Children As Reporters of Their Own Health Status? Early Lessons from the ?CHIRP? Project

Linda Radecki ¹, Mary Pat Frintner ¹ and Lynn M. Olson ¹. ¹Department of Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL. Poster presentation to the Pediatric Academic Societies, 2004.

 

Background: The capacity of children to report on their own health status is an increasingly important issue in health outcomes research and clinical practice yet little is known about the age at which children become appropriate informants.

 

Objective: To qualitatively assess acceptability and feasibility of child report on an asthma-specific instrument.

 

Design/Methods: Intensive 1-1 interviews were conducted (separately) with 39 parent-child dyads. Parents completed a review and structured debriefing of the Childrens Health Survey for Asthma-Child Version (CHSA-C) and gave permission for the child interview. Children completed the interviewer-administered CHSA-C, a short debriefing about the CHSA-C and a test of cognitive development.

 

Results: 59% of child participants were male; M age = 8.8 years (range = 7-11 years). Over 2/3 of the sample reported shortness of breath, coughing or wheezing at least some of the time in the past 2 weeks. All parents permitted their child to complete the CHSA-C. Parent response to having children themselves respond was positive, especially about emotional health items (eg, feeling upset or left out due to asthma). Parents were particularly uncertain about children?s ability to provide accurate 2-week recall. Mean completion time for the child CHSA-C = 11:30 minutes (range = 7:30 -21:40 ). In general, children were able to understand and use a 5-point Likert scale. Like parents, children expressed positive feedback about emotional health questions (eg, ?For me, it kind of felt good to tell somebody how I?m feeling?). Concepts/terms difficult for 7-9 year olds were ?stress,? ?limited,? and ?health.?

 

Conclusions: Results indicate parent and child acceptance of the self-report CHSA-C and support the feasibility of obtaining child report using traditional questionnaire methodology. Lessons learned have informed the next phase of the Child Health Information Reporting Project (CHIRP) - - the assessment of the age-specific psychometric quality of child report in a sample of 400 child-parent pairs.