Skip to main content
SpringerLink
Log in

Extending the importance–performance analysis (IPA) approach to Turkish elderly people’s self-rated home accessibility

  • Article
  • Published:
Journal of Housing and the Built Environment Aims and scope Submit manuscript

Abstract

Designers are still struggling to make good and fair home designs for elderly people. Although there are a lot of studies on accessibility in homes, there are few methodologies to rate the importance of accessible home attributes, or address the relationships between the most important and most satisfactory attributes (in terms of creating a good fit between the elderly and their homes). This study suggests using the importance–performance analysis (IPA) approach to set accessibility priorities and identify the critical performance factors that determine the elderly’s satisfaction with accessible homes. A self-assessment questionnaire instrument was developed based on housing accessibility literature and conducted with 342 Turkish elderly people chosen through stratified sampling among neighborhood clusters in Ankara, Turkey. The descriptive results and factor analysis of the study are significant in that they indicate significant differences among dwelling types. There were differences in importance and performance priority levels of home accessibility factors associated with each dwelling type. Moreover, the study found that safety and ease of use are the key indicators of home accessibility. According to the results, the IPA could be an effective tool to overcome the messy character of evaluating home accessibility for the elderly. By extending the accessibility attributes with the IPA analysis, it is possible to identify specific accessibility attributes, establish highest and lower priorities for intervention and decide which attributes should be maintained and/or ignored. Thus, this study contributes to the literature on aging by being the first study to explore the applicability of the IPA technique while eliciting elderly people’s accessibility requirements for healthy aging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Abalo, J., Varela, J., & Manzano, V. (2007). Importance values for importance–performance analysis: A formula for spreading out values derived from preference rankings. Journal of Business Research, 60, 115–121.

    Article  Google Scholar 

  • Adler, M., & Ziglio, E. (1996). Gazing into the Oracle. Bristol, PA: Jessica Kingsley Publishers.

    Google Scholar 

  • Afacan, Y. (2008). Designing for an aging population: Residential preferences of the Turkish older people to age in place. In P. Langdon, P. J. Clarkson, & P. Robinson (Eds.), Designing inclusive futures (pp. 237–248). London: Springer.

    Chapter  Google Scholar 

  • Afacan, Y. (2013). Elderly–friendly inclusive urban environments: Learning from Ankara. Open House International, 38(1), 52–62.

    Google Scholar 

  • Afacan, Y., & Demirkan, H. (2010). A priority-based approach for satisfying the diverse users’ needs, capabilities and expectations: A universal kitchen design case. Journal of Engineering Design, 21(2–3), 315–343.

    Article  Google Scholar 

  • Ahrentzen, S., & Tural, E. (2015). The role of building design and interiors in ageing actively at home. Build Research and Information, 43, 582–601.

    Article  Google Scholar 

  • Alberty, S., & Mihalik, B. (1989). The use of importance–performance analysis as an evaluative technique in adult education. Evaluation Review, 13(1), 33–44.

    Article  Google Scholar 

  • Altman, I., Lawton, M. P., & Wohlwill, J. F. (1984). Elderly people and the environment. New York: Plenum Press.

    Book  Google Scholar 

  • Aminzadeh, F., Dalziel, W. B., Molnar, F. J., & Garcia, L. J. (2009). Symbolic meaning of relocation to a residential care facility for persons with dementia. Aging and Mental Health, 13, 487–496.

    Article  Google Scholar 

  • Annear, M., Keeling, S., Wilkinson, T., Cushman, G., Gidlow, B., & Hopkins, H. (2014). Environmental influences on healthy and active ageing: A systematic review. Ageing & Society, 34, 590–622.

    Article  Google Scholar 

  • Argyrous, G. (2005). Statistics for research. London: Sage.

    Google Scholar 

  • Bianchin, M., & Heylinghen, A. (2018). Just design. Design Studies, 54, 1–22.

    Article  Google Scholar 

  • Burby, R. J., & Rohe, W. M. (1990). Providing for the housing needs of the elderly. Joumal of the American Planning Association, 56, 324–340.

    Article  Google Scholar 

  • Burton, E., & Mitchell, L. (2006). Inclusive urban design: streets for life. Oxford: Elsevier.

    Google Scholar 

  • Carlsson, G., Schilling, O., Slaug, B., Fange, A., Stahl, A., Nygren, C., et al. (2009). Towards a screening tool for housing accessibility problems: A reduced version of the housing enabler. Journal of Applied Gerontology, 28(1), 59–80.

    Article  Google Scholar 

  • Cervero, R. (1996). Paradigm shift: From automobility to accessibility planning (Working Paper No. 677, Institute of Urban and Regional Development). Berkeley, CA: University of California.

  • Chen, M., Murphy, H. C., & Knecht, S. (2016). An importance performance analysis of smartphone applications for hotel chains. Journal of Hospitality and Tourism Management, 29, 69–79.

    Article  Google Scholar 

  • Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S., & Swift, C. (1999). Prevention of falls in the elderly trial (PROFET): A randomized controlled trial. The Lancet, 353, 93–97.

    Article  Google Scholar 

  • Connell, B. R., McConnell, E. S., & Francis, T. G. (2002). Tailoring the environment of oral health care to the needs and abilities of nursing home residents with dementia. Alzheimer’s Care Quarterly, 3(1), 19–25.

    Google Scholar 

  • Dalkey, N., & Helmer, O. (1963). An experimental application of the DELPHI method to the use of experts. Management Science, 9(3), 458–467.

    Article  Google Scholar 

  • Engel, L., Chudyk, A. M., Ashe, M. C., McKay, H. A., Whitehurst, D. G., & Bryan, S. (2016). Older adults’ quality of life—Exploring the role of the built environment and social cohesion in community-dwelling seniors on low income. Social Science and Medicine, 164, 1–11.

    Article  Google Scholar 

  • Evans, M. R., & Chon, K. S. (1989). Formulating and evaluating tourism policy using importance–performance analysis. Hospitality Education and Research Journal, 13, 203–213.

    Article  Google Scholar 

  • Froyen, H. (2012). Universal design: a methodological approach. Boston: IHCD Books.

    Google Scholar 

  • Fuhrer, U., & Kaiser, F. G. (1992). Bindung an das Zuhause: Die emotionalen Ursachen [Attachment to the home place: The emotional bases]. Zeitschrift für Sozialpsychologie, 23(2), 105–118.

    Google Scholar 

  • Gabriel, Z., & Bowling, A. (2004). Quality of life from the perspectives of older people. Ageing & Society, 24(5), 675–691.

    Article  Google Scholar 

  • Go, F., & Zhang, W. (1997). Applying importance–performance analysis to Beijing as an international meeting destination. Journal of Travel Research, 35, 42–49.

    Article  Google Scholar 

  • Granbom, M., Himmelsbach, I., Haak, M., Löfqvist, C., Oswald, F., & Iwarsson, S. (2014). Residential normalcy and environmental experience in very old age. Changes in residential reasoning over time. Journal of Aging Studies, 29, 9–19.

    Article  Google Scholar 

  • Guadagnolo, F. (1985). The importance–performance analysis: An evaluation and marketing tool. Journal of Park and Recreation Administration, 3(2), 13–22.

    Google Scholar 

  • Handy, S. L., Boarnet, M. G., Ewing, R., & Killingsworth, R. E. (2002). How the built environment affects physical activity views from urban planning. American Journal of Preventive Medicine, 23(1), 64–73.

    Article  Google Scholar 

  • Hansen, W. G. (1959). How accessibility shapes land use. Journal of the American Institute of Planners, 25(2), 73–76.

    Article  Google Scholar 

  • Hansen, E., & Bush, R. J. (1999). Understanding customer quality requirements: Model and application. Industrial Marketing Management, 28, 119–130.

    Article  Google Scholar 

  • Harrison, J. (1997). Housing for the ageing population of Singapore. Ageing International, 23(3/4), 32–48.

    Article  Google Scholar 

  • Herssens, J., Nijs, M., & Froyen H. (2014). Inclusive Housing (Lab) for all: A home for research, demonstration and information on Universal Design (UD). Assistive technology research series, Vol. 35: Universal design 2014: Three days of creativity and diversity (pp. 185–194).

  • Heylighen, A., Linden, V. V., & Steenwinkel, I. V. (2017). Ten questions concerning inclusive design of the built environment. Building and Environment, 114, 507–517.

    Article  Google Scholar 

  • Heywood, F. (2005). Adaptation: Altering the house to restore the home. Housing Studies, 20, 531–547.

    Article  Google Scholar 

  • Hidalgo, M. C., & Hernandez, B. (2001). Place attachment: Conceptual and empirical questions. Journal of Environmental Psychology, 21, 273–281.

    Article  Google Scholar 

  • New Fair Multi-Family Housing. (1996). A design primer to assist in understanding the accessibility guidelines of the fair housing act. North Carolina: North Carolina State University Press.

    Google Scholar 

  • Imamoğlu, O. E., & Imamoğlu, V. (1992). Housing and living environments of the Turkish elderly. Journal of Environmental Pscychology, 12, 35–43.

    Article  Google Scholar 

  • Imrie, R. (2012). Universalism, universal design and equitable access to the built environment. Disability and Rehabilitation, 34(10), 873–882.

    Article  Google Scholar 

  • Insch, A. (2010). Managing residents’ satisfaction with city life: Application of importance–satisfaction analysis. Journal of Town and City Management, 1(2), 164–174.

    Google Scholar 

  • Iwarsson, S. (2005). A long-term perspective on person–environment fit and ADL dependence among older Swedish adults. The Gerontologist, 45, 327–336.

    Article  Google Scholar 

  • Iwarsson, S., Nygren, C., & Slaug, B. (2005). Cross-national and multi-professional inter–rater reliability of the housing enabler. Scandinavian Journal Occupational Therapy, 12, 29–39.

    Article  Google Scholar 

  • Iwarsson, S., & Slaug, B. (2001). Housing enabler: an instrument for assessing and analysing accessibility problems in housing. Nävlinge and Staffanstorp, Sweden: Veten & Skapen HB and Slaug Data Management.

    Google Scholar 

  • Iwarsson, S., Slaug, B., & Malmgren Fänge, A. (2012). The housing enabler screening tool: Feasibility and interrater agreement in a real estate company practice context. Journal of Applied Gerontology, 31(5), 641–660.

    Article  Google Scholar 

  • Iwarsson, S., & Stahl, A. (2003). Accessibility, usability, and universal design. Positioning and definition of concepts describing person–environment relationships. Disability and Rehabilitation, 25, 57–66.

    Google Scholar 

  • Iwarsson, S., Wahl, H.-W., Nygren, C., Oswald, F., Sixsmith, A., Sixsmith, J., et al. (2007). Importance of the home environment for healthy aging: Conceptual and methodological background of the European ENABLE-AGE Project. The Gerontologist, 47, 85–95.

    Article  Google Scholar 

  • Keates, S. (2015). Design for the value of inclusiveness. In J. Van den Hoven, P. E. Vermaas, & I. van der Poel (Eds.), Handbook of ethics, values and technological design (pp. 383–402). Dordrecht: Springer.

    Chapter  Google Scholar 

  • Kylberg, M., Lofqvist, C., & Horstmann, V. (2013). The use of assistive devices and change in use during the ageing process among very old Swedish people. Disability and Rehabilitation: Assistive Technology, 8, 58–66.

    Google Scholar 

  • Maisel, J. (2011). The evolution of universal design in housing in the United States: Toward visitability and pattern books. In W. F. E. Preiser & K. H. Smith (Eds.), Universal design handbook (pp. 25.1–25.8). New York: McGraw Hill.

    Google Scholar 

  • Maisel, J. L., Smith, E. A., & Steinfeld, E. (2008). Increasing home access: Designing for visitability, Research Report 2008–2014. Washington DC: AARP Public Policy Institute.

    Google Scholar 

  • Martilla, J., & James, J. (1977). Importance–performance analysis. Journal of Marketing, 41, 77–79.

    Article  Google Scholar 

  • Matzler, K., Bailom, F., Hinterhuber, H. H., Renzl, B., & Pichler, J. (2004). The asymmetric relationship between attribute level performance and overall customer satisfaction: A reconsideration of the importance–performance analyses. Industrial Marketing Management, 33(4), 271–277.

    Article  Google Scholar 

  • Michael, Y. L., Green, M. K., & Farquhar, S. A. (2006). Neighborhood design and active aging. Health and Place, 12, 734–740.

    Article  Google Scholar 

  • National Research Council (US) Committee. (2010). The physical environment and home health care. The role of human factors in home health care (pp. 211–245). Washington, DC: National Research Council.

    Google Scholar 

  • Niemeier, D. (1997). Accessibility: An evaluation using consumer welfare. Transportation, 24(4), 377–396.

    Article  Google Scholar 

  • Nygren, C., Oswald, F., Iwarsson, S., Fange, A., Sixsmith, J., & Schilling, O. (2007). Relationships between objective and percieved housing in very old age. The Gerontologist, 47(1), 85–95.

    Article  Google Scholar 

  • Oguz, D., Cakci, I., Sevimli, G., & Ozgur, S. (2010). Outdoor space design in elderly nursing homes. Elderly Issues Research Journal, 1(1), 23–33.

    Google Scholar 

  • Okoli, C., & Pawlowski, S. D. (2004). The Delphi method as a research tool: An example, design considerations and applications. Information & Management, 42(1), 15–29.

    Article  Google Scholar 

  • Orimo, H., Ito, H., Suzuki, T., Araki, A., Hosoi, T., & Sawabe, M. (2006). Reviewing the definition of “elderly”. Geriatrics and Gerontology International, 6, 149–158.

    Article  Google Scholar 

  • Pettersson, C., Slaug, B., Granbom, M., Kylberg, M., & Iwarsson, S. (2017). Housing accessibility for senior citizens in Sweden: Estimation of the effects of targeted elimination of environmental barriers. Scandinavian Journal of Occupational Therapy. https://doi.org/10.1080/11038128.2017.1280078.

    Article  Google Scholar 

  • Potter, R., Sheehan, B., Cain, R., Griffin, J., & Jennings, P. A. (2018). The impact of the physical environment on depressive symptoms of older residents living in care homes: A mixed methods study. The Gerontologist, 58(3), 438–447.

    Article  Google Scholar 

  • Rantanen, T. (2013). Promoting mobility in older people. Journal Preventine Medicine and Public Health, 46, 50–54.

    Article  Google Scholar 

  • Raviselvam, S., Wood, L. K., Holtta-Otto, K., Tam, V., & Nagarajan, K. (2016). A lead user approach to universal design-involving older adults in the design process. Studies in Health Technology and Informatics, 229, 5–6. https://doi.org/10.3233/978-1-61499-684-2-131.

    Article  Google Scholar 

  • Rooney, C., Hadjri, K., Mcallister, K., Rooney, M., Faith, V., & Craig, C. (2017). Experiencing visual impairment in a lifetime home: An interpretative phenomenological inquiry. Journal of Housing and the Built Environment, 33(1), 1–23.

    Google Scholar 

  • Sampson, S. E., & Showalter, M. J. (1999). The performance–importance response function: Observations and implications. The Service Industries Journal, 19, 1–26.

    Article  Google Scholar 

  • Oswald, F., Wahl, H. W., Schilling, O., & Iwarsson, S. (2007). Housing-related control beliefs and independence in activities of daily living in very old age. Scandinavian Journal of Occupational Therapy, 14, 33–43.

    Article  Google Scholar 

  • Skok, W., Kophamel, A., & Richardson, I. (2001). Diagnosing information systems success: Importance–performance maps in the health club industry. Information & Management, 38, 409–419.

    Article  Google Scholar 

  • Slaughter, S. E., & Morgan, D. G. (2012). Functional outcomes of nursing home residents in relation to features of the environment: Validity of the professional environmental assessment protocol. Journal of the American Medical Directors Association, 13(5), 487.e1–487.e7.

  • Smith, S. K., Rayer, S., & Smith, E. A. (2008). Aging and disability: Implications for the housing industry and housing policy in the United States. Journal of the American Planning Association, 74(3), 289–306.

    Article  Google Scholar 

  • Steenwinkel, I. V., Casterle, B. D., & Heylighen, A. (2017). How architectural design affords experiences of freedom in residential care for older people. Journal of Aging Studies, 41, 84–92.

    Article  Google Scholar 

  • Türel, H. S., Yiğit, M. E., & Altuğ, I. (2007). Evaluation of elderly people’s requirements in public open spaces: A case study in Bornova District (Izmir, Turkey). Building and Environment, 42, 2035–2045.

    Article  Google Scholar 

  • Turkish Statistical Institute. (2017). Statistical reports. http://www.tuik.gov.tr/UstMenu.do?metod=kategorist.

  • Verbeek, H., Zwakhalen, S. M. G., van Rossum, E., Kempen, G. I. J. M., & Hamers, J. P. H. (2012). Small-scale, homelike facilities in dementia care: A process evaluation into the experiences of family caregivers and nursing staff. International Journal of Nursing Studies, 49(1), 21–29.

    Article  Google Scholar 

  • Wahl, H.-W., Fänge, A., Oswald, F., Gitlin, L. N., & Iwarsson, S. (2009). The home environment and disability-related outcomes in aging individuals: What is the empirical evidence? The Gerontologist, 49(3), 355–367.

    Article  Google Scholar 

  • Yeo, A. Y. C. (2003). Examining a Singapore bank’s competitive superiority using importance–performance analysis. Journal of American Academy of Business, 3(1/2), 155–161.

    Google Scholar 

  • Young, L. C. (2011). Universal housing: A critical component of a sustainable community. In W. F. E. Preiser & K. H. Smith (Eds.), Universal design handbook (pp. 241–2413). New York: McGraw Hill.

    Google Scholar 

  • Yung, E., Conejos, S., & Chan, E. (2016). Social needs of the elderly and active aging in public open spaces in urban renewal. Cities, 52, 114–122.

    Article  Google Scholar 

  • Yung, E. H. K., Winky, K. O. H., & Chan, H. E. W. (2017). Elderly satisfaction with planning and design of public parks in high density old districts: An ordered logit model. Landscape and Urban Planning, 165, 39–53.

    Article  Google Scholar 

Download references

Acknowledgements

Preparation of this article was supported by the grant of Science Academy’s Young Scientist Awards Program 2017 (BAGEP), Turkey.

Author information

Authors and Affiliations

  1. Department of Interior Architecture and Environmental Design, Faculty of Art, Design and Architecture, Bilkent University, 06800, Bilkent, Ankara, Turkey

    Yasemin Afacan

Authors
  1. Yasemin Afacan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasemin Afacan.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix: Exemplary photos of accessibility problems taken from the participants’ homes

Appendix: Exemplary photos of accessibility problems taken from the participants’ homes

See Figs. 4, 5, 6, 7, 8, 9, 10 and 11.

Fig. 4
figure 4

Exemplary bathroom photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 5
figure 5

Exemplary bathroom photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 6
figure 6

Exemplary room photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 7
figure 7

Exemplary room photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 8
figure 8

Exemplary corridor photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 9
figure 9

Exemplary corridor photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 10
figure 10

Exemplary kitchen photo taken from one of the participants’ homes by the Interviewers

Full size image
Fig. 11
figure 11

Exemplary kitchen photo taken from one of the participants’ homes by the Interviewers

Full size image

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Afacan, Y. Extending the importance–performance analysis (IPA) approach to Turkish elderly people’s self-rated home accessibility. J Hous and the Built Environ 34, 619–642 (2019). https://doi.org/10.1007/s10901-019-09645-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10901-019-09645-3

Keywords

Search

Navigation