At What Age Can Children Report Dependably on Their Asthma Health Status?

Abstract

This study examined psychometric properties and feasibility issues surrounding child-reported asthma health status data. In separate interviews, parents and children completed 3 visits. Child questionnaires were interviewer administered. The primary instrument was the Children's Health Survey for Asthma-Child Version, used to compute 3 scales (physical health, activities, and emotional health). The following were assessed: reliability (internal consistency and test-retest reliability), validity (general health status, symptom burden, and lung function), and feasibility (completion time, missing data, and inconsistent responses). A total of 414 parent-child pairs completed the study (mean child age: 11.5 years). Reliability estimates for the activities and emotional health scales were > .70 in all but 1 age category; 5 of 9 age groups had acceptable internal consistency ratings (> or = .70) for the physical health scale. Cronbach's alpha tended to increase with child age. In general, test-retest correlations between forms and intraclass correlation coefficients were strong for all ages but tended to increase with child age. Correlations between forms ranged from .57 (7-year-old subjects, physical health) to .96 (14-year-old subjects, activities). Intraclass correlation coefficients ranged from .76 (13-year-old subjects, emotional health) to .94 (15-16-year-old subjects, physical health). Children with less symptom burden reported higher mean Children's Health Survey for Asthma-Child Version scores (indicating better health status) for each scale, at significant levels for nearly all age groups. Children's Health Survey for Asthma-Child Version completion times decreased from 12.9 minutes at age 7 to 6.9 minutes at age 13. This research indicates that children with asthma as young as 7 may be dependable and valuable reporters of their health. Data quality tends to improve with age.