Date Presented 4/9/2016
The Outdoor Falls Questionnaire examines outdoor fall risks and strategies used for prevention among community-dwelling seniors. Results from this study suggest the questionnaire has good internal consistency as well as content and face validity. Further development of the tool is warranted.
Primary Author and Speaker: Tracy Chippendale
Contributing Authors: RoseAnn Knight, Mi Sun Monica An, Lauren Cefalo, Talia Lautman, Cali Stoffel, Ruth Harris, Bhumi Mahadevia, Diane Huang
PURPOSE: The purpose of this study was to develop and examine content and face validity and internal consistency of the Outdoor Falls Questionnaire (OFQ), which examines outdoor fall risk and strategies used for prevention among community-dwelling older adults.
BACKGROUND: Outdoor falls account for half of falls among seniors, yet the focus of fall prevention has been on intrinsic factors the home environment. Existing fall risk assessments have not been shown to be relevant among healthy, high-functioning seniors and among outdoor fallers. A questionnaire specific to outdoor falls that includes known predictors and that examines perceived risks and strategies used for prevention is warranted to establish intervention needs at the individual and population level.
DESIGN: A descriptive study examining content and face validity and internal consistency of a newly developed questionnaire.
PARTICIPANTS: Five geriatric content experts, an expert in questionnaire design, and community-dwelling seniors.
METHOD:
Phase 1: The initial questionnaire was developed based on two exploratory studies and the existing literature on outdoor falls.
Phase 2: Expert review for questionnaire structure, content, and face validity.
Phase 3: Cognitive interviewing to ensure correct interpretation of the questions.
Phase 4: Pilot study with community-dwelling seniors (n = 55) to refine the questionnaire and establish internal consistency.
ANALYSIS: Content experts were asked to rate each question and the questionnaire in its entirety on a 4-point scale. The design expert provided written feedback on structure and wording of questions. Questions incorrectly interpreted by the older adult participants were noted by the Principal Investigator. Cronbach’s α and Spearman–Brown statistics were used to establish internal consistency for each domain.
RESULTS: Content experts rated the questionnaire as a whole as “quite relevant” or “very relevant” to outdoor falls. The majority of individual questions (22 out of 32) were rated by experts as either quite relevant or very relevant. Feedback from reviewers and older adults regarding specific questions, and feedback from pilot testing, were incorporated into the revised questionnaire.
The following domains are included in the revised version of the questionnaire: demographic information relevant to outdoor falls, use of an assistive device, instrumental activities of daily living and activities of daily living status, frequency and type of physical activity participation, time spent outdoors during summer, time spent outdoors during winter, gait speed, alcohol consumption, depression, psychotropic medication use, falls self-efficacy for outdoor activity, perceived outdoor fall risks, strategies used for outdoor fall prevention, and outdoor fall history. Internal consistency ranged from .65 to .90 for each domain.
DISCUSSION: The OFQ demonstrates good content and face validity and reasonable internal consistency. Further research is needed to examine factor structure, additional reliability measures, and intraclass correlations for different modes of delivery. Pending the results of further testing, envisioned applications include an evaluative, discriminative and predictive function.
IMPACT STATEMENT: Outdoor falls have detrimental effects on the well-being of older adults. The OFQ can help to determine individual and population-level needs for outdoor fall prevention that will help to promote productive aging among community-dwelling well elders.
