Content validity study for the development of an assessment tool measuring livability in older adults

Introduction: Ensuring livable environments that support independence and well-being in later life has become a critical task. However, few approaches comprehensively capture the interplay between personal, environmental, and occupational factors. This study aimed to develop and content-validate preliminary items of livability to support continued residence in familiar homes and communities. Methods: A modified Delphi technique was employed with 17 experts in health, welfare, architecture, and residential environments. Over two survey rounds, experts evaluated and refined item relevance and importance to achieve consensus. Results: The Delphi process produced 70 preliminary items across four domains: person, environment, daily activities, and performance. In the second round, strong expert agreement was reached (content validity ratio = 0.92; convergence = 0.38; consensus = 0.78; stability = 0.15). A validity–importance matrix identified 35 core items exceeding the mean, representing key indicators of livability. Conclusion: The content-validated items provide a practical framework for assessing livability among older adults. By capturing the dynamic interaction between individual abilities and environmental support, it informs interventions and policies aimed at promoting aging in place and improving quality of life in community settings.