Assessing avoidance behavior due to concerns about falling: Psychometric properties of the FES-IAB in a sample of older adults of an online panel

Background and Objectives: The Falls Efficacy Scale-International (FES-I) and its shorter version (Short FES-I) are widely used measures of concerns about falling (CaF) and have consistently demonstrated good psychometric properties. The FES-I Avoidance Behavior (FES-IAB) and Short FES-IAB were developed to gain insight into activity avoidance due to CaF and add a question to each item of the FES-I and Short FES-I. The objective was to assess the psychometric properties of the FES-IAB and Short FES-IAB in community-dwelling older people.Methods: A community-dwelling sample of the Dutch population (n = 744) aged 60 and over completed the FES-IAB twice with one month in between (with a follow-up response rate of 92.2%).Results: Confirmatory factor analysis confirmed the unidimensionality of the FES-IAB, with high factor loadings and very good fit. The scale correlated strongly with the FES-I, and moderately with ADL disability and 1-item questions of activity avoidance and CaF. The FES-IAB discriminated well between groups based on age, sex, fall history. Internal consistency and test-retest reliability were high (Cronbach's alpha: 0.92, intraclass correlation coefficient: 0.85). FES-IAB scores were positively skewed; 343 people (46.1%) had the lowest possible score of 16. The psychometric properties of the Short FES-IAB were comparable. No problems were identified with the feasibility of the FES-IAB and Short FES-IAB.Discussion: Overall, the FES-IAB and Short FES-IAB demonstrated good psychometric properties in assessing activity avoidance due to CaF in community-dwelling older people. These instruments may help researchers and clinicians to investigate the behavioral consequences of CaF.