Reliability, validity, and clinical utility of a self-reported screening tool in the prediction of fall incidence in older adults.

The Chinese HomeFAST self-reported screening tool was developed to measure the number of hazards and the risk of home falls and other accidents for community-living older adults. This reliability, validity, and clinical utility study consisted of three phases. The tool's linguistic validity was established in the first phase of study, with a panel of domiciliary healthcare experts. In the second phase, the instrument yielded inter-rater reliability between community-living older adults and a group of experienced occupational therapists. Furthermore, in the third phase of study, factor analysis of the Chinese Home-FAST self-reported screening tool was conducted. There was good linguistic validity, test-retest reliability and good to excellent internal consistency of the Chinese Home-FAST self-reported screening tool among older adults living in the community. Moreover, a structure with three factors - namely "Home Environment and Furniture," "Capability in Activities of Daily Living," and "Use of Devices" - was yielded from categorical principal components analysis. Clinically, the incidence of falls among this group of recruited older adults in a six-month period was 18%. The identification of seven or more hazards was associated with prediction of unplanned fall-related hospital admission with sensitivity of 83.33% and specificity of 95.83%. The Chinese HomeFAST self-reported screening tool is thus demonstrated to be a valid and reliable tool for measuring home hazards and can predict home falls in Chinese-speaking older adults.Implications for rehabilitationTo develop an easily understandable screening tool for older adults.Older adults can perform home safety screening on their own, and can identify potential risk of falls and other accidents at home.This can serve as a communication tool between older adults and healthcare professionals.Identified hazards can be reported to healthcare professionals for further intervention.This validated instrument can help healthcare professionals to identify higher-risk older adults in the community and thus to better prioritize their provision of professional services.