Reliability of the 44-question Home Fall Hazard Assessment Tool and demographic characteristics associated with home hazards among the Thai elderly.

Background: The 44-question Thai Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to assist healthcare professionals in identifying the risk of falls among community-dwelling older adults from their home environment. However, the reliability of this tool has not been studied. This study aimed to examine the reliability of the 44-question Thai-HFHAT and determine the demographic characteristics associated with home hazards. Methods: A descriptive cross-sectional study design was used to evaluate inter-rater reliability. The participants in this study were 51 older people from various types of Thai houses: a one-story elevated house, a one-story non-elevated house, and a house with two or more floors, 51 caregivers of older patients, and 5 village health volunteers (VHV). A prospective design was used to evaluate test-retest reliability with older people at different times in their homes. All participants answered 44 Thai-HFHAT questions to determine inter-rater and test-retest reliabilities. The reliabilities were analyzed using an intra-class correlation coefficient (ICC). Demographic characteristics including sex, occupation, and education were used to identify the factors affecting home hazards, and linear regression was used to analyze. Results: The ICC of inter-rater reliability of the 44-question Thai-HFHAT was 0.74 (95% CI: 0.57-0.84) and the test-retest reliability was 0.80 (95% CI: 0.64-0.88) for the older adults, 0.80 (95% CI: 0.65-0.89) for the caregivers and 0.70 (95% CI: 0.477-0.83) for the VHV. In demographic variables, personal business career and education level (grades 1-3) had significant relations with the total number of home hazards in the 44-questions Thai-HFHAT. Conclusions: The 44-question Thai-HFHAT is suitable for home hazard assessment among older adults in Thailand. Further studies are needed to investigate changes in the house environment after using the 44-question Thai-HFHAT to determine which changes can reduce fall risk.

Home hazard modification programs for reducing falls in older adults: a systematic review and meta-analysis.

Objective: This study aims to assess the effect of home modification in preventing falls in older adults. Methods: A systematic review and meta-analysis of randomized studies were performed. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered prospectively. Five electronic databases were systematically searched for related articles. The titles and abstracts of the articles found using the key search phrases-home modification and falling-were screened using inclusion and exclusion criteria. The Cochrane risk of bias tool was used to evaluate the studies' methodology. Results: A total of 12 trials were included. A meta-analysis was conducted using 10 studies with n = 1, 960 participants showing a clinically meaningful 7% reduction in falls (risk ratio = 0.93; 0.87-1). Conclusions: Falls can be significantly reduced with the use of home modification interventions that are thorough, well-focused, have an environmental-fit perspective, and have adequate follow-up.

Construction of the Mobility to Participation Assessment Scale for Stroke (MPASS) and Testing Its Validity and Reliability in Persons With Stroke in Thailand.

OBJECTIVES: This study was conducted to develop the Mobility to Participation Assessment Scale for Stroke (MPASS) and assess its content validity, internal consistency, inter-rater and intra-rater reliability, and convergent validity in people with stroke living in the community. METHODS: The MPASS was developed using published data on mobility-related activity and participation timing in elderly individuals, and then reviewed by community physical therapists. Content validity was established by reaching a consensus of experienced physical therapists in a focus group. The MPASS was scored for 32 participants with stroke (mean age 61.75±4.92 years) by 3 individual testers. Reliability was examined using the intraclass correlation coefficient (ICC), internal consistency using the Cronbach alpha coefficient (α), and convergent validity using the Pearson correlation coefficient (r) to compare the MPASS to the Modified Rivermead Mobility Index as a referent test of mobility. RESULTS: The MPASS consists of 8 items, and its scoring system provides information on the ability of people with stroke to reach a movement level enabling them to live in society, including interactions with other people and safe living in the community. The inter-rater and intra-rater reliability were excellent (ICC, 0.948; 95% confidence interval [CI], 0.893 to 0.982 and ICC, 0.967; 95% CI, 0.933 to 0.989, respectively). Internal consistency was good (α=0.877). The convergent validity was moderate (r=0.646; p<0.001). CONCLUSIONS: The newly developed MPASS showed acceptable construct validity and high reliability. The MPASS is suitable for use in people with stroke, especially those who have been discharged and live in the community with the ability to initiate sitting.

Construction of the Short-Form Thai-Home Fall Hazard Assessment Tool (Thai-HFHAT-SF) and Testing Its Validity and Reliability in the Elderly.

The Thai-Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to identify the fall risk among the elderly arising from their home environment. However, it is more time consuming for large items. Therefore, this study developed a short-form of Thai-HFHAT (Thai-HFHAT-SF). In phase I, we developed the Thai-HFHAT-SF by performing a confirmatory factor analysis (CFA) of 450 rural elderly people. In phase II, a total of 105 participants; 50 elderly people, 50 caregivers, and 5 village health volunteers (VHV) were recruited to examine the reliability of the Thai-HFHAT-SF. Intra-class correlation coefficient (ICC) was used to analyze the inter-rater and test-retest reliability. Factor analysis selected 28 out of the 69 original Thai-HFHAT items in 4 components: indoor area, garage, outdoor areas, and risky spots/areas including pets. The factor loading was 0.67, 0.60, 0.32, and 0.31 in each component. The fitness index indicated that this model was fit (χ2/df = 1.38, goodness-of-fit Index (GFI) = 0.988, adjusted goodness-of-fit index (AGFI) = 0.970, standardized root mean square residual (SRMR) = 0.030, and root mean square error of approximation (RMSEA) = 0.029). The inter-rater reliability of the Thai-HFHAT-SF was 0.82 (95% CI: 0.71-0.89). The test-retest reliability was 0.77 (95% CI: 0.60-0.87) for the older person group, 0.85 (95% CI: 0.73-0.91) for the caregiver group, and 0.60 (95% CI: 0.29-0.77) for the VHV group. The new 28-item scale focused on home fall hazards and can be conducted in 10-15 min. Thai-HFHAT-SF is suitable for home hazards assessment among elderly in Thailand.

Effectiveness of an Academic-Practice Team Approach on Research Capacity Building of Nurses and Public Health Professionals.

The purpose of this study was to determine the need for research training among nurses and health professionals in a rural province of Thailand and to evaluate the effectiveness of the interventions designed to address the identified factors. This two-phase study used a cross-sectional design with one-group pre- and post-tests. In phase I, 149 subjects from 16 subdistrict health promoting hospitals and one district hospital were sampled. As an intervention, an academic-practice team approach to research capacity building was designed. Twenty-four volunteers completed a three-time point assessment of intervention in phase II. Data were collected using self-report questionnaires and analyzed using bivariate and multivariate statistics. Phase-I results indicated that 33.6% of subjects were involved in the research implementation. They had a moderate perception of research barriers and capacity. The research experiences, capacity, and barriers associated with the research implementation were described in detail (p < 0.05). The only positive predictor of research implementation was research training (p < 0.001). The intervention improved 24 participants' competency (p < 0.05). Most of their research proposals had received ethics approval and a small grant. These findings highlight the efforts of innovative research capacity development and its impact on research and health practices among nurses and health professionals.