# Development and Pilot Validation of an Age-Friendly City Assessment Tool Based on Older Adults’ Perspectives in a Semi-Urban Community

## TL;DR

This paper introduces a new assessment tool to evaluate age-friendly city environments from the perspective of older adults in semi-urban areas.

## Contribution

The study develops a perception-based assessment tool tailored for semi-urban, low- and middle-income country settings, validated through older adults’ input.

## Key findings

- The assessment tool showed strong content validity and high internal consistency reliability.
- Pilot responses indicated high perceived age-friendliness, with moderate scores in some subdomains.
- The tool is feasible for use in community-based public health planning.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Population aging and urbanization require age-friendly community environments to support healthy aging and functional independence.Existing age-friendly city assessments often rely on administrative or expert evaluations, which may overlook older adults’ lived experiences in semi-urban settings.

Population aging and urbanization require age-friendly community environments to support healthy aging and functional independence.

Existing age-friendly city assessments often rely on administrative or expert evaluations, which may overlook older adults’ lived experiences in semi-urban settings.

Public health significance—Why is this work of significance to public health?
This study develops and pilot-validates a perception-based Age-Friendly City assessment tool tailored to semi-urban communities in a low- and middle-income country context.The instrument demonstrates strong content validity and excellent preliminary reliability, supporting its use in community-based public health assessment and planning.

This study develops and pilot-validates a perception-based Age-Friendly City assessment tool tailored to semi-urban communities in a low- and middle-income country context.

The instrument demonstrates strong content validity and excellent preliminary reliability, supporting its use in community-based public health assessment and planning.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
The tool provides local authorities and public health practitioners with a practical method to identify environmental facilitators and barriers affecting older adults’ participation and well-being.Findings support the importance of incorporating older adults’ perspectives into age-friendly policies and interventions to promote inclusive, healthy, and sustainable communities.

The tool provides local authorities and public health practitioners with a practical method to identify environmental facilitators and barriers affecting older adults’ participation and well-being.

Findings support the importance of incorporating older adults’ perspectives into age-friendly policies and interventions to promote inclusive, healthy, and sustainable communities.

Background: Age-friendly city (AFC) initiatives are widely promoted to support healthy aging; however, most existing AFC assessments rely on administrative or expert-driven evaluations that primarily reflect institutional perspectives. These approaches may overlook how age-friendly characteristics are experienced by older adults—the population most directly affected by community environments—particularly in semi-urban settings. This study aimed to develop and conduct a preliminary psychometric evaluation of an AFC assessment tool based on older adults’ perspectives. Methods: A Research and Development (R&D) design was employed. The instrument was conceptually grounded in the World Health Organization Age-Friendly Cities framework and adapted from a governmental checklist through item reformulation and contextual modification for semi-urban application in Thai setting. Content validity was examined by an expert panel using the Index of Item–Objective Congruence (IOC). Preliminary internal consistency reliability testing was conducted with a small purposive sample of older adults. The refined instrument was then pilot-tested with an independent sample of community-dwelling older adults to evaluate feasibility and descriptive response patterns. Internal consistency reliability was assessed using Cronbach’s alpha, and descriptive analyses were performed across domains and subdomains. Results: The finalized instrument comprised 52 items across three domains and eight subdomains. Content validity was strong, with IOC values ranging from 0.80 to 1.00. Preliminary reliability testing demonstrated high internal consistency (Cronbach’s alpha = 0.97), indicating suitability for pilot use while suggesting potential item redundancy. Pilot responses showed predominantly high perceived age-friendliness, with moderate scores in selected subdomains. Conclusions: The AFC Assessment Tool demonstrated strong preliminary psychometric properties and practical feasibility for use among community-dwelling older adults in semi-urban settings. By incorporating older adults’ perspectives, the tool provides a context-sensitive approach that complements existing administrative and objective assessments. Further validation using larger and more diverse samples is needed to establish construct validity, confirm dimensional structure, and strengthen applicability in public health and environmental gerontology research.