Challenges of cross-national housing research with older persons: lessons from the ENABLE-AGE project

Although it is generally acknowledged that housing is a major issue regarding health in old and very old age, most empirical research still tends to treat the role of the housing environment in a rather superficial manner. The cross-national project Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing (ENABLE-AGE) seeks to make a substantial contribution to this shortcoming. The main objective of the project is to examine subjective and objective aspects of housing and their impact on health in very old age, while health is understood mainly in terms of autonomy, participation and well-being. The project involves five European Union member countries, i.e. Sweden (coordinating unit), Germany, the United Kingdom, Latvia and Hungary. The total sample includes 1,918 older adults in the age range of 75–89 years and living in single households. We provide a systematic analysis of major challenges coming with cross-national research in the housing and ageing domain based on the experience of the ENABLE-AGE Project. Treated are: challenges related to sampling and data collection procedures, challenges related to inclusion and exclusion criteria based on housing characteristics, challenges related to differences in housing legislation, norms, and guidelines, challenges related different availability of professional expertise for person-environment assessments, challenges related to valid and reliable person-environment assessments, and challenges related to the interpretation of housing-related findings.

[1]  M. Powell Lawton,et al.  Annual Review of Gerontology and Geriatrics , 1988, Springer Berlin Heidelberg.

[2]  Å. Brandt,et al.  Older people's use of powered wheelchairs for activity and participation. , 2004, Journal of rehabilitation medicine.

[3]  Susanne Iwarsson,et al.  Accessibility and usability in housing: construct validity and implications for research and practice , 2003, Disability and rehabilitation.

[4]  Hans-Werner Wahl,et al.  Environmental gerontology at the beginning of the new millennium: reflections on its historical, empirical, and theoretical development. , 2003, The Gerontologist.

[5]  A. Stuck,et al.  Risk factors for functional status decline in community-living elderly people: a systematic literature review. , 1999, Social science & medicine.

[6]  J. Jackson.  Conceptual and Methodological Linkages in Cross–Cultural Groups and Cross–National Aging Research , 2002 .

[7]  W. Preiser,et al.  Universal design handbook , 2001 .

[8]  M. Powell Lawton,et al.  Ecology and the aging process. , 1973 .

[9]  Susanne Iwarsson,et al.  Cross-national and multi-professional inter-rater reliability of the Housing Enabler , 2005, Scandinavian journal of occupational therapy.

[10]  K. Morgan,et al.  The Nottingham Longitudinal Study of Activity and Ageing: a methodological overview. , 1998, Age and ageing.

[11]  Susanne Iwarsson,et al.  Development of a Novel Instrument for Occupational Therapy of Assessment of the Physical Environment in the Home—A Methodologic Study on “The Enabler” , 1996 .

[12]  Paul B. Baltes,et al.  Multilevel and systemic analyses of old age: Theoretical and empirical evidence for a fourth age , 1999 .

[13]  M P Lawton,et al.  Environment and other determinants of well-being in older people. , 1983, The Gerontologist.

[14]  I. Graham,et al.  Multidisciplinary Cross-National Studies: A Commentary on Issues of Collaboration, Methodology, Analysis, and Publication , 2003, Qualitative health research.

[15]  Janet Harkness,et al.  In pursuit of quality: Issues for cross-national survey research , 1999 .

[16]  E. Steinfeld,et al.  Theory as a Basis for Research on Enabling Environments , 1999 .

[17]  Peter Lynn,et al.  Developing quality standards for cross-national survey research: five approaches , 2003 .

[18]  A. Strauss,et al.  The Discovery of Grounded Theory , 1967 .

[19]  F. Oswald,et al.  Everyday competence in visually impaired older adults: a case for person-environment perspectives. , 1999, The Gerontologist.

[20]  M P Lawton,et al.  The ecology of social relationships in housing for the elderly. , 1968, The Gerontologist.

[21]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[22]  L. Gitlin,et al.  Conducting research on home environments: lessons learned and new directions. , 2003, The Gerontologist.

[23]  Susanne Iwarsson,et al.  The Housing Enabler. An Instrument for Assessing and Analysing Accessibility Problems in Housing. , 2001 .

[24]  Hans-Werner Wahl.  Environmental influences on aging and behavior. , 2001 .

[25]  R. Morgan,et al.  Rectal examinations in elderly subjects: attitudes of patients and doctors , 1998 .

[26]  M. Kohn,et al.  CROSS-NATIONAL RESEARCH AS AN ANALYTIC STRATEGY* American. Sociological Association, 1987 Presidential Address , 1987 .

[27]  S. Iwarsson,et al.  The ENABLE-AGE Project: Multi-dimensional methodology for European housing research , 2005 .

[28]  Jagdip Singh,et al.  Measurement Issues in Cross-National Research , 1995 .

[29]  S. Iwarsson,et al.  Accessibility, usability and universal design—positioning and definition of concepts describing person-environment relationships , 2003, Disability and rehabilitation.

[30]  M. T. J. Buñuales,et al.  La clasificación internacional del funcionamiento de la discapacidad y de la salud (CIF) 2001 , 2002 .

[31]  Susanne Iwarsson,et al.  Housing Enabler 1.0: A Tool for Housing Accessibility Analysis. Software for PC. , 2001 .