Table 1 Adaptations of the NEWS-A for Chinese older adults

Additions

Distance to doctor/clinical service ^a

Relevant to older adults (health issues)

Distance to Chinese coffee/tea or noodle shop ^a

To distinguish Chinese-style from Western cafés; differences in affordability and food

Distance to Chinese non-fast food restaurant ^a

To distinguish Chinese-style from Western restaurants; differences in affordability and food

Distance to community or elderly centre ^a

Relevant to older adults (place for socializing)

Distance to places of worship (church, temple) ^a

Relevant to older adults (common practice)

Distance to public toilet ^a

Relevant to older adults (incontinence)

Distance to bakery/cake shop ^a

Common food outlet in Hong Kong

Distance to betting branch ^a

Popular activity among Hong Kong residents

Shopping areas are easily accessible via public transport ^a

The public transport network in Hong Kong is very developed. This facilitates access to services outside the neighborhood.

The streets are so crowded that it is difficult to walk ^a

Characteristic of many urban areas of Hong Kong

Need to walk over a bridge or through a tunnel to access the nearest services ^a

Common feature of Hong Kong.

Can easily access the entrance/exit of the building I live in (e.g., there is a lift that I can use) ^a

Lack of lifts in high-rise buildings poses accessibility problems to older adults

There are 'hawkers' and shops on the streets and sidewalks blocking the way ^a.

Common obstacle on Hong Kong streets.

There are many covered sidewalks in my neighborhood. ^a

Common feature of Hong Kong. Facilitates walking in wet or hot weather conditions.

There are indoor, air-conditioned places (shopping malls) where people can walk ^a

Common feature of Hong Kong. Facilitates walking in wet or hot weather conditions.

The streets of my neighborhood are often slippery. ^a

Hazard on steep road sections, common in Hong Kong.

There are sitting facilities (e.g., benches) where I can rest in my neighborhood ^a

Important feature for older adults

The level of air pollution in my neighborhood is often high ^a

Air pollution, especially road-side pollution levels, can be very high.

There are lots of animal droppings making walking unpleasant ^a.

Some areas of Hong Kong have high rates of dog ownership. This creates some street hygiene problems, especially unpleasant in warmer weather.

It is unsafe to walk in my neighborhood because of objects dropping from high-rise buildings ^a

A common problem in some areas of Hong Kong.

There are parked vehicles that block my vision and make it difficult to safely cross the road ^a

Common problem in older adults, less capable of quickly reacting to traffic conditions

I am afraid to cross the road because there are too many passing cars ^a

Common problem in older adults, less capable of quickly reacting to the traffic conditions

There are many homeless people, drug addicts and/or prostitutes in my neighborhood ^a

Signs of social disorder are more common than actual crime, which is very low in Hong Kong.

It would be difficult to ask for help in my neighborhood because there are not many people around ^a

Important issue for older fragile adults.

Modifications

Two items measuring commonness of detached single-family residences and townhouses or row hoses of 1-3 stories merged into a single item ^a

Uncommon type of housing in Hong Kong urban areas

Item measuring commonness of apartments of more than 13 stories changed to 'apartments of 13-20' stories. Additional item referring to commonness of apartment buildings with more than 20 stories added ^a

A large percentage of residential buildings have more than 20 stories.

Destination 'fruit/vegetable market' renamed 'fresh food market' ^a

Markets usually sell vegetables, fruit as well as fresh meat and seafood

Destination 'other schools' changed to 'nursery schools' ^a

It is common for Hong Kong older adults to drop and pick up their grandchildren

Destinations 'fast-food restaurant' renamed 'Chained Western or Chinese fast-food restaurant' ^a

Clarify type of destination to respondents. Western and Chinese fast-food restaurants sell similarly priced products

Destination 'non-fast food restaurant' changed to 'Western/international non-fast food restaurant' ^a

To distinguish Chinese-style from Western restaurants; differences in affordability and food

Destination 'recreation centre' changed to 'swimming pool' ^a

Swimming is a very popular recreational activity among Hong Kong older adults

Destination 'clothing store' changed to 'clothing & shoe store' ^a

Linguistically more appropriate

Item 'Parking is difficult in local shopping areas' omitted ^b

Not relevant because they do not drive nor own a car

Destination 'your job or school' ^b

Not relevant as they are retired

'Sidewalks are separated from the road/traffic by parked cars' changed to 'there are motor vehicles parked on the sidewalks making it difficult to walk' ^b

Cannot understand the purpose of the original item. Parked cars relevant features only if perceived as an obstacle to walking.

'There is a grass/dirt strip that separates the streets from the sidewalks' changed to 'there is a fence that separates the streets from the sidewalks' ^a

Grass/dirt strips a very uncommon in Hong Kong. Metal fences are used to separate sidewalks from roads.

'Walkers and bikers on the streets can be easily seen by people in their homes' changed to 'walkers on the streets can be easily seen by other people' ^a

Bikers are rare n Hong Kong. Most residences are in high-rise buildings making it difficult to see walkers on the streets. There are usually other people on the streets.