The Age-Friendly Cities and Communities Questionnaire launched in The Hague

In early 2020, the municipality of The Hague assigned the consortium consisting of The Hague University of Applied Sciences, Hulsebosch Advies and AFEdemy to develop a questionnaire and run a representative survey on the perceived age-friendliness of the city among its older citizens. The Hague has been an official member of the World Health Organization’s Global Network for Age-friendly Cities and Communities since 2014.

The consortium started to review scientific and public sources to check whether a default questionnaire was already available. The search delivered several examples of questionnaires that either lacked transparency on the development and validation or did not measure the construct of age-friendliness as a whole. This made the consortium decide to develop a validated questionnaire, coined the Age-Friendly Cities and Communities Questionnaire.

In order to develop the questionnaire, the consortium made use of the Consensus-based Standards for selection of health Measurement Instruments (COSMIN). The development consisted of the following four phases: Development, Initial validation, Psychometric validation and Instrument translation.

The theoretical basis of the questionnaire was the Global Age-friendly Cities Guide, published by the World Health Organization in 2007, and its accompanying Checklist. This guide published a model of age-friendly cities and communities, consisting of eight domains: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services. The features of the Checklist formed the foundation of the items for the questionnaire. Additionally, questions on technology and the financial situation were added based on the literature review.

After several rounds of validation by different panels of regional, national and international experts and checks on the readability, a questionnaire of 64 items remained that was launched as online survey or questions for a telephone enquiry. In the months June-September 2020, a number of 384 respondents of 60 years and over filled out the questionnaire.

Based on the responses, the consortium performed a Confirmatory Factor Analysis to check the relevance and internal consistency of the questions. This finally led to 23 remaining questions that are valid to measure the entire construct of an age-friendly city. The 23 questions have been translated from Dutch into English.

The Age-Friendly Cities and Communities Questionnaire measures the views of older adults on the eight domains already defined by the WHO and on a relevant ninth domain, namely their own financial situation. The questionnaire is open for use by every public authority, municipality, civil society organization, researcher or any other who is interested.

For further reading:

Dikken, J. van den Hoven, R.F.M., van Staalduinen, W.H., Hulsebosch-Janssen, L.M.T., van Hoof, J. (2020) How older people experience the age-friendliness of their city: Development of the Age-Friendly Cities and Communities Questionnaire. International Journal of Environmental Research and Public Health 2020;17(18):6867 doi: 10.3390/ijerph17186867

The full paper and supplementary materials can be downloaded via:

 WHO website Age-friendly world