Checklist to Capture Food, Physical Activity, and Sedentary Devices in the Home Environment: The Home Inventory Describing Eating and Activity (Home-IDEA2)

OBJECTIVE

To modify and test a self-report checklist for the home food and activity environment, Home-Inventory Describing Eating and Activity (IDEA2), psychometrically with families of young children.

DESIGN

A mixed-methods approach: (1) cognitive interviews informed instrument design (content validity), (2) parent and trained independent raters concurrently and independently completed the Home-IDEA2 during home visits (criterion validity); (3) the Home-IDEA2 was compared with a national sample via the Food Acquisition and Purchase Survey (FoodAPS) database (construct validity).

SETTING

Rural communities in Colorado.

PARTICIPANTS

Families of preschoolers: cognitive interviews (n = 20) and home visits (n = 26).

MAIN OUTCOME MEASURES AND ANALYSIS

Content validity: responses to each question were analyzed using a general inductive approach. Criterion validity: Cohen's kappa (κ) coefficient was calculated for each Home-IDEA2 item. Construct validity: frequencies were calculated to determine the proportion of Home-IDEA2 food items found in FoodAPS households.

RESULTS

Cognitive interviews identified the need for more food descriptions and the reduction of total items from 154 to 134. Testing resulted in acceptable agreement (κ = 0.6-1.0) for 82 items (58 food, 16 physical activity, and 8 electronics), moderate agreement for 36 (35 food and 1 physical activity; κ = 0.4-0.5), and poor agreement for 16 (15 food and 1 electronics; κ ≤ 0.3). Overall reliability improved from 55% to 65% for Home-IDEA2 items. Comparison of Home-IDEA2 items with FoodAPS demonstrated that 60% of foods found in US homes were covered by the Home-IDEA2.

CONCLUSIONS AND IMPLICATIONS

This study resulted in a valid, reliable, and low-burden self-report measure for food, activity, and electronic home environments by low-income, minority parents of preschoolers.

Home food and activity assessment. Development and validation of an instrument for diverse families of young children

The purpose of this study was to refine and psychometrically test an instrument measuring the home food and activity environment of geographically and economically diverse families of preschool aged children. Caregivers of preschool aged children (n = 83) completed a modified self-report questionnaire. Reliably trained researchers conducted independent observations on 25 randomly selected homes. Agreement statistics were conducted at the item level (154 total items) to determine reliability. Frequency counts were calculated to identify item availability. Results showed Kappa statistics were high (.67-1.00) between independent researchers but varied between researchers and parents resulting in 85 items achieving criterion validity (Kappa >.60). Analyses of reliable items revealed the presence in the home of a high frequency of unhealthy snack foods, high fat milk and low frequency of availability of fruits/vegetables and low fat milk. Fifty-two percent of the homes were arranged with a television in the preschool child's bedroom. Physical Activity devices also were found to have high frequency availability. Families reporting lower education reported higher levels of sugar sweetened beverages and less low-fat dairy (p < .05) compared with higher education families. Low-income families (<$27K per year) reported significantly fewer Physical Activity devices (p < .001) compared with higher income families. Hispanic families reported significantly higher numbers of Sedentary Devices (p < .05) compared with non-Hispanic families. There were no significant differences between demographic comparisons on available fruits/vegetables, meats, whole grains, and regular fat dairy. A modified home food and activity instrument was found to reliably identify foods and activity devices with geographically and economically diverse families.

Indoor smoking bans in Bulgaria, Croatia, Northern Cyprus, Romania and Turkey

Background

The purpose of this study was to examine attitudes towards attempts to limit second-hand smoke (SHS) in five Eastern European nations.

Methods

The data consist of a Eurobarometer (64.3) survey distributed from November to December 2005. Logistic regression was employed to investigate support levels for indoor smoking bans across the five political units.

Results

Across nations, there is more support for smoking bans in offices and indoor work spaces and indoor public space as opposed to restaurants and bars and pubs. Personal smoking behaviours are linked strongly with the smoking bans. Most importantly, it is specific knowledge about the health dangers of smoking which fosters support for indoor smoking bans.

Conclusion

Policy implications suggest that government and the media must disseminate accurate information about the harm of smoking to broader segments of the population to gain support for policies that affect the dangers of SHS in these nations.