Original article
Evidence of the Psychometric Qualities of a Simplified Version of the Activities-specific Balance Confidence Scale for Community-Dwelling Seniors

Presented in part to the Canadian Occupational Therapy Association, May 27, 2005, Vancouver, BC, Canada.
https://doi.org/10.1016/j.apmr.2007.02.003Get rights and content

Abstract

Filiatrault J, Gauvin L, Fournier M, Parisien M, Robitaille Y, Laforest S, Corriveau H, Richard L. Evidence of the psychometric qualities of a simplified version of the Activities-specific Balance Confidence scale for community-dwelling seniors.

Objective

To evaluate the validity, reliability, and item hierarchy of a modified version of the Activities-specific Balance Confidence (ABC) scale using an item-response theory framework and integrating modifications aimed at increasing user-friendliness and promoting better congruence of the scale with public health falls prevention strategies.

Design

Cross-sectional study.

Setting

Community-based.

Participants

Two hundred community-dwelling seniors involved in an effectiveness study of a falls prevention program. Participants were recruited by community-based organizations.

Interventions

Not applicable.

Main Outcome Measure

Balance confidence.

Results

The modified ABC scale (called ABC-Simplified [ABC-S] scale) has high internal consistency (reliability index, .86) and good convergent validity (statistically significant associations with perceived balance; performances on the one-leg stance, tandem stance, tandem walking, functional reach, and lateral reach [on the right side] tests; fear of falling; and occurrence of falls in the previous 12mo). Analyses also showed differing degrees of difficulty across items, allowing for a determination of the scale’s item hierarchy.

Conclusions

The ABC-S scale is a valid and reliable measure for the assessment of balance confidence among community-dwelling seniors. The fact that this measure was validated with high-functioning seniors makes it particularly well-suited for identifying community-dwelling seniors who are beginning to lose confidence in their balance and who could benefit from community falls prevention programs.

Section snippets

Design and Participants

The initial sample included 200 community-dwelling seniors living in the Montreal area who were recruited by community-based organizations to participate in an effectiveness study of a falls prevention program (called Stand Up!) on the balance of participants.21 For inclusion in the intervention study, participants had to meet the following criteria: (1) be aged 60 years or over, (2) be community dwellers, (3) be exempt from disabling conditions (eg, Parkinson’s disease, multiple sclerosis) and

Participant Characteristics

Among the 200 participants, 1 could not complete the ABC-S scale because of a communication problem (slight expressive aphasia). Data for 2 other participants were excluded from the analyses because the interviewers expressed serious concerns about the quality of responses. That is, 1 participant completed the interview in a rush and another participant was interviewed at the end of the day and appeared very tired. Most questionnaires (88%) were administered in French.

Table 1 provides

Discussion

The purpose of this study was to examine the psychometric properties of a modified version of the ABC scale, the ABC-S scale, through application of IRT methods and multilevel modeling techniques. The proposed amendments to the scale include simplifying the cue question and response format to improve the scale’s user-friendliness with seniors and removing the last item of the original scale (walk on icy sidewalks) to increase congruence of the scale with public health falls prevention

Conclusions

This study responds to a need to better establish the psychometric properties of available measures for the assessment of psychologic constructs related to falls.7 This study provides evidence in support of the validity and internal consistency of a modified, more user-friendly version of the ABC scale. Its psychometric qualities, its simplicity, the fact that it can be rapidly administered, and its high correlation with overall scores produced through IRT and multilevel methods render this

Acknowledgments

We thank Céline Gosselin, MA, and Francine Trickey, MSc, from the Direction de Santé Publique de Montréal for their contribution to the scale’s modification and translation into French.

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  • Cited by (0)

    Supported by the Canadian Institutes of Health Research (grant no. MOP 53123); the Regional Health and Social Services Boards of Montreal, Laval, and Montérégie, QC, Canada; and the Fonds de la Recherche en Santé du Québec (doctoral scholarship) and the Ordre des Ergothérapeutes du Québec (doctoral scholarship).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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