Development and validation of the Upstream Social Interaction Risk Scale (U-SIRS-13): a scale to assess threats to social connectedness among older adults
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Matthew Lee Smith, Matthew E Barrett
Social disconnection often becomes visible only after it has taken hold. This study looks earlier, at whether someone can reach people—and whether those encounters actually leave them feeling connected.
Background: Social interactions are essential to social connectedness among older adults. While many scales have been developed to measure various aspects of social connectedness, most are narrow in scope, which may not be optimally encompassing, practical, or relevant for use with older adults across clinical and community settings. Efforts are needed to create more sensitive scales that can identify “upstream risk,” which may facilitate timey referral and/or intervention. Objective: The purposes of this study were to: (1) develop and validate a brief scale to measure threats to social connectedness among older adults in the context of their social interactions; and (2) offer practical scoring and implementation recommendations for utilization in research and practice contexts. Methods: A sequential process was used to develop the initial instrument used in this study, which was then methodologically reduced to create a brief 13-item scale. Relevant, existing scales and measures were identified and compiled, which were then critically assessed by a combination of research and practice experts to optimize the pool of relevant items that assess threats to social connectedness while reducing potential redundancies. Then, a national sample of 4,082 older adults ages 60 years and older completed a web-based questionnaire containing the initial 36 items about social connection. Several data analysis methods were applied to assess the underlying dimensionality of the data and construct measures of different factors related to risk, including item response theory (IRT) modeling, clustering techniques, and structural equation modeling (SEM). Results: IRT modeling reduced the initial 36 items to create the 13-item Upstream Social Interaction Risk Scale (U-SIRS-13) with strong model fit. The dimensionality assessment using different clustering algorithms supported a 2-factor solution to classify risk. The SEM predicting highest risk items fit exceptionally well (RMSEA = 0.048; CFI = 0.954). For the 13-item scale, theta scores generated from IRT were strongly correlated with the summed count of items binarily identifying risk (r = 0.896, p < 0.001), thus supporting the use of practical scoring techniques for research and practice (Cronbach’s alpha = 0.80). Conclusion: The U-SIRS-13 is a multidimensional scale with strong face, content, and construct validity. Findings support its practical utility to identify threats to social connectedness among older adults posed by limited physical opportunities for social interactions and lacking emotional fulfillment from social interactions.
Transcript
Social disconnection often becomes visible only after it has taken hold. This study looks earlier, at whether someone can reach people—and whether those encounters actually leave them feeling connected. Social interactions are essential to social connectedness among older adults.
But many existing measures are narrow and may not be broad, practical, or relevant across clinical and community settings. The goal is to identify “upstream risk”: emerging threats to social connection that may allow timely referral or intervention, before the problem becomes harder to address.
The problem is not that existing measures are useless. They identify important parts of risk, but when used alone, they may miss its complexity and offer little guidance about where help could begin. So the study treats social interaction like a front door with two locks: one is having chances to meet people, and the other is feeling emotionally fulfilled when those meetings happen.
Either lock can fail. The study gathered a wide range of existing questions about social connectedness, then reduced them to a brief set that could still measure threats to connection. The purpose of making the measure brief was practical: to make it easier to use in research and everyday practice.
The shorter scale fit the data better than the original longer set. The selected questions could identify differences across the full range of social-connection risk. A version that allowed for random guessing did not improve the fit enough to justify its extra complexity, so the simpler model was judged most appropriate for these data.
The model fit exceptionally well, with an RMSEA of zero point zero four eight and a CFI of zero point nine five four. The strongest finding is that the scale contains three distinct parts: general feelings of disconnection, physical opportunities for social interaction, and emotional fulfillment from those interactions.
Having opportunities to interact and feeling fulfilled by those interactions were related, but both strongly predicted general feelings of disconnection. In other words, access to people does not always create a sense of connection.
The scale consists of three distinct factors: general disconnectedness, physical opportunities for interaction, and emotional fulfillment from those interactions, or its absence. Despite those distinct factors, all thirteen items conform to a singular trait, supported by strong internal reliability, with Cronbach’s alpha at zero point eight zero.
The U-SIRS-thirteen should therefore be scored as a continuous count of risk, rather than by scoring each subscale independently; examining each item can still help practitioners identify threats to social connection and choose appropriate resources, programs, or services. The findings have limits.
The participants were diverse older adults from across the United States, but they were not selected through a process that makes the results nationally representative. Because the study used the internet, it may have missed people with less access to technology, less education, or fewer financial resources—people who may face greater risk of social disconnection.
The study drew on diverse professional input, robust statistical analyses, and emerging evidence that its practical scoring approach can be replicated. A short set of questions can treat social disconnection as one connected risk, while still showing whether the problem is access to people, emotional satisfaction, or both.
That could help services respond earlier and more specifically.
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