Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB 7461, Chapel Hill, NC 27599-7461, USA.
Int J Behav Nutr Phys Act. 2013 Dec 5;10:132. doi: 10.1186/1479-5868-10-132.
The home environment has a significant influence on children's physical activity, sedentary behavior, dietary intake, and risk for obesity and chronic disease. Our understanding of the most influential factors and how they interact and impact child behavior is limited by current measurement tools, specifically the lack of a comprehensive instrument. HomeSTEAD (the Home Self-administered Tool for Environmental assessment of Activity and Diet) was designed to address this gap. This new tool contains four sections: home physical activity and media equipment inventory, family physical activity and screen time practices, home food inventory, and family food practices. This paper will describe HomeSTEAD's development and present reliability and validity evidence for the first section.
The ANGELO framework guided instrument development, and systematic literature reviews helped identify existing items or scales for possible inclusion. Refinement of items was based on expert review and cognitive interviews. Parents of children ages 3-12 years (n = 125) completed the HomeSTEAD survey on three separate occasions over 12-18 days (Time 1, 2, and 3). The Time 1 survey also collected demographic information and parent report of child behaviors. Between Time 1 and 2, staff conducted an in-home observation and measured parent and child BMI. Kappa and intra-class correlations were used to examine reliability (test-retest) and validity (criterion and construct).
Reliability and validity was strong for most items (97% having ICC > 0.60 and 72% having r > 0.50, respectively). Items with lower reliability generally had low variation between people. Lower validity estimates (r < 0.30) were more common for items that assessed usability and accessibility, with observers generally rating usability and accessibility lower than parents. Small to moderate, but meaningful, correlations between physical environment factors and BMI, outside time, and screen time were observed (e.g., amount of child portable play equipment in good condition and easy to access was significantly associated with child BMI: r = -0.23), providing evidence of construct validity.
The HomeSTEAD instrument represents a clear advancement in the measurement of factors in the home environment related to child weight and weight-related behaviors. HomeSTEAD, in its entirety, represents a useful tool for researchers from which they can draw particular scales of greatest interest and highest relevance to their research questions.
家庭环境对儿童的身体活动、久坐行为、饮食摄入以及肥胖和慢性病风险有重大影响。我们对最具影响力的因素的了解，以及它们如何相互作用并影响儿童行为，受到当前测量工具的限制，特别是缺乏全面的工具。家庭环境活动和饮食自我评估工具（HomeSTEAD）旨在弥补这一空白。这个新工具包含四个部分：家庭身体活动和媒体设备清单、家庭身体活动和屏幕时间实践、家庭食品清单和家庭食品实践。本文将描述 HomeSTEAD 的开发，并介绍第一部分的可靠性和有效性证据。
ANGELO 框架指导了仪器的开发，系统文献回顾有助于确定可能纳入的现有项目或量表。根据专家审查和认知访谈对项目进行了改进。3-12 岁儿童的家长（n=125）在 12-18 天内分三次完成 HomeSTEAD 调查（时间 1、2 和 3）。时间 1 调查还收集了人口统计信息和家长对儿童行为的报告。在时间 1 和 2 之间，工作人员进行了一次家庭观察，并测量了家长和儿童的 BMI。kappa 和组内相关系数用于检验可靠性（测试-重测）和有效性（标准和结构）。
大多数项目的可靠性和有效性都很强（97%的 ICC>0.60，72%的 r>0.50）。可靠性较低的项目通常人与人之间的差异较小。可用性和可及性评估项目的有效性估计值较低（r<0.30），观察者通常对可用性和可及性的评价低于家长。还观察到身体环境因素与 BMI、户外活动时间和屏幕时间之间存在小到中度但有意义的相关性（例如，状况良好且易于取用的儿童便携游乐设备数量与儿童 BMI 显著相关：r=-0.23），这为结构有效性提供了证据。
HomeSTEAD 工具代表了测量与儿童体重和与体重相关行为相关的家庭环境因素的重大进展。HomeSTEAD 作为一个整体，是研究人员的有用工具，他们可以从中提取出最感兴趣和最相关的特定量表，以回答他们的研究问题。
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