Abstract
BackgroundPreventive child health care is well suited for the early detection of parenting and developmental problems. However, as far as the younger age group is concerned, there are no validated early detection instruments which cover both the child and its environment. Therefore, we have developed a broad-scope structured interview which assesses parents’ concerns and their need for support, using both the parental perspective and the experience of the child health care nurse: the Structured Problem Analysis of Raising Kids (SPARK). This study reports the psychometric characteristics of the SPARK.MethodA cross-sectional study of 2012 18-month-old children, living in Zeeland, a province of the Netherlands. Inter-rater reliability was assessed in 67 children. Convergent validity was assessed by comparing SPARK-domains with domains in self-report questionnaires on child development and parenting stress. Discriminative validity was assessed by comparing different outcomes of the SPARK between groups with different levels of socio-economic status and by performing an extreme-groups comparison. The user experience of both parents and nurses was assessed with the aid of an online survey.ResultsThe response rate was 92.1% for the SPARK. Self-report questionnaires were returned in the case of 66.9% of the remaining 1721 children. There was selective non-reporting: 33.1% of the questionnaires were not returned, covering 65.2% of the children with a high-risk label according to the SPARK (p < 0.001). Inter-rater reliability was good to excellent with intraclass correlations between 0.85 and 1.0 for physical topics; between 0.61 and 0.8 for social-emotional topics and 0.92 for the overall risk assessment. Convergent validity was unexpectedly low (all correlations ≤0.3) although the pattern was as expected. Discriminative validity was good. Users were satisfied with the SPARK and identified some topics for improvement.ConclusionThe SPARK discriminates between children with a high, increased and low risk of parenting and developmental problems. It does so in a reliable way, but more research is needed on aspects of validity and in other populations.
Highlights
Preventive child health care is well suited for the early detection of parenting and developmental problems
There was selective non-reporting: 33.1% of the questionnaires were not returned, covering 65.2% of the children with a high-risk label according to the Structured Problem Analysis of Raising Kids (SPARK) (p < 0.001)
The SPARK discriminates between children with a high, increased and low risk of parenting and developmental problems
Summary
Preventive child health care is well suited for the early detection of parenting and developmental problems. The SPARK is a structured interview for early detection and risk assessment of parenting and developmental problems in young children This instrument combines the perspectives of the parent(s) and the professional. The SPARK asks parents to voice any concerns and problems on a broad range of topics, and to indicate the need for support perceived by both parent and CHC-professional, followed by a joint decision on subsequent care. It finishes with a structured overall risk assessment for parenting and developmental problems by the professional
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