Assessment of fall risk in the home environment of Korean older adults: revision and validation of the K-HOME FAST

Abstract

Background Most older adults experience falls inside their house. To prevent them, specially designed screening tools are required to assess fall risk in the home environment. As the home environment can vary significantly due to cultural differences and changes over time, it is essential to regularly update and validate these tools to ensure their continued accuracy and relevance. Therefore, this study aimed to develop the Revised K-HOME FAST (Korean version of the Home Falls and Accidents Screening Tool) and evaluate its validity and reliability. Methods The Revised K-HOME FAST was developed in these phases: (1) development of the Revised K-HOME FAST, (2) feasibility test, (3) verification of content validity, and (4) data collection and verification of reliability. Verification of content validity involved the participation often experts. Internal consistency was confirmed by conducting home-visit assessments with 211 community-dwelling older adults who had experienced at least one fall in the local community. Verification of inter-rater reliability involved six investigators forming pairs and conducting individual evaluations of the homes of 20 older adults with a history of falls. Results The final Revised K-HOME FAST consisted of 25 items categorized into seven home areas: bathroom/toilet, bedroom, living room, kitchen, stairs, entrance, and entire house. The item-content validity index of the Revised K-HOME FAST ranged from 0.8 to 1.0, except for one item. The internal consistency (Kuder-Richardson Formula 20) of the Revised K-HOME FAST was 0.65 (95% CI = 0.58-0.71). The agreement percentage for each item ranged from 92% to 100%, and the intraclass correlation coefficient ranged from 0.64 to 1.00, indicating high inter-rater reliability. Conclusions The Revised K-HOME FAST has satisfactory validity and reliability for assessing the risk of falls in the home environment of community-dwelling older adults in Korea. By incorporating the characteristics of Korea, the Revised K-HOME FAST is positioned to contribute substantially to the reduction of home fall risks for Korea's aging population.