Test-Retest Reliability of a Fall Risk Screening Tool for Michigan 2-1-1: A Pilot Study

Introduction: Falls are a leading cause of injury and injury-related death among older adults, yet many falls are preventable through early identification of risk and connection to appropriate resources.Reliable screening tools are essential for guiding older adults to individualized fall prevention programs, particularly through statewide resource systems such as Michigan 2-1-1.This pilot study examined the item-level testretest reliability of a screening tool intended to guide older adults toward appropriate fall prevention resources.Materials and methods: The Oakland University Institutional Review Board determined this study to be exempt.We examined the item-level test-retest reliability of a 12-item fall risk screening questionnaire.A convenience sample of 30 community-dwelling adults aged 60 years and older completed the questionnaire twice, approximately one week apart.Community-dwelling participants were defined as adults who lived independently in non-congregate residential environments.Two participants completed both administrations by telephone, and 28 completed both through emailed electronic survey links.Cohen's kappa coefficients and corresponding 95% confidence intervals were calculated for all 12-item fall risk screening questionnaire items.Results: All 30 individuals who expressed interest were subsequently screened, met the eligibility criteria, enrolled, and completed both survey administrations.Nine of the 12 items included in the test-retest analysis demonstrated almost perfect agreement, with kappa coefficients ranging from 0.84 to 1.00; five items demonstrated perfect agreement (kappa = 1.00).Worry about falling demonstrated substantial agreement (kappa = 0.71).Two items demonstrated fair agreement: medication-related lightheadedness or fatigue (kappa = 0.35) and furniture-assisted ambulation within the home (kappa = 0.37).Conclusion: In this pilot sample, most 12-item fall risk screening questionnaire items demonstrated substantial to almost perfect test-retest agreement.The two items with fair agreement warrant continued evaluation to better understand potential differences in interpretation or reporting in a larger and more diverse sample.These preliminary findings support further study of the 12-item fall risk screening questionnaire before its integration into a process for matching older adults with individualized fall prevention resources through Michigan 2-1-1.