title: Development and initial validation of the Falls Efficacy Scale-International (FES-I).
abstract: BACKGROUND
  There is a need for a measure of fear of falling that assesses both easy and difficult physical activities and social activities and is suitable for use in a range of languages and cultural contexts, permitting direct comparison between studies and populations in different countries and settings.
  
  
  OBJECTIVE
  To develop a modified version of the Falls Efficacy Scale to satisfy this need, and to establish its psychometric properties, reliability, and concurrent validity (i.e. that it demonstrates the expected relationship with age, falls history and falls risk factors).
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Community sample.
  
  
  METHODS
  704 people aged between 60 and 95 years completed The Falls Efficacy Scale-International (FES-I) either in postal self-completion format or by structured interview.
  
  
  RESULTS
  The FES-I had excellent internal and test-retest reliability (Cronbach's alpha=0.96, ICC=0.96). Factor analysis suggested a unitary underlying factor, with two dimensions assessing concern about less demanding physical activities mainly in the home, and concern about more demanding physical activities mainly outside the home. The FES-I had slightly better power than the original FES items to discriminate differences in concern about falling between groups differentiated by sex, age, occupation, falls in the past year, and falls risk factors (chronic illness, taking multiple or psychoactive medications, dizziness).
  
  
  CONCLUSIONS
  The FES-I has close continuity with the best existing measure of fear of falling, excellent psychometric properties, and assesses concerns relating to basic and more demanding activities, both physical and social. Further research is required to confirm cross-cultural and predictive validity.
authors.affiliation: School of Psychology, University of Southampton, UK. L.Yardley@soton.ac.uk
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
authors.forename: Nina
authors.initials: N
authors.lastname: Beyer
authors.forename: Klaus
authors.initials: K
authors.lastname: Hauer
authors.forename: Gertrudis
authors.initials: G
authors.lastname: Kempen
authors.forename: Chantal
authors.initials: C
authors.lastname: Piot-Ziegler
authors.forename: Chris
authors.initials: C
authors.lastname: Todd
mesh_terms: D000058:Accidental Falls; D000368:Aged; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005239:Fear; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires