the most positive scores. Only for the domain of respect and social inclusion results were reversed. The Russian language version of the AFCCQ proved a valid and reliable instrument to evaluate age-friendliness of cities and communities in Russia. Data gathered through the instrument can be used as input for planning, implementing and further monitoring of age-friendly initiatives in the country.
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As the World Health Organization launched its age-friendly city and communities programme nearly two decades ago, it raises concerns how to measure and evaluate urban policies concerning age-friendliness. This work presents the translation, validation and results of survey research for the older population of two age-friendly Polish cities (Kraków and Wrocław), using the Age-Friendly Cities and Communities Questionnaire. The study was conducted with two representative samples of older people living in Kraków (n = 392) and Wrocław (n = 409), who were asked to rate the age-friendliness of their cities. Based on the cluster analysis three typologies of older people emerged, reflecting the different views on their experience of living in the city. These resulting typologies showed that people's socio-economic status, living arrangements and health situation play an important role in how they experience city life. Results highlight the value of quantitative city evaluation in order to design and better monitor urban policies following an age-friendly agenda. The most important findings of particular relevance to public age-friendly policy in Poland is to secure the need for the older person to receive assistance with daily activities and mobility especially among those who do not see the positive aspects of living in an age-friendly city.
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Current global trends show that different regions of the globe face an increased level of urbanization, and there is a swift aging process from the Western to the Eastern European countries. Romania is a typical country expecting to triple the percentage of the older population aged 65 and over in the next 30 years. Urban policies often neglect such demographic perspectives. The World Health Organization launched the age-friendly city and communities' movement that proposes solutions for older people to age actively by improving their welfare and social participation. The concept of an age-friendly city comprised eight dimensions: (1) outdoor spaces and buildings; (2) transportation; (3) housing; (4) social participation; (5) respect and social inclusion; (6) civic participation and employment; (7) communication and information; and (8) community support and health services. It raises some important questions about how to measure and evaluate urban policies in this framework. Current work presents the process of adaptation and validation for the Romanian older population of a standardized tool - the Age-Friendly Cities and Communities Questionnaire (AFCCQ). The validation study was conducted in Bucharest (n = 424) on a representative sample of older people, who were asked to rate their life in the city, following the eight dimensions and an additional one regarding their financial situation. Four clusters were differentiated in the analysis, resulting in different views of older adults on their experience of living in the city, showing that people's socio-economic status, their living arrangements and health situation play a role in shaping their views on city life. The results highlight the importance of standardized tools to design urban policies following an age-friendly agenda.
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If parents perceive the neighborhood as child friendly, they will allow their children more independent travel and play. Parental perception of child friendliness is therefore an important prerequisite for designing neighborhoods that promote children's health and wellbeing. However, there is currently no comprehensive and practical instrument to measure it. This study develops and empirically validates a measurement instrument for parental perception of child friendliness in neighborhoods. Survey data was collected from 309 parents in the Netherlands. The data was randomly divided into a calibration (n = 155) and a validation sample (n = 154). The factorial validity of parental perception of child friendliness in neighborhoods was examined using exploratory and confirmatory factor analysis. The construct validity was tested by using structural equation modelling (SEM) of assumed relationships between parental perception of child friendliness in neighborhoods and variables influencing this perception (antecedents) and children's physical activity (consequence). Overall, the results provided good reliability and validity for the instrument. This instrument does not only offer a practical tool; it also provides practical guidelines for designing child-friendly neighborhoods as perceived by parents. It suggests that measures, such as providing green spaces, care facilities and recreation facilities, can enhance child friendliness of neighborhoods as perceived by parents.
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Citizen science has demonstrated potential to foster local changes in public health, including physical (in)activity. We used community-engaged citizen science to explore how to improve the exercise-friendliness of a Dutch neighborhood, chosen because it scored below average on important health parameters.We followed the steps of design thinking and employed the Our Voice citizen science method to find out how community members perceived exercise-friendliness in their neighborhood. Members participated in technology-enabled “discovery” walks using the multi-lingual Stanford Neighborhood Discovery Tool mobile application. Positive, negative, and dual features in the neighborhood were captured. During a researcher-facilitated process, citizen scientists analyzed their data together, leading to overarching themes reflecting resident needs and desires. These themes served as the basis for developing a walking route throughout the neighborhood. Several initial walking route prototypes were developed and tested by citizen scientists, resulting in a final route design that was realized in collaboration with local government officials. Citizen scientists were interviewed and asked about their engagement with and sense of agency throughout the research process. They reported commitment to the project and their neighborhood, and a desire to contribute to society. They also reported increased agency in contributing to neighborhood impacts.This project showed that citizen science “by the people” is a powerful way to engage people with projects in their own neighborhoods. It provided local perspectives on the neighborhood, which led to actual changes in the environment
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To date, a range of qualitative and mixed-methods approaches have been applied to assess the age-friendliness of cities and communities. The Age-Friendly Cities and Communities Questionnaire (AFCCQ) has been developed to fill a gap for a systematic quantitative method approach to evaluate baseline age-friendliness in cities and communities and then measure ongoing efforts to become more age-friendly, aligned with the model by the World Health Organization (WHO). As such, it offers a valid and valuable quantitative method for cities to assess age-friendliness. This paper presents the process and results of a study undertaken to test the validity and reliability of the AFCCQ for the Australian context. It is part of a broader cross-cultural project seeking to test the AFCCQ across Europe, Asia, Oceania, and North America to generate methodological insight and comparable data. Informed by consultation with local experts in population and ageing research, as well as with people aged 65 and over, the instrument proved reliable in the Australian context before being distributed to 334 older people in Greater Adelaide for validation. Results show that the AFCCQ-AU proved a valid and reliable tool for evaluating the age-friendliness of larger cities and communities in Australia. Overall, the total score indicated moderate-good satisfaction with the age-friendliness features of the Greater Adelaide Region with the domain of Housing scoring highest (highly satisfactory). Psychometric validation and cluster analysis led to the identification of five typologies of older people living in Greater Adelaide, characterised by distinct socio-demographic profiles and concomitant experiences and evaluations of age-friendliness. This Australian validation adds further weight to the role of the AFCCQ in being able to assess the age-friendliness of cities and communities across the WHO's Global Network for Age-Friendly Cities and Communities. Used in combination with the rich and nuanced qualitative data at the local level, the tool has the ability to create significant outcomes for older people and their communities.
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As an active member of the Global Network for Age-Friendly Cities and Communities, The Hague has been monitoring the progress over the years. In 2022, a second cross-sectional survey based on the Age Friendly Cities and Communities Questionnaire (AFCCQ) was conducted among 396 community-dwelling older citizens in the municipality. During times of the pandemic, scores for Social Participation went notably down, and scores for Respect and Social Inclusion increased. For the first time, based on survey data, four personas were found through cluster analysis. These personas ranged from the precariat and people with personal health issues with lower scores, to the silent majority without the limitations of health problems, and the upper echelon who score positively in all domains. Age-friendly policies in The Hague should focus particularly on the first two clusters through dedicated action plans, which would help steer efforts towards those most in need for support. This would help The Hague to become an age-friendly city for all, and not only for those living in good health and with sufficient financial means.
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