Expert-Informed Development and Content Validation of a Survey Examining Fall Risk Assessment Selection in Home Health Physical Therapy

Background: Falls are a leading cause of morbidity, injury, and healthcare utilization among older adults receiving home health services. In the United States, healthcare spending for non-fatal falls was estimated at approximately $80 billion in 2020, with annual costs projected to exceed $100 billion by 2030 as the older adult population increases. Although physical therapists routinely assess fall risk, variability in the selection of assessment outcomes may limit the accuracy, reliability, and interpretation of findings in home health physical therapy practice. Purpose: To describe the expert-informed development and content validation of a survey examining fall risk assessment selection in home health physical therapy. Methods: Five expert home health physical therapists participated in semi-structured interviews to evaluate survey clarity, contextual relevance, and structural design. Interviews were transcribed and analyzed using pragmatic deductive and inductive coding to identify areas requiring refinement. Member checking was performed to confirm interpretive accuracy. Results: Four themes informed survey modification: (1) operational variability in fall risk prioritization, (2) contextual drivers of assessment tool selection, (3) variability in tool familiarity and ranking interpretation, and (4) structural and inclusive considerations. These findings resulted in refinement of survey domains, expansion of contextual response options, clarification of ranking logic, and updates to demographic and structural items. Conclusions: Expert-informed refinement enhanced the contextual sensitivity of the survey and supported its content validation. Incorporating practitioner perspectives strengthens workforce research tools and informs research, education, and practice in home health physical therapy.