Peer-reviewed article
Development and validation of a new instrument to assess risk of falls among infants and toddlers.
Tian J, Cheng P, Wang X, Xiang H, Gao Q et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study developed and validated a new three-part instrument to assess the risk of falls among infants and toddlers, which is the leading cause of disability and death in this age group. The instrument measures home environment hazards, children's activity levels, and parental supervision through 43 items total. Validation involved expert consultation, a cross-sectional survey of 296 respondents, and testing with 100 participants in a randomized trial. The instrument showed strong internal consistency and reliability across its three scales.
Key points
- Falls are the leading cause of disability and mortality among infants and toddlers
- The instrument has three scales: home environment hazards (20 items), children's activity (12 items), and parental supervision (11 items)
- Cronbach's alpha values ranged from 0.898 to 0.907, indicating high internal consistency
- Test-retest reliability was 0.837 and inter-observer reliability was 0.812 for the home environment hazards scale
- Fall-related injury hazard density was higher in the fall-occurrence group (1.511 vs 1.475 per 10 m²) though the difference was not statistically significant
Limitations
The document does not specify which country or countries the validation study was conducted in, limiting understanding of generalizability to other contexts. The study reports development and initial validation but does not provide details on the practical implementation or effectiveness of using the instrument to prevent falls in real-world settings.
Abstract
BACKGROUND: Fall-related injuries are the leading cause of disability and mortality among infants and toddlers. Effective prevention requires reliable assessment of fall risk, however, existing tools have several limitations. This study aimed to develop and validate a new instrument to assess risk of falls in this population. METHODS: The instrument was developed using Delphi process and validated through statistical analysis. Fourteen experts participated in the consultation, and 296 respondents completed an online cross-sectional survey. External validation was performed using a randomized controlled trial (RCT) design involving 100 participants. Evaluation measurements included Cronbach’s alpha, correlation coefficients, exploratory graph analysis, and factor analysis. RESULTS: The Delphi process yielded three-scale instrument, including home environment hazards (20 items), children’s activity (12 items) and parental supervision (11 items), with Cronbach’s alpha of 0.898, 0.898 and 0.907 respectively. Test–retest reliability and inter-observer reliability were 0.837 and 0.812 for home environment hazards scale. Fall-related injury hazard density (1.511 vs 1.475 per 10 m2, P = 0.878) and dynamic hazard exposure (1.035 vs 0.847 per 10 m2, P = 0.412) were higher in the fall-occurrence group compared to the non-fall group. CONCLUSION: The newly developed instrument demonstrated high internal consistency and acceptable validity for assessing fall risk among infants and toddlers, supporting its use in the subsequent RCT study for further validation. TRIAL REGISTRATION: RCT study involved in our research was registered on 25 April 2021 at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn ), clinical trial number: ChiCTR2100045859.