| Strongly disagree | Disagree | Agree | Strongly Agree | Undecided | |
| ‘I consider stair fall prevention at home a priority’ | ◻ | ◻ | ◻ | ◻ | ◻ |
| ‘I am aware of what changes can be made at home to reduce the risk of stair falls’ | ◻ | ◻ | ◻ | ◻ | ◻ |
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