Canadian Healthy After School Environments (CHASE): Validity and Reliability Study
Date
2013-05-01
Authors
Lobsinger, Tosha
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Abstract
The present study aimed to assess the current affordances for physical activity (PA) and healthy eating (HE) in after-school child care. The primary purpose of this study was to develop a valid and reliable online survey to assess the affordance of PA and HE in Canadian after-school childcare settings. A two-stage instrument validation procedure was implemented. Stage 1 was an instrument review (n=5) to create the Canadian Healthy After School Environments (CHASE) survey and an expert review (n=7) to establish logical validity of its items and components. Stage 2 was a comparison of the self-administered CHASE survey with existing observation tools to establish concurrent validity and test retest to establish its reliability in 20 after-school child care programs on Vancouver Island (n=20). Observation tools included the Environment and Policy Assessment and Observation (EPAO), an audit of the facility environment, staff behaviours, and snacks and activities observed, and the Physical Activity Observation Recording Sheet (PAORS), a scan of the physical activity intensity and facilitation of each child during each minute of activity. Pearson correlations were calculated for subscales and items on CHASE, EPAO and PAORS to establish validity. Percent agreement and intra-class correlations (ICCs) between CHASE T1 and T2 scores were calculated to establish reliability. The results indicated that CHASE T1 Social HE Environment subscale significantly correlated with 5 objective measures: EPAO-measured proportion of time in PA (r=0.715, p<.001); total PA minutes (r=0.680, p=.001); total outdoor PA (r=0.521, p=.018); total sedentary behaviour (r=-0.580, p=.009); and PAORS-measured total PA minutes (r=0.631, p=.003). CHASE T1 HE Total subscale also significantly correlated with these objective measures: EPAO-measured proportion of time in PA (r=0.450, p=.047); total PA minutes (r=0.565, p=.009); total outdoor PA (r=0.517, p=.020); total sedentary behaviour (r=-0.577, p=.010); and PAORS-measured total PA minutes (r=0.514, p=.020). Other significant correlations were found between EPAO total outdoor PA and CHASE T1 Physical HE Environment subscale (r=0.501, p=.024), as well as EPAO total minutes of television and CHASE T1 PA Practices subscale (r=-0.459, p=.042). Other CHASE subscales were not significantly correlated with objective PA measures. Significant correlations between CHASE and EPAO subscales were found for Social PA Environment (r=0.664, p=.001) and HE Total (r=0.553, p=.040). The remaining correlations between CHASE and EPAO subscales were not significant. ICCs indicated strong reliability for all CHASE subscales, excluding Social PA Environment, Social HE Environment, PA Practices. ICCs indicated strong reliability for all CHASE sections, excluding HE Environment and Policies. Average percent agreement calculations indicated high reliability for CHASE Environment Total (Mean=84.42, SD=7.02), PA Total (Mean=75.43, SD=10.29), HE Total (Mean=83.70, SD=3.42) and Overall Total section scores (Mean= 81.18, SD=5.56). The CHASE survey has the potential to increase the feasibility of assessing the physical activity and healthy eating environment in after-school child-care programs in many sites across Canada. These findings highlight that it is reliable and that some of the subscales and items have concurrent validity. More work has to be done to explore why certain subscales and items lacked validity and to compare CHASE to directly measured physical activity using accelerometers.
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Keywords
children, health, after school, child care, physical activity, nutrition, environment, survey validation