Werklund School of Education, University of Calgary, Calgary, AB.
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
Clin J Sport Med. 2021 Sep 1;31(5):e221-e228. doi: 10.1097/JSM.0000000000000943.
The study sought to present normative and psychometric data and reliable change formulas for the Health and Behavior Inventory (HBI), a postconcussive symptom rating scale embedded in the Child Sport Concussion Assessment Tool 5th edition (Child SCAT5).
Prospective cohort study with longitudinal follow-up.
Pediatric emergency departments (EDs).
As part of 3 studies conducted in the United States and Canada between 2001 and 2019, 450 children aged 8 to 16 years with mild orthopedic injuries were recruited during ED visits and assessed postacutely (M = 9.38 days, SD = 3.31) and 1 month and 3 months postinjury. Independent variables were rater (child vs parent), sex, and age at injury.
HBI ratings.
Children and parents rated children's symptoms at each time point; parents also rated children's preinjury symptoms retrospectively. Normative data (mean, SD, skewness, kurtosis, and percentiles) were computed for child and parent ratings. Internal consistency was assessed using Cronbach alpha (α), and test-retest reliability and interrater agreement were assessed with intraclass correlations (ICCs). Reliable change formulas were computed using linear regression and mixed models.
HBI ratings were positively skewed. Mean ratings and percentiles were stable over time. Child and parent ratings demonstrated good-to-excellent internal consistency (α 0.76-0.94) and moderate-to-good test-retest reliability (ICC 0.51-0.76 between adjacent assessments). However, parent-child agreement was poor to moderate (ICC 0.31-0.69).
The HBI demonstrates acceptable normative and psychometric characteristics. Modest parent-child agreement highlights the importance of multiple informants when assessing postconcussive symptoms. The results will facilitate the use of the HBI in research and clinical practice.
本研究旨在呈现嵌入儿童运动性脑震荡评估工具第 5 版（Child SCAT5）中的脑震荡后症状评定量表——健康与行为量表（HBI）的常模和心理计量学数据以及可靠变化公式。
前瞻性队列研究，纵向随访。
儿科急诊部（ED）。
作为 2001 年至 2019 年间在美国和加拿大进行的 3 项研究的一部分，在 ED 就诊期间招募了 450 名 8 至 16 岁、伴有轻度骨科损伤的儿童，他们在受伤后急性期（M=9.38 天，SD=3.31）、1 个月和 3 个月时进行评估。自变量为评定者（儿童或父母）、性别和受伤时的年龄。
HBI 评定结果。
儿童和父母在每个时间点对儿童的症状进行评定；父母还对儿童的受伤前症状进行回顾性评定。计算儿童和父母评定的常模数据（均值、标准差、偏度、峰度和百分位数）。采用克朗巴赫α（α）评估内部一致性，采用组内相关系数（ICC）评估测试-重测信度和评定者间一致性。使用线性回归和混合模型计算可靠变化公式。
HBI 评定结果呈正偏态。平均评分和百分位数随时间保持稳定。儿童和父母的评分均表现出良好至优秀的内部一致性（α值为 0.76-0.94）和中度至良好的测试-重测信度（相邻评估的 ICC 为 0.51-0.76）。然而，父母-儿童的一致性较差至中等（ICC 为 0.31-0.69）。
HBI 具有可接受的常模和心理计量学特征。适度的父母-儿童一致性强调了在评估脑震荡后症状时使用多个信息来源的重要性。研究结果将有助于 HBI 在研究和临床实践中的应用。
