Urdu translation and cross-cultural adaptation of fall risk awareness questionnaire for older adults

BACKGROUND: While numerous assessment tools exist, their availability in local languages ensures their applicability and requires cross-cultural adaptation. This study aimed to cross-culturally adapt and evaluate psychometric properties of the Urdu version of the Fall Risk Awareness Questionnaire (FRAQ) among older adults, assessing its reliability and preliminary validity in this population. METHODS: Two hundred older adults aged between 60 and 85 participated in the study. The FRAQ was translated into Urdu by two native language experts, followed by consensus-building and back-translation by two other bilingual translators to ensure linguistic and cultural equivalence. Reliability was assessed using Cronbach's alpha coefficient, and construct validity was examined through correlation analysis with the Urdu version of the Falls Efficacy Scale-International (FES-I). The content validity index (item-level and scale-level CVI) was used to measure content validity. RESULTS: Urdu FRAQ was found to have moderate to good internal consistency according to Cronbach's alpha (α = 0.747). A weak but statistically significant relationship exists between FRAQ scores and FES-I scores (Spearman rho, = 0. 144, p = 0.042), thus providing evidence of construct validity. The questionnaire presented satisfactory content validity with lower CVI values on the item level and acceptable on the scale level. Exploratory Factor analysis supported a predominantly unidimensional structure. All items demonstrated acceptable loadings. CONCLUSION: The study concluded that the Urdu version of the fall risk awareness questionnaire is satisfactorily reliable, culturally appropriate, and demonstrated preliminary validity for assessing awareness of fall risks in Urdu-speaking older adults.