Reliability of the 44-question Home Fall Hazard Assessment Tool and demographic characteristics associated with home hazards among the Thai elderly [version 4; peer review: 2 approved]

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.