Development of a Falls Efficacy Scale: A Contextually Relevant and Appropriate Tool for Indian Seniors.

Introduction India is expected to have one of the largest elderly populations in the world by 2050, with approximately 20% of the total population projected to be senior citizens. Currently, fall efficacy scales do not include all the relevant activities, and some daily activities performed by seniors at risk of falls are not included in them. Therefore, it is important to have a fall risk assessment screening tool that is contextually appropriate for the Indian elderly population. Methodology A literature review, opinions from eight multidisciplinary experts and an interview with 104 senior participants were held. Based on this, the activities performed by seniors at risk of falls were identified. Consensus among experts was sought in finalising the items, and then the scale was pilot-tested with seniors. Results A total of 22 items were pooled, comprising 14 items identified through interviews with seniors, three new items suggested by experts, and five items from existing scales. Some items were added with additional conditions. The item-level Content Validity Index (CVI) was between 0.86 and 1, and the full-scale CVI was 0.95. After the pilot testing, 20 items were included in the final scale. Conclusion The newly developed scale is expected to address the current gap of a contextually relevant falls efficacy scale in India. Future studies on test-retest reliability and content validity of the new scale are warranted.