Development and validation of the Upstream Social Interaction Risk Scale (U-SIRS-13): a scale to assess threats to social connectedness among older adults.

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 ( 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.