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 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

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 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

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 through
better 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
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 Mobility do
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 Safety of nc
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 Accommodation & Finance R isk nd
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 Staying Healthy In ff
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 Mental Health and Well-Being
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 Other Information

12. EASY-Care International
Research Network Europe
Belgium Latvia
Lithuania
Czech Republic Netherlands
England Poland
Finland Portugal
France Russia
Germany Scotland
Greece Sweden
Italy Switzerland
Turkey

13. EASY-Care International
Research Network
Australia
Brazil
Canada
Colombia
Hong Kong
Iran
Malaysia
Taiwan
USA
© The University of Sheffield

14. EASY-Care,
Undertaken programs in Iran
2008
 Signing the contract with The University of Sheffield
to start the work

15. 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

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)
 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

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 Analysis
Data 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 of
EASY-Care between Iranian and Portuguese
older 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 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

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
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