title: Validation of an instrument to measure older adults' expectations regarding movement (ERM).
abstract: BACKGROUND
  Many individuals with Parkinson's disease are not diagnosed and treated. Attitudes about aging and related help-seeking may affect the timely diagnosis of Parkinson's disease. Our objectives were to develop measures of older adults' expectations regarding movement with aging, specifically related to parkinsonism, and their beliefs about seeking healthcare for the diagnosis and treatment of parkinsonism.
  
  
  METHODS
  We established content and face validity from interviews with experts, review of the literature, and pre-testing with key informants. Two 9-item instruments resulted: Expectations Regarding Movement (ERM) and Healthcare Seeking Beliefs for parkinsonism (HSB). These instruments were administered to 210 older adults at senior centers to investigate internal consistency and construct validity.
  
  
  RESULTS
  192 (91%) of the older adults completed more than 90% of the survey. The mean age was 76; 17 (9%) reported parkinsonism. Both scales demonstrated good internal consistency (α = 0.90). Factor analysis supported construct validity of the ERM and HSB scores. Older age, lower education, worse self-reported health and African American race each were associated with lower ERM scores, but not HSB scores.
  
  
  CONCLUSIONS
  The ERM, a brief measure of expectations regarding movement with aging, shows reliability and validity. This scale may be useful in identifying older adults at increased risk for under-identification of Parkinson's disease. Further work is needed to measure healthcare seeking for parkinsonism.
authors.affiliation: Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America. dahodwan@mail.med.upenn.edu
authors.forename: Nabila
authors.initials: N
authors.lastname: Dahodwala
authors.forename: Jason
authors.initials: J
authors.lastname: Karlawish
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.forename: Cynthia
authors.initials: C
authors.lastname: Zubritsky
authors.forename: Matthew
authors.initials: M
authors.lastname: Stern
authors.forename: David S
authors.initials: DS
authors.lastname: Mandell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001294:Attitude to Health; D003469:Culture; D005260:Female; D006801:Humans; D009068:Movement; D010300:Parkinson Disease / Q000175:diagnosis* / Q000523:psychology; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires