Original researchThe HAPPY Study: Development and reliability of a parent survey to assess correlates of preschool children's physical activity
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
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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.
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The HAPPY Study survey is a reliable instrument for measuring correlates of physical activity in preschool children.
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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.
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