EC Nursing and Healthcare

Background: The number of older adults that choose to age in place is rapidly growing creating a need for efficient and standardized home assessment measures. The Home for Life Design (HfLD), Home Assessment was created on a technology platform to enhance occupational therapy (OT) home assessment practice. This inter-rater agreement study includes the enhanced training including a Scoring Decision Guide that were developed during the inter-rater agreement analysis to improve the inter-rater agreement. This is a preliminary study for the tool’s standardization for reliable use by occupational therapists.

Method: The study composed of 52 occupational therapy student raters’ home accessibility scores against the author’s scores using a Rater Test. Prior to taking the Rater Test, the students viewed the on-line training that included instructions on how to use the newly developed Scoring Decision Guide. Each of the student raters’ scores were compared to the test author’s using descriptive stats and an intraclass correlation with absolute agreement, two way mixed effects model and 95% confidence interval.

Results: The average intraclass correlation for the 52 raters was .93, with a standard error of 0.011 and a 95% confidence level of 0.022. This indicates good/excellent inter-rater agreement between the 52 raters and the author of the tool.

Conclusion: Practitioners who choose to measure accessibility of a client’s home and follow the on-line training of the HfLD Home Assessment, can use this tool as a reliable OT home assessment.

Keywords: Home for Life Design (HfLD); Occupational Therapy (OT); Home Assessment

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