Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 19, 2020
Date Accepted: Jun 2, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and validation of a mHealth falls risk screening app (FallSA©) among Malaysian Community Dwelling Older Persons
ABSTRACT
Background:
Recent falls prevention guidelines recommend early routine falls risk assessment among older persons.
Objective:
The purpose of current study was to develop a Falls Screening Mobile Application (FallSA©), determine its acceptance, concurrent validity, test-retest reliability, discriminative ability and predictive validity as a self-screening tool to identify falls risk among Malaysian older persons.
Methods:
FallSA© acceptance was tested among 15 participants (mean age: 65.93±7.42 years); its validity and reliability among 91 participants (mean age: 67.34±5.97); discriminative ability and predictive validity among 610 participants (mean age: 71.78±4.70). Acceptance of FallSA© was assessed using a questionnaire and it was validated against a comprehensive falls risk assessment tool, Physiological Profile Assessments (PPA). Participants used FallSA© to test their falls risk repeatedly twice between an hour. Its discriminative ability and predictive validity were determined by comparing participants fall risk scores between fallers and non-fallers and prospectively through a 6 months follow-up respectively
Results:
The findings of our study showed that FallSA© had a high acceptance level with 80% older persons agreeing on its suitability as a falls self-screening tool. Concurrent validity test demonstrated a significant moderate correlation (rs= 0.518, P<0.001) and agreement (K= 0.516, P<0.001) with acceptable sensitivity (80.4%) and specificity (71.1%). FallSA© also had good reliability (ICC: 0.948, CI: 0.921-0.966) and an internal consistency (α= 0.948, P<0.001). FallSA© score demonstrated a moderate to strong discriminative ability in classifying fallers and non-fallers. FallSA© had a predictive validity of falls with positive likelihood ratio of 2.27, pooled sensitivity of 82% and specificity of 64%, and AUC of 0.802.
Conclusions:
These results suggest that FallSA© is a valid and reliable fall risk self-screening tool. Further studies are required to empower and engage older persons or care givers in the use of FallSA© to self-screen for falls and thereafter to seek early prevention intervention. Clinical Trial: NA
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.