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Utilization of a screening tool to identify homebound older adults at risk for falls: validity and reliability
1Pi Beta Phi Rehabilitation Institute, Vanderbilt University, Nashville, TN, USA. pat.flemming@vanderbilt.edu
Purpose:
This study examined the reliability and validity of a Falls Risk Assessment (FRA) tool developed to identify risk factors associated with falls in homebound older adults.
Design And Methods:
FRA scores of 307 Medicare-eligible adults over 65 admitted sequentially to a home health agency (HHA) were analyzed retrospectively using a case-control design. A total of 18 subjects participated prospectively in assessment of criterion-related validity and rater reliability.
Results:
Mean FRA scores of fallers were significantly higher than non-fallers (10.13, 7.2, respectively; p < 0.05). The FRA and Performance-Oriented Mobility Assessment (POMA) demonstrated a strong negative correlation (r =-0.74), utilizing a Pearson correlation. Using percent agreement, FRA scores of nine raters yielded 94.74% agreement. Kuder-Richardson (KR)-20 analysis yielded internal consistency of 0.98, 0.97, and 0.98 within subjects scored, indicating high consistency among raters. An intraclass correlation coefficient (Model 3,1) of 0.83 supports intra-rater reliability. History of recurrent falls was the only significant predictor in logistic regression (p = 0.027, odds ratio: 2.83).
Implications:
Data support use of the FRA in screening for fall-related risk factors in homebound older adults.
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