The Seniors’ Outdoor Survey (SOS Tool): comparing ratings and reliability between Italy and the USA

ABSTRACT

To test applicability of an environmental assessment instrument in new settings, the ratings and reliability of the SOS Tool were compared in diverse settings with a similar climate: Milan, Italy; and Bryan/College Station, Texas, USA. This instrument evaluates physical environment support for outdoor usage by residents at senior facilities. Two trained raters assigned ratings (using a 1–7 scale) to the 60 instrument items at each setting (Italy: 94 outdoor spaces, 67 facilities; US: 22 outdoor spaces, 12 facilities). Overall mean ratings were similar across both sites (6% difference), and three of the five domains had comparable mean ratings. Mean inter-rater reliability was good in both settings but higher in Italy (ICC = .97 versus .82). Despite geographic/cultural differences, mean ratings for most items and domains were surprisingly similar between Italy and the US. This finding, and the high inter-rater reliability found in both settings, suggest this instrument may be useful in a wide range of settings.

KEYWORDS:

• Access to nature
• outdoor space
• healing garden
• therapeutic green space
• cross-cultural
• ageing
• elderly
• older adults
• environmental assessment
• audit tool

Acknowledgements

The authors gratefully acknowledge the contributions of coordinators Laura Lanfredini, Walter Toigo, Luca Bassoli, and Livia Alemanni (Azienda Sanitaria Locale of Milan), and of US research assistants Katelyn Williams and Kaitlin Legg.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported in part by SBIR grant # R44AG24786 from the National Institute on Aging (NIA), a division of the National Institutes of Health (NIH), U.S.A.