Xuxi Zhang

presents an overview of process evaluation components for each study question and the way these were measured in the study. Questionnaire A quantitative questionnaire was developed mainly for the purpose of the effect evaluation of the UHCE approach. It was administered to older persons at baseline and at follow ‐ up after 12 months. To study reach and dose received; characteristics of participants who were lost to follow ‐ up and characteristics of participants who did not enrol in care ‐ pathways (Table 2; question 1.2 and 2.2), we used 10 items included in the baseline questionnaire: age (in years), sex (male/female), living situation (alone/not alone), education level (low/high; based on International Standard Classification of Education; ISCED) 32 , function (limited/not limited; based on Global Activity Limitation Index; GALI) 33, 34 and mental health (poor/good; based on 5 ‐ item mental well ‐ being scale of the SF ‐ 36) 35 . To study satisfaction with the UHCE approach (Table 2; question 3.1), we used 5 items included in the follow ‐ up questionnaire. Four items measured whether persons agreed on being satisfied with each of the three UHCE stages on a five point Likert scale. Answers were categorized into ‘agree/strongly agree’ and ‘neither agree nor disagree/disagree/strongly disagree’. A final item rated person’s satisfaction with the UHCE approach on a scale from 1 to 10. Items that were not available in local language (age, sex, living situation and satisfaction with the UHCE approach) were developed in English and translated into local languages. Items were translated into the local languages and backward into English. Backward English translations were discussed among the study team and translation was adapted when needed. In each city, the questionnaire was piloted in at least five older persons. When questions were misinterpreted by participants, minor changes were made. Logbooks To study dose delivered to and received by the participants (Table 2; question 2.1 and 2.3), a logbook was developed for all cities. This logbook was kept for each older person involved in the UHCE approach. In this logbook, quantitative information of the delivery and involvement of the older person in the three stages of the UHCE approach was kept: 1) Whether or not a health assessment took place and whether the participant had an indication for any care ‐ pathways, 2) Whether or not shared decision making took place, and 3) Whether or not the participant followed any care ‐ pathways. Additionally, an open ‐ ended qualitative question on the reason for not enrolling into any care ‐ pathways was included. After 6 months at least, the care coordinator documented (if needed contact was made with either the participant or responsible health care provider) whether the three stages of the UHCE approach were delivered. The paper logbooks were subsequently entered into an electronic data ‐ entry form. Electronic data were checked for missing/incorrect data. 108 Chapter 5