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Original Article
Validation of a HOME Injury Survey
  1. K J Phelan1,2,3,
  2. J Khoury3,4,
  3. Y Xu2,3,
  4. B Lanphear2,3,5
  1. 1
    Division of Health Policy & Clinical Effectiveness, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
  2. 2
    Division of General & Community Pediatrics, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
  3. 3
    Center for Children’s Environmental Health, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
  4. 4
    Division of Biostatistics & Epidemiology, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
  5. 5
    Faculty of Health Sciences, Simon Fraser University and Child & Family Research Institute, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
  1. Correspondence to Dr K J Phelan, Associate Professor of Pediatrics, Divisions of Health Policy & Clinical Effectiveness, S Building, Rm 2.347, MLC 7014, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA; kieran.phelan{at}cchmc.org

Abstract

Background: There are no validated observational surveys to assess injury hazards in the home environment.

Objective: To evaluate the reproducibility and reliability of a survey quantifying home injury hazards for children.

Methods: A nested cohort of children in the intervention arm of the Home Observations and Measures of the Environment (HOME) Study trial were analysed. The number and density of hazards were quantified by research assistants in the homes of participants at a baseline visit (BHV) for four high-risk rooms (kitchen, main activity room, child’s bathroom and child’s bedroom) and stairways and later at an intervention planning visit (IPV) for the four high-risk rooms and entire household. Statistical analysis included Pearson correlation, Bland–Altman analysis of agreement, analysis of variance and κ statistics.

Results: There were163 households with measurements at BHV and IPV. The number and density of hazards for the four high-risk rooms correlated significantly between BHV and IPV (r = 0.50 and 0.75, respectively). The number and density of hazards for the four high-risk rooms correlated significantly with that for the whole household at the IPV (r = 0.17 and 0.52, respectively). The number of injury hazards was significantly higher in the kitchen than in the other high-risk rooms, whereas density was highest in the child’s bathroom. Inter-rater reliability between research assistants, as measured by the κ statistic, was excellent with a mean of 0.81.

Conclusions: The HOME Injury Survey was a reliable and replicable tool for quantifying residential injury hazards. The density of injury hazards was a more stable and valid measure than the number of injury hazards.

https://doi.org/10.1136/ip.2008.020958

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    Footnotes

    • Presented at the Pediatric Academic Society Meetings, Honolulu, Hawaii, 3 May 2008.

    • Funding KP was supported by 1K23HD045770-01A2 Career Development Award from the National Institute of Child Health and Development (NICHD). BL was supported by the National Institute of Environmental Health Sciences and US Environmental Protection Agency (PO1-ES11261) and the National Institutes for Environmental Health Sciences (R01ES014575).

    • Competing interests None.

    • Trial registration number: NIH Trial Registration (www.clinicaltrials.gov): NCT00129324.

    • Provenance and Peer review Not commissioned; externally peer reviewed.