Samuel Teferi Chanie ^1* Moges Gashaw ^1,2 Kassaw Belay Shiferaw ¹ Fiseha Sefiwu ¹ Setegn Fentahun ³ Kassahun Cherkos ¹ Alemu Kasaw ¹ Ermias Solomon Yalew ¹ Assefa Mengesha ⁴ HABTAMU SEMAGNE ⁴ Zufan Abriham ⁵ Mihret Degen ¹

• ¹ Departments of Physiotherapy, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
• ² Department of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
• ³ Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
• ⁴ Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
• ⁵ Department of Medical parasitology, school of Biomedical and health science, College of medicine and health science, University of Gondar, Gondar, Ethiopia., Gondar, Ethiopia

The modified John-Hopkins fall risk assessment tool (mJH-FRAT) is a comprehensive and multi-factor fall risk assessment tool used to screen and grade older adult`s fall risk levels in home health care services. This can help to identify risky individuals early, establish prevention protocols, and reduce the occurrence of injury. Nevertheless, there is a dearth of contextually valid and reliable fall risk assessment tools among this population in the study area. The aim of this study is therefore to cross-culturally adapt and assess the content validity and reliability of the modified John-Hopkins fall risk assessment tool among older adults following home health care in Ethiopia.The English version of the mJH-FRAT underwent cross-cultural adaptation into Amharic. The final Amharic version was subjected to face validity and then content validity was computed. This community-based study was conducted from November 2023 to May 2024 with a total of 150 participants selected through convenience sampling. Data collection occurred through face-to-face interviews. Epi-Info 7 and Statistical Package for the Social Sciences software version 25 facilitated data entry and analysis, respectively. Reliability was assessed by employing intra-rater and inter-rater reliability using Cohen`s kappa.The CVI based on the item level of all the items was between 0.8 and 1. The S-CVI based on average for domains such as general condition and clinical condition was 0.925 and 1, respectively, and the S-CVI (average) of the scale was 0.96. The S-CVI based on the universal agreement value for the overall 8 items was 0.75. The kappa statistic coefficient value was between 0.79 and 1. The intra-rater reliability and inter-rater reliability were 0.94 and 0.93, respectively.The rigorous adaptation process, face and content validity, and reliability analyses demonstrated that the Amharic mJH-FRAT is a content valid and reliable tool for assessing the fall risk level in this population. Clinicians and researchers can utilize this tool for the advancement of both clinical practice and research work on this group of people in Ethiopia.