Development and psychometric evaluation of knowledge, attitude, and behavior questionnaire on fall risk-increasing...

Fall risk-increasing drugs (FRIDs) increase the risks of falls, injuries, and fractures among older adults. However, limited evidence exists on how older adults perceive and manage FRID use, particularly in Indonesia.

This study developed and psychometrically evaluated a questionnaire for assessing knowledge, attitudes, and behaviors (KABs) related to FRID use (hereafter KABQ-FRID) among older adults.

KABQ-FRID was developed through a three-stage process. The first stage involved defining a conceptual framework and generating items based on a literature review, team discussions, and expert meeting. The second stage included an expert panel review and assessment of face validity. The third stage involved psychometric testing with 100 older adults receiving medications from a public health center in Surakarta City, Indonesia. Data analysis included Mokken scale analysis, confirmatory factor analysis (CFA), construct validity assessment, and reliability testing.

The final KABQ-FRID comprised 21 items across 3 dimensions: knowledge (7 items), attitude (5 items), and behavior (9 items). Psychometric evaluation demonstrated acceptable scalability for all items (Loevinger's H ≥ 0.30) and strong reliability (Cronbach's α > 0.7; intraclass correlation coefficient >0.9). CFA results revealed a χ²/df of 2.0, suggesting a reasonable model fit; all dimensions exhibited satisfactory loadings. Construct validity testing demonstrated strong convergent validity; 90.5 % of the items had a correlation coefficient of >0.4, and 100 % of the items had stronger correlations within their dimensions than with other constructs.

KABQ-FRID is a reliable and valid instrument for assessing KAB related to FRID use among community-dwelling older adults.