Development and validation of the co-designed social frailty 10-Item screening tool (SF-10)

Area of Science:

• Gerontology
• Social Sciences
• Psychometrics

Background:

• Social frailty significantly impacts older adults' well-being and health outcomes.
• Existing social frailty measures often lack robust conceptualization, cultural adaptation, and psychometric validation.

Purpose of the Study:

• To develop and psychometrically evaluate a co-designed social frailty assessment tool for community-dwelling older adults.
• To establish the 10-item Social Frailty Index (SF-10) as a brief, reliable screening instrument.

Main Methods:

• A three-phase scale development framework was employed, integrating a scoping review and co-design workshops with older adults, caregivers, and professionals.
• Content validity was refined through stakeholder engagement and cognitive interviews.
• The 15-item Social Frailty Index (SF-15) was administered to 234 older adults, followed by psychometric evaluation using Bayesian confirmatory factor analysis and development of the SF-10.

Main Results:

• The initial SF-15 showed poor model fit, while the developed SF-10 demonstrated acceptable fit and excellent composite reliability (ω = 0.913).
• The SF-10 exhibited strong internal consistency (α = 0.824) and captured key dimensions including resources, participation, connections, relationships, and self-management.
• Reliable variance attributable to the general factor was moderate (ωH = 0.625), with high factor score quality (ρη^,η = 0.94).

Conclusions:

• The SF-10 is a theoretically grounded and culturally sensitive brief screening tool with promising psychometric properties for Hong Kong Chinese older adults.
• The SF-10 effectively identifies overall social vulnerability and can guide tailored assessments and interventions.
• Further independent, longitudinal, and cross-cultural validation is recommended prior to widespread clinical application.