Development and Validation of the Lifestyle Medicine Assessment Tool for Community-Dwelling Thai Older Adults: A Case Study of Health Region 7: การพัฒนาและตรวจสอบคุณภาพของเครื่องมือประเมินพฤติกรรม ตามหลักเวชศาสตร์วิถีชีวิตสำหรับผู้สูงอายุไทยในชุมชน : กรณีศึกษาเขตสุขภาพที่ 7

Kanya Janpol; Sadudee Phuhongsai; Maliwan Benchawanich; Chatree Methatharathip

Authors

Kanya Janpol Regional Health Promotion Centre 7 Khonkaen, Department of Health, Ministry of Public health
Sadudee Phuhongsai Regional Health Promotion Center 7 Khon Kaen
Maliwan Benchawanich Regional Health Promotion Center 7 Khon Kaen
Chatree Methatharathip Regional Health Promotion Center 7 Khon Kaen

Keywords:

Lifestyle Medicine, Thai Older Adults, Instrument Development, Psychometric Properties, COSMIN

Abstract

As Thailand transitions into a complete aged society, the burden of non-communicable diseases (NCDs) continues to increase. Effective assessment tools based on Lifestyle Medicine (LM) principles are essential for screening behavioral risks and monitoring health outcomes. This study aimed to develop and psychometrically validate the Thai Lifestyle Medicine Assessment Tool for Older Adults (Thai LM-OA) in accordance with the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) standards. A Research and Development (R&D) design was employed. Data were collected from 273 community-dwelling older adults in Health Region 7 (mean age 70.30 ± 6.60 years), the majority of whom were female (71.8%), with 62.6% reporting underlying chronic conditions. Statistical analyses included content validity, feasibility, formative model evaluation, criterion validity, and test-retest reliability.

The resulting Thai LM-OA comprises 21 items across six core pillars: Nutrition, Physical Activity, Sleep, Substance Use, Stress Management, and Social Connection. The instrument demonstrated high content validity (S-CVI = 0.97) and excellent feasibility, with an average completion time of 5.40 minutes. Formative model evaluation indicated no multicollinearity issues (VIF: 1.04–1.55). All sub-components showed significant outer weights (p < 0.001), with Sleep (λ = 0.364) and Physical Activity (λ = 0.335) being the most significant contributors to the lifestyle construct. Furthermore, criterion validity was established by a significant negative correlation between overall LM behaviors and the number of chronic diseases (r = -0.344, p < 0.001). One-week test-retest reliability was good, with an ICC of 0.71 (95% CI: 0.50–0.84).

The Thai LM-OA is a systematically developed, concise, and psychometrically sound instrument. It provides healthcare professionals with an effective tool for screening and evaluating lifestyle behaviors among Thai older adults to support proactive health management.

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