Cross-cultural adaptation, reliability, and validity of the St. Thomas’s Falls Risk Assessment Tool in Older Adults (STRATIFY)

Abstract

Introduction: Falls are an important adverse event among older adults. The St. Thomas’s Falls Risk Assessment Tool in Older Adults (STRATIFY) is a tool to assess the risk of falls; however, it is not translated and adapted to Portuguese. Objective: To translate and perform a cross-cultural adaptation of STRATIFY in Brazilian Portuguese, as well as to test the reliability and validity of the instrument. Method: The cross-cultural adaptation process was carried out in six stages: A) T1 and T2 translations; B) synthesis of translations (T12); C) T12 back translations (RT1 and RT2); D) expert committee review; E) pretesting of the version approved by the committee; F) adapted version of STRATIFY for Brazilian Portuguese. Inter-rater and test-retest reliability were performed using the intraclass correlation coefficient (ICC) and 95% confidence interval (CI). Validity was assessed by the Spearman’s correlation coefficient of the STRATIFY with the Morse Fall Scale (MFS). Data analysis was performed by the Microsoft Office Excel 2016 (translation and adaptation) and by the IBM SPSS Statistics 20.0 (reliability and validity). We used a level of significance of p<0.05. Results: Data were presented about the perception of 33 health professionals on the adapted version of STRATIFY. The following ICC and CI were found for inter-rater and test-retest reliability, respectively: ICC=0.729; CI=0.525-0.845 and ICC=0.876; CI=0.781-0.929. STRATIFY and MFS showed a moderate but significant correlation (ρ=0.50, p<0.001). Conclusion: The translated and adapted version of the STRATIFY presented moderate inter-rater reliability and good test-retest reliability, in addition to a moderate correlation to the MFS.