Abstract

Unintentional falls are a leading cause of injury among preschool children, primarily occurring in home environments, yet validated tools to assess household fall prevention capacity in low- and middle-income countries remain limited. This study aimed to develop and psychometrically validate the Home-Based Preschool Fall Prevention Instrument using the Rasch Measurement Model. A cross-sectional validation study was conducted in Depok City, Indonesia, involving 167 primary caregivers of preschool children enrolled in kindergartens selected through multistage cluster random sampling. The instrument was developed based on an etiological injury model, socio-ecological perspectives, and risk management principles, and comprised four main factors: child, home, agent, and caregiver knowledge. Rasch Rating Scale Model analyses were conducted by dimension within the four factors to evaluate item fit, item difficulty hierarchy, and reliability. The validation retained 58 items across four factors: child factor (12), home factor (19), agent factor (6), and caregiver knowledge factor (21). All retained items met acceptable fit criteria, with overall infit mean square values ranging from 0.72 to 1.33 and outfit mean square values ranging from 0.70 to 1.38. The analyses also revealed meaningful item-difficulty hierarchies. The validated Home-Based Preschool Fall Prevention Instrument provides a psychometrically sound and contextually relevant foundation for household safety assessment and evidence-based preschool fall prevention programs.

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