Abstract
BackgroundFew 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.MethodsThe 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.ResultsEight items were removed and acceptable internal consistency was documented for all scales (α = .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.ConclusionThe 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.
Highlights
Few measures exist to measure the overall home environment for its ability to support physical activity (PA) and healthy eating in overweight children
One study by Moore in 1990 using data from the Framingham Children's Study found that children ages 3– 7 who have active mothers are 2.0 times as likely to be physically active, 3.5 times as likely to be active if their fathers are active, and 5.8 times as likely to be active if both parents are physically active [7]
The goal of the present study is to develop a survey instrument that can accurately and reliably assess aspects of the home social and physical environment that influence a child's eating and physical activity habits
Summary
Few measures exist to measure the overall home environment for its ability to support physical activity (PA) and healthy eating in overweight children. The current social and physical environment that children encounter at home and school are often counterproductive to promoting healthy eating and physically active lifestyles [2,3,4]. The effect of the home environment (both physical and social) on these two behavioural areas is a focus of current investigation. Parental support for children's physical activity has been significant in several studies. Parental support in the form of providing transportation to sports or other physical activities was correlated with increased physical activity in children ages 9 to 14 in several studies [8,9,10]. Parental verbal encouragement and prompting children to be physically active were found to be significantly associated with higher physical activity in preschool through adolescent children [5,8,10]
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