| Strongly disagree | Disagree | Agree | Strongly agree | Undecided | |
| ‘I consider myself at risk of falling on stairs at home’ | ◻ | ◻ | ◻ | ◻ | ◻ |
| ‘I am fit and healthy so I don’t see myself at risk falling on stairs’ | ◻ | ◻ | ◻ | ◻ | ◻ |
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