Assessing Concerns about Falling: A Comparison of Telephone-Based and In-Person FES-I Interviews in Older Adults

Purpose The objective of this analysis was to assess the agreement of telephone-based Falls Efficacy Scale-International (FES-I) interviews versus face-to-face interviews in older adults. We examined whether the two modes of data collection differed in reporting concerns about falling (CaF). Methods Data were drawn from the FEARFALL study, a longitudinal randomized controlled trial on stress and functional health in older adults with CaF. FES-I scores of 160 participants aged 70 years and older were collected via both telephone and face-to-face interviews. Differences in total scores, item-level differences, and regression models were analyzed to identify potential influencing factors. Results Telephone interviews yielded lower FES-I scores than face-to-face interviews ( p  = .004; d = -0.23). Agreement between the two modes was moderate (ICC = 0.66) with a high correlation ( r  = 0.68), though heterogeneous at the item level. One item (Item 4: “bathing/showering”) showed significant deviations ( p _adj < .001, d  = 0.32). Regression analyses identified age as a significant predictor of mode differences: with increasing age, telephone values tended to be lower ( β = -0.238, 95% CI [-0.46, -0.01], p  = .037). Conclusion The telephone FES-I is a valid and efficient tool for group comparisons and large-scale screenings. However, it is not equivalent to face-to-face interviews for clinical decisions in individual cases, particularly among people aged 70 years and older. Mode effects should be considered in study design and clinical interpretation. Future research should examine mechanisms such as cognitive and sensory deficits and social presence, and adapt assessment processes accordingly.