Exploring the reliability of the Home Falls and Accidents Screening Tool (HomeFAST) when conducted and scored over the phone compared to face-to-face

Abstract

Introduction: The frequency and impact of a fall increases with age. The Home Falls and Accidents Screening Tool (HomeFAST) is used to screen the fall risks of older adults (65+ years) by considering both an individual’s functional capacity and socioenvironmental factors within the home. Whilst literature is readily available on the psychometric properties of the HomeFAST when administrated during face-to-face practice, there was limited knowledge on how the tool translates in a telehealth environment. Therefore, this study aimed to explore the reliability and validity of the HomeFAST when conducted and scored over the phone, compared to face-to-face. 

Methods: Data were collected from older adults receiving occupational therapy services through an aged care organisation. The HomeFAST was initially completed over the phone by the primary researcher and then conducted by an occupational therapist during the initial home visit. Data were analysed using Intra-class correlation coefficient and Kappa statistics to provide measures of reliability.

Results: Data from 46-participants were analysed. The HomeFAST had an overall Intra-class correlation coefficient of 0.66 (95% CI 0.40 – 0.82) when comparing face-to-face to over the phone delivery. When considering individual items within the tool, reliability varied considerably (Kappa range -0.055 to 1.00).  

Conclusion: This study adds to the current literature on the utility of the HomeFAST as a means of identifying fall risks in the home environment. The results of this study alone should not be used to support a transition from face-to-face to telehealth use of the HomeFAST. Therapists should exercise caution if using the HomeFAST over the phone as reliability is not supported for some items. Further research is indicated to validate the HomeFAST as a more reliable telehealth tool.