Setting and Participants
This study was conducted in the communities of Kaohsiung City (11 districts with 459 communities), southern Taiwan. Inclusion criteria were as follows: (a) community-dwelling older adults aged 65 and over and (2) participants had to be living in Kaohsiung City for at least 6 months. Participants were screened for dementia through the Short Mental Status Questionnaire and were excluded if they scored 7 or less. Stratified random sampling was used to select the participants from a list of names of older adults provided by the Kaohsiung City government to ensure an equal representation of the participants from the 11 districts in Kaohsiung City. A total of 1,209 potential participants were approached; 694 of them met the inclusion criteria, and 384 (55.33%) of them agreed to participate in this study. Among the 310 older adults who refused to participate, 73.23% of the older adults refused and family members refused in the remaining 26.77% of older adults. The refusal reasons for the older adults and family members who chose not to participate were the result of feelings that it would be difficult or annoying (67.74%), not wanting to be disturbed (27.42%), and not trusting the interviewers and worrying that it would be a fraud (4.84%). Previous studies have shown that less than 50% of older adults agree to participate in research, and the possible causes were disabilities and worrying about creating further trouble (Campbell, Winder, Richards, & Hobart, 2007; Jang, Cho, & Kawachi, 2010).