Validation of a survey instrument to assess home environments for physical activity and healthy eating in overweight children

Michelle L Gattshall, Jo Ann Shoup, Julie A Marshall, Lori A Crane, Paul A Estabrooks, Michelle L Gattshall, Jo Ann Shoup, Julie A Marshall, Lori A Crane, Paul A Estabrooks

Abstract

Background: Few measures exist to measure the overall home environment for its ability to support physical activity (PA) and healthy eating in overweight children. The purpose of this study was to develop and test the reliability and validity of such a measure.

Methods: The Home Environment Survey (HES) was developed to reflect availability, accessibility, parental role modelling, and parental policies related to PA resources, fruits and vegetables (F&V), and sugar sweetened drinks and snacks (SS). Parents of overweight children (n = 219) completed the HES and concurrent behavioural assessments. Children completed the Block Kids survey and wore an accelerometer for one week. A subset of parents (n = 156) completed the HES a second time to determine test-retest reliability. Finally, 41 parent dyads living in the same home (n = 41) completed the survey to determine inter-rater reliability. Initial psychometric analyses were completed to trim items from the measure based on lack of variability in responses, moderate or higher item to scale correlation, or contribution to strong internal consistency. Inter-rater and test-retest reliability were completed using intraclass correlation coefficients. Validity was assessed using Pearson correlations between the HES scores and child and parent nutrition and PA.

Results: Eight items were removed and acceptable internal consistency was documented for all scales (alpha = .66-84) with the exception of the F&V accessibility. The F&V accessibility was reduced to a single item because the other two items did not meet reliability standards. Test-retest reliability was high (r > .75) for all scales. Inter-rater reliability varied across scales (r = .22-.89). PA accessibility, parent role modelling, and parental policies were all related significantly to child (r = .14-.21) and parent (r = .15-.31) PA. Similarly, availability of F&V and SS, parental role modelling, and parental policies were related to child (r = .14-36) and parent (r = .15-26) eating habits.

Conclusion: The HES shows promise as a potentially valid and reliable assessment of the physical and social home environment related to a child's physical activity and eating habits.

Figures

Figure 1
Figure 1
Conceptual Model for Eating and Physical Activity Environmental. Influences in the Home.

References

    1. American Academy of Pediatrics Policy statement: prevention of pediatric overweight and obesity. Pediatrics. 2003;112:424–30. doi: 10.1542/peds.112.2.424.
    1. Richter KP, Harris KJ, Paine-Andrews A, Fawcett SB, Schmid TL, Lankenau BH, Johnston J. Measuring the health environment for physical activity and nutrition among youth: A review of the literature and applications for community initiatives. Preventive Medicine. 2000;31:S98–S111. doi: 10.1006/pmed.1999.0541.
    1. French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annual Review of Public Health. 2001;22:309–35. doi: 10.1146/annurev.publhealth.22.1.309.
    1. Dowda M, Ainsworth BE, Addy CL, Saunders R, Riner W. Environmental influences, physical activity, and weight status in 8- to 16-year-olds. Arch Pediatr Adolesc Med. 2001;155:711–717.
    1. Sallis JF, Nader PR, Broyles SL, Berry CC, Elder JP, McKenzie TL, Nelson JA. Correlates of physical activity at home in Mexican-American and Anglo-American preschool children. Health Psychology. 1993;12:390–98. doi: 10.1037/0278-6133.12.5.390.
    1. Stucky-Ropp RC, DiLorenzo TM. Determinants of exercise in children. Preventive Medicine. 1993;22:880–89. doi: 10.1006/pmed.1993.1079.
    1. Moore JL, Lombardi DA, White MJ, Campbell JL, Oliveria SA, Ellison RC. Influence of parents' physical activity levels on activity levels of young children. The Journal of Pediatrics. 1991;118:215–219. doi: 10.1016/S0022-3476(05)80485-8.
    1. Sallis JF, Alcaraz JE, McKenzie TL, Hovell MF. Predictors of change in children's physical activity over 20 months. American Journal of Preventive Medicine. 1999;16:222–29. doi: 10.1016/S0749-3797(98)00154-8.
    1. Sallis JF, Alcaraz JE, McKenzie TL, Hovell MF, Kolody B, Nader PR. Parental behavior in relation to physical activity and fitness in 9-year-old children. Am J Dis Child. 1992;146:1383–1387.
    1. Hoefer WR, McKenzie TL, Sallis JF, Marshall SJ, Conway TL. Parental provision of transportation for adolescent physical activity. American Journal of Preventive Medicine. 2001;21:48–51. doi: 10.1016/S0749-3797(01)00314-2.
    1. Hearn MD, Baranowski T, Baranowski J, Doyle C, Smith M, Lin LS, Resnicow K. Environmental influences on dietary behaviour among children: availability and accessibility of fruits and vegetables enable consumption. Journal of Health Education. 1998;29:26–32.
    1. Baronowski T, Smith M, Hearn MD, Lin LS, Baranowski J, Doyle C, Resnicow K, Wang DT. Patterns in children's fruit and vegetable consumption by meal and day of the week. Journal of the American College of Nutrition. 1997;16:216–223.
    1. Kirby SD, et al. Children's fruit and vegetable intake: Socioeconomic, adult-child, regional, and urban-rural influences. Journal of Nutrition Education. 1995;27:261–269.
    1. Coates TJ, Jeffery RW, Wing RR. The Relationship between persons' relative body weights and the quality and quantity of food stored in their homes. Addictive Behaviours. 1978;3:179–184. doi: 10.1016/0306-4603(78)90016-3.
    1. Cullen KW, Baranowski T, Owens E, Marsh T, Rittenberry L, De Moor C. Availability, accessibility, and preferences for fruit, 100% fruit juice, and vegetables influence children's dietary behaviour. Health Education and Behaviour. 2003;30:615–26. doi: 10.1177/1090198103257254.
    1. Golan M, Weizman A. Familial approach to the treatment of childhood obesity: conceptual model. J Nutr Educ. 2001;33:102–107. doi: 10.1016/S1499-4046(06)60173-5.
    1. Golan M, Weizman A, Apter A, Fainaru M. Parents as the exclusive agents of change in the treatment of childhood obesity. American Journal of Clinical Nutrition. 1998;67:1130–5.
    1. Cullen KW, Klesges LM, Sherwood NE, Baranowski T, Beech B, Pratt C, Zhou A, Rochon J. Measurement characteristics of diet-related psychosocial questionnaires among African-American parents and their 8- to 10-year-old daughters: results from the Girls' health Enrichment Multi-site Studies. Preventive Medicine. 2004;38:S34–S42. doi: 10.1016/j.ypmed.2003.05.002.
    1. Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the Children's Eating Behaviour Questionnaire. J Child Psychol Psychiat. 2001;42:963–970. doi: 10.1111/1469-7610.00792.
    1. Hume C, Ball K, Salmon J. Development and reliability of a self-report questionnaire to examine children's perceptions of the physical activity environment at home and in the neighbourhood. Int J Behav Nutr Phys Act. 2006;3:16. doi: 10.1186/1479-5868-3-16. 3/1/16.
    1. Marsh T, Cullen KW, Baranowski T. Validation of a fruit, juice, and vegetable availability questionnaire. J Nut Ed Behaviour. 2003;35:93–99. doi: 10.1016/S1499-4046(06)60045-6.
    1. Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis. 2006;3:A118.
    1. Kristal AR, Shattuck AL, Henry HJ. Patterns of dietary behavior associated with selecting diets low in fat: reliability and validity of a behavioral approach to dietary assessment. J Am Diet Assoc. 1990;90:214–220.
    1. Shannon J, Kristal AR, Curry SJ, Beresfird SA. Application of a behavioral approach to measuring dietary change: the fat- and fiber-related diet behavior questionnaire. Cancer Epidemiol Biomarkers Prev. 1997;6:355–361.
    1. Puyau MR, Adolph AL, Vohra FA, Butte NF. Validation and calibration of physical activity monitors in children. Obesity Research. 2002;10:150–157.
    1. Block G, Murphy M, Roullet P, Wakimoto P, Crawford PB, Block T. Pilot validation of a FFQ for children 8–10 years. Manuscript for Fourth International Conference on Dietary Assessment Methods. 2001.
    1. Sandvik C, De Bourdeaudhuij I, Due P, Brug J, Wind M, Bere E, Perez-Rodrigo C, Wolf A, Elmadfa I, Thorsdottir I, Vas de Almeida MD, Yngve A, Klepp KI. Personal and environmental factors regarding fruit and vegetable intake among schoolchildren in nine European countries. Annals of Nutrition & Metabolism. 2005;49:255–266. doi: 10.1159/000087332.

Source: PubMed

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