Original research
The HAPPY Study: Development and reliability of a parent survey to assess correlates of preschool children's physical activity

https://doi.org/10.1016/j.jsams.2011.12.009Get rights and content

Abstract

Correlates of preschool children's physical activity across all domains of the social ecological model have previously been reported in the literature. However, there is a scarcity of reliable instruments designed to capture such correlates in preschool-aged children.

Objectives

This study reports the development, and assessment of the test–retest and internal reliability of a comprehensive proxy survey instrument designed to measure correlates of preschool children's physical activity across the three domains of the social ecological model.

Design

Study one included data from 47 parents of preschool aged (3–5 years) children who completed the survey on two occasions. Study two included data from 943 participants who completed the survey as part of the larger Healthy Active Preschool Years Study.

Methods

A comprehensive search of the literature and a series of focus groups were used to identify potential correlates for inclusion in the survey. Study one investigated the test–retest reliability of the survey; study two investigated internal reliability. Test–retest reliability was assessed using Kappa statistics and percent agreement for categorical variables, and intraclass correlation for continuous variables. Internal reliability was assessed using Cronbach's alpha.

Results

In total, 230 items, summed and composite scores were assessed. Of those items, 190 (83%) showed acceptable reliability. The majority of items in each domain of the social ecological model – individual (75%), social (81%) and physical environment (90%) – showed acceptable reliability.

Conclusions

The Healthy Active Preschool Years parent proxy survey shows good reliability and is appropriate for use with the target population. Future studies should investigate validity of the constructs in the survey.

Introduction

Despite the fact that correlates of physical activity in adults,1 adolescents and school-age children2 have been widely researched and published, there is little understanding of the correlates of preschool children's physical activity. Evidence suggests that the foundations of health behaviors may be developed during early childhood3, 4 and that the presence of some behaviors during childhood and adolescence may be associated with health and other outcomes in adulthood.5, 6 Therefore, understanding correlates of behaviors, such as physical activity, during the preschool period is crucial.

Preschool children spend only a small proportion of their time being active.7, 8 Establishing optimal levels of physical activity in this age group is, therefore, essential. There is little understanding of factors which might support or constrain physical activity.9 Accurately measuring potential correlates is necessary to identify effective intervention approaches yet instruments with established psychometric properties designed to specifically measure such correlates are scarce.

Theoretical models provide a foundation to investigate and comprehensively understand how various factors and physical activity interact. The social ecological model (SEM)10, 11 provides a framework for identifying and investigating potential correlates of physical activity in early childhood. The SEM recognizes that individual, social and physical environment factors interact to support or constrain preschool children's physical activity. Correlates have been reported from each of these domains.9 Therefore, when investigating potential correlates of preschool children's physical activity, multiple domains should be explored concurrently to more fully understand the relative contribution of potential correlates and intervention targets.

Previous studies have mostly explored only a few correlates within a single domain. Psychometric properties of those instruments have rarely been reported.9 Further, most research that has investigated correlates of physical activity in preschool children has used instruments designed for older children which may exclude important potential correlates and may not be reliable or relevant in the preschool population. Therefore, the development of a reliable and comprehensive instrument, capturing correlates specific to the preschool population and across the SEM domains, is necessary to more robustly examine the potential correlates of preschool children's physical activity in multiple domains.

The aims of this study were to describe the development of the Healthy Active Preschool Years (HAPPY) parent proxy report survey to assess potential correlates of preschool children's physical activity across multiple domains and examine the test–retest and internal reliability of that survey.

Section snippets

Methods

The HAPPY survey includes items on relevant constructs which were identified through several methods. A thorough search of the literature9 identified several constructs from the SEM. Focus groups with mothers of preschoolers were conducted and potential correlates were identified.12 Relevant items from existing surveys13, 14, 15, 16, 17, 18 which addressed the potential constructs and correlates identified were used or modified for inclusion. New items were developed as necessary. The survey

Results

Fifty-seven parents initially consented to participate in Study 1. The final sample consisted of 47 parents (82%) of three- to five-year-old children who had not commenced school and who completed both the first and second reliability surveys. Sixty-eight percent of the participants had a university degree or higher qualification. No other demographic data were collected.

In total, 943 surveys were returned from 1002 participants initially recruited (94%) into Study 2. The majority of

Discussion

Despite growing interest in aspects of preschool children's physical activity including its correlates and potential intervention points, valid and reliable measures of those correlates, which may be targeted as potential mediators in interventions, are lacking. The survey reported in this study includes items assessing potentially important correlates not previously reported in the preschool population. Overall, the survey displayed good reliability, with 83% of all items, summed and composite

Conclusion

This study described the test–retest and internal reliability of a proxy-report instrument to be used to assess a comprehensive range of potential correlates of preschool children's physical activity across multiple domains. The results showed mostly acceptable or better reliability. The items, composite and summed scores in the survey which showed acceptable reliability are appropriate for use with the target population. The survey would be strengthened by the removal or redevelopment of items

Practical implications

  • Despite the fact that physical activity behaviors are developed during early childhood, instruments to reliably measure potential correlates, identify future intervention targets and measure potential mediators of behaviour change, are scarce.

  • The HAPPY Study survey is a reliable instrument for measuring correlates of physical activity in preschool children.

  • Items or constructs in this survey may also be used to measure potential mediators of behaviour change in future interventions.

Conflicts of interest

The authors declare no conflict of interest.

Acknowledgements

Trina Hinkley was supported by a Deakin University APA PhD Scholarship during part of the data collection period. Jo Salmon is supported by a National Heart Foundation of Australia Career Development Award and sanofi-aventis. Kylie Hesketh is supported by a National Heart Foundation of Australia Career Development Award. David Crawford is supported by a Victorian Health Promotion Foundation Senior Research Fellowship. The project was funded by Deakin University.

References (29)

  • M. Oliver et al.

    Physical activity in preschoolers: understanding prevalence and measurement issues

    Sports Med

    (2007)
  • T. Hinkley et al.

    Preschool children and physical activity: a review of correlates

    Am J Prev Med

    (2008)
  • U. Bronfenbrenner

    The ecology of human development: experiments by nature and design

    (1979)
  • K.K. Davison et al.

    Childhood overweight: a contextual model and recommendations for future research

    Obes Rev

    (2001)
  • Cited by (65)

    • The reliability and validity of a physical activity and sedentary behaviour home audit tool for children aged 2–5 years

      2021, Journal of Science and Medicine in Sport
      Citation Excerpt :

      For example, Hales et al.12 included adult exercise equipment in their audit tool, which is unlikely to be relevant for younger children. Other items that are likely to be more influential in younger children than older primary school aged children15 may have been excluded from that tool (e.g., a tricycle would be more relevant to younger children). A further limitation of existing evidence is that only one study has measured both the indoor and outdoor home environments in relation to physical activity.16

    • Ecological correlates of sedentary behavior in young children with Autism Spectrum Disorder

      2020, Research in Autism Spectrum Disorders
      Citation Excerpt :

      The current study examines the total score. Additional potential correlates of SB (Table 1) were extracted from the Healthy Activity Preschool and Primary Years (HAPPY) survey (Hinkley et al., 2012). Prior to conducting analyses, all data were cleaned and screened for missing values, outliers and data entry errors.

    View all citing articles on Scopus
    View full text