Using concept mapping to design an integrated framework for mobility for older adults

Mobility, broadly defined as movement in all of its forms from ambulation to transportation, is critical to optimal aging. We present a new conceptual framework for mobility among community-dwelling older adults to help promote an integrated perspective and multidisciplinary research and practice response. Concept mapping engages stakeholders in identifying and organizing ideas on a relevant topic using multi-dimensional scaling and cluster analysis to create visual maps of relationships among ideas. In the first phase, a steering committee composed of members from CDC's Healthy Aging Research Network, along with other national partners, generated the specific focus prompt, “One specific action that can lead to positive change in mobility for older adults in the U.S. is…” More than 200 stakeholders, representing diverse perspectives and disciplines, were asked to generate ideas in response to the prompt. In the second phase, 211 stakeholders rated the items along two dimensions (response rates: impact 40%, achievability 34%) to help identify priorities, and a subset of 50 stakeholders were invited to sort items (60% response rate) to construct the concept maps. In the final phase, action items were refined and a final concept map framework evolved with the following clusters: built environment and safety, transportation, policy, housing and accessibility, community supports, training, research to practice, independence, and coordinated action. Members of the Network then met to rank priorities for future action for each cluster. This multidisciplinary project resulted in a mobility framework that can be implemented as a coordinated response across public health and aging organizations.