Abstract
Citation
Bryant MJ, Ward DS, Hales D, Vaughn A, Tabak RG, Stevens J. Reliability and validity of the Healthy Home Survey: a tool to measure factors within homes hypothesized to relate to overweight in children. Int J Behav Nutr Phys Act 2008 Apr 28;5:23.
Abstract
BACKGROUND: The contribution of the environment to the obesity epidemic is well recognized. Parents have control over their home environment and can, therefore, support healthy dietary and activity habits in their children by manipulating factors such as access to energy-dense foods, availability of physical activity equipment, and restricting screen time. This paper describes the development of the Healthy Home Survey and its reliability and validity. The Healthy Home Survey was designed to assess characteristics of the home environment that are hypothesized to influence healthy weight behaviors in children including diet and physical activity. METHODS: We recruited 85 families with at least one child between 3-8 years. The Healthy Home Survey was administered to parents via telephone and repeated in a random sample of 45 families after 7 days. In-home observations were performed within 14 days of the first Healthy Home Survey interview. Percent agreement, Kappa statistics, Intra-class correlation coefficients and sensitivity analyses were used to evaluate reliability and validity evidence. RESULTS: Reliability and validity estimates for the Healthy Home Survey were varied, but generally high (0.22-1.00 and 0.07-0.96 respectively), with lower scores noted for perishable foods and policy items. Lower scores were likely related to actual change in the perishable foods present and the subjective nature or clarity of policy questions and response categories. CONCLUSION: Initial testing demonstrated that the Healthy Home Survey is a feasible, reliable, and valid assessment of the home environment; however, it has also highlighted areas that need improvement. The Healthy Home Survey will be useful in future research exploring the relationship between the home environment and child weight.
Full Text
The full text is available at https://dx.doi.org/10.1186/1479-5868-5-23
At A Glance
Food Environment Variables
| # | Type of Environment/Institution |
|---|---|
| 82 | Total Environments/Locations |
| 82 | Home |
| Measure | objective | perceived |
|---|---|---|
| Availability/Access | ✘ | ✔ |
| Policy/Practice | ✘ | ✔ |
| Meals eaten together, breakfast eaten at home | ✘ | ✔ |
| Food Group/Type of Food |
|---|
| Fruits and vegetables |
| Foods of minimal nutritional value |
| Sweetened beverages |
| Frozen foods |
Physical Activity Environment Variables
| # | Type of Environment/Location |
|---|---|
| - | home |
| # | Scale |
|---|---|
| - | Building |
| Measure | objective | perceived |
|---|---|---|
| Facility Adequacy/Appeal or Quality | ✔ | ✔ |
Domain(s)
Food Environment
Physical Activity Environment
Measure Type
Questionnaire
Measure Availability
Measure included in article
Number of Items
21 Reported
Study location
Chapel Hill, NC, USA
Languages
English
Information about Development of Measure
Nothing to add
Study Design
Study Participants
Age
2 - 5 Years
6 - 11 Years
Sex
Female
Male
Race/Ethnicity
White
Black/African American
Predominantly Low-income/Low-SES
No
Sample Size
45
Study Design
Design Type
Validation/Reliability
Health Outcomes Assessed
None
Obesity Measures
Not applicable
BMI Measured or Self-reported
Not applicable
Covariates
Not reported
Data Reported on Race/Ethnicity
Quantitative data on study sample
Data Reported on SES
Quantitative data on study sample
SES-related Variables
Income
How To Use
Administration
Who Administered
Researcher-administered
How Administered
In-person
Direct observation, hard-copy form
Time Required
Not reported
Training Required
Yes, time not reported
Instructions on Use
Access at Included with instrument
Data Analysis
Data Collection/Analysis Costs
Not available
Data Collection/Protocol
HHS repeated in a random sample of 45 families for reliability after 7 days. In home observations performed within 14 days of first HHS interview
Instructions on Data Analysis
Not reported
Validity (3)
| Type of validity | Construct/subscale assessed | Criterion measure used | Test/statistic used | Result |
|---|---|---|---|---|
| Criterion | Food Availability | Healthy Home Survey vs. In-home Observation | Percent Agreement Kappa Statistic range Fresh fruit- Frozen fruit | Greater than 80% -0.02-0.87 |
| Criterion | Physical activity and media environment | Healthy Home Survey vs. In-home Observation | Kappa Statistic Biking or riding toy-Cable TV | -0.02-0.96 |
| Criterion | Food Environment | Healthy Home Survey vs. In-home Observation | Kappa Statistic range Access to savory snacks- TV in view of dining area | 0.07-0.57 |
Reliability (4)
| Type of reliability | Construct/subscale assessed | Test/statistic used | Result |
|---|---|---|---|
| Inter-rater | Food availability range HHS interview 1 and 2 | Kappa statistic Frozen fruit-salty snacks | -0.02-0.87 |
| Inter-rater | Food environment range HHS interview 1 and 2 | Kappa statistic Fruit in view-Adequate counter space | 0.49-0.88 |
| Inter-rater | Eating practices and eating, media, and physical activity policies | Kappa statistic Seconds policy- breakfast at home | 0.36-0.86 |
| Inter-rater | Physical activity and media environment | Kappa statistic Number of DVDs- Number of TVs/ Cable TV/ TV in child''s bedroom/ computer in child''s room/ Yard | 0.56-1.0 |