Validating the Falls Behavioural (FaB) scale for older people: a Rasch analysis.

Area of Science:

• Gerontology
• Rehabilitation Science
• Psychometrics

Background:

• Falls are a significant concern for older adults, impacting independence and quality of life.
• Assessing fall risk and the effectiveness of interventions requires validated tools.
• The Falls Behavioural (FaB) Scale was developed to evaluate older adults' awareness and management of fall-related hazards.

Purpose of the Study:

• To establish the validity and robustness of the Falls Behavioural (FaB) Scale for older people using Rasch modelling.
• To refine the FaB Scale into versions suitable for intervention and outcome evaluation.

Main Methods:

• Rasch modelling analysis was applied to data from 678 community-residing elderly individuals (aged 65-98).
• Goodness of fit statistics, principal components analysis of residuals, and response scale effectiveness were examined.
• A partial-credit rating scale model was identified as the best fit.

Main Results:

• A 29-item intervention version and a 24-item outcome evaluation version of the FaB Scale were supported.
• The 24-item version demonstrated excellent fit statistics (infit 1.00, outfit 1.03), good person separation (2.36), and high internal reliability (0.85).

Conclusions:

• The 29-item FaB Scale is a valid and reliable tool for clinical use, aiding in hazard awareness and as an outcome measure.
• The 24-item short form is effective for evaluating fall reduction interventions focused on protective strategies.
• Enhancements, such as including very easy and very difficult items, could further improve the precision of both scales across a wider ability range.