Exploring the Remote Administration of a Performance-Based Functional Assessment.

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Performance-based assessments of Instrumental Activities of Daily Living (IADL) offer superior detection of functional impairments compared to self-report questionnaires.
• Traditional in-person administration of IADL assessments limits accessibility for vulnerable older adults.
• Remote administration presents a potential solution to broaden access to functional assessments.

Purpose of the Study:

• To compare the efficacy and feasibility of in-person versus remote administration of specific IADL tasks.
• To evaluate score equivalence, changes over time, and differential item functioning (DIF) between administration methods.
• To assess clinician perceptions of remote IADL assessment acceptability and feasibility.

Main Methods:

• Community-dwelling older adults underwent in-person IADL assessments at baseline.
• Follow-up assessments were conducted two years later, using either in-person or modified remote administration.
• Statistical analyses compared scores between administration methods, examined changes from baseline, and identified DIF.

Main Results:

• No significant differences were found in overall scores between in-person and remote IADL assessment methods.
• Remote administration of IADL tasks was associated with longer completion times.
• One specific IADL task exhibited significant differential item functioning (DIF) between the two administration methods (p < .01).

Conclusions:

• Remote administration of selected IADL tasks (shopping, checkbook balancing, medication management) is supported with minor adaptations.
• Clinicians reported remote administration as acceptable and feasible, suggesting its potential for wider implementation.
• Further research is warranted to fully validate remote IADL assessment protocols and address identified DIF.