The Environmental Audit Screening Evaluation: Establishing Reliability and Validity of an Evidence-Based Design Tool

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Author(s)Kaup, Migette L.
Author(s)Calkins, Margaret P.
Author(s)Davey, Adam
Author(s)Wrublowsky, Robert
Date Accessioned2023-07-27T15:03:54Z
Date Available2023-07-27T15:03:54Z
Publication Date2023-04-28
DescriptionThis article was originally published in Innovation in Aging. The version of record is available at: https://doi.org/10.1093/geroni/igad039. © The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.
AbstractBackground and Objectives Current assessment tools for long-term care environments have limited generalizability or ability to be linked to specific quality outcomes. To discriminate between different care models, tools are needed to assess important elements of the environmental design. The goal of this project was to systematically evaluate the reliability and validity of the Environmental Audit Screening Evaluation (EASE) tool to better enable the identification of best models in long-term care design to maintain quality of life for persons with dementia and their caregivers. Research Design and Methods Twenty-eight living areas (LAs) were selected from 13 sites similar in organizational/operational commitment to person-centered care but with very different LA designs. LAs were stratified into 3 categories (traditional, hybrid, and household) based primarily on architectural/interior features. Three evaluators rated each LA using the Therapeutic Environment Screening Scale (TESS-NH), Professional Environmental Assessment Protocol (PEAP), Environmental Audit Tool (EAT-HC), and EASE. One of each type of LA was reassessed approximately 1 month after the original assessment. Results EASE scores were compared against the scores of 3 existing tools to evaluate its construct validity. The EAT-HC was most closely related to the EASE (r = 0.88). The PEAP and the TESS-NH were less correlated to the EASE (r = 0.82 and 0.71, respectively). Analysis of variance indicated that the EASE distinguished between traditional and home-like settings (0.016), but not hybrid LAs. Interrater and inter-occasion reliability and agreement of the EASE were consistently high. Discussion and Implications Neither of the 2 U.S.-based existing environmental assessment tools (PEAP and TESS-NH) discriminated between the 3 models of environments. The EAT-HC was most closely aligned with the EASE and performed similarly in differentiating between the traditional and household models, but the dichotomous scoring of the EAT-HC fails to capture environmental nuances. The EASE tool is comprehensive and accounts for nuanced design differences across settings.
SponsorThe Phase I: Face Validity portion of the project was supported by SAGE: Society for the Advancement of Gerontological Environments and Shaw Industries. The Phase II: Reliability and Convergent and Criterion-Related Validity portion of the project was supported by the National Institute on Aging (3R21AG067010-01S1).
CitationMigette L Kaup, PhD and others, The Environmental Audit Screening Evaluation: Establishing Reliability and Validity of an Evidence-Based Design Tool, Innovation in Aging, Volume 7, Issue 5, 2023, igad039, https://doi.org/10.1093/geroni/igad039
ISSN2399-5300
URLhttps://udspace.udel.edu/handle/19716/33038
Languageen_US
PublisherInnovation in Aging
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
Keywordsenvironmental assessment
Keywordshousehold model
Keywordslong-term care
Keywordsnursing home
Keywordsperson-centered care
TitleThe Environmental Audit Screening Evaluation: Establishing Reliability and Validity of an Evidence-Based Design Tool
TypeArticle
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