TY - JOUR
T1 - A novel household water insecurity scale
T2 - Procedures and psychometric analysis among postpartum women in western Kenya
AU - Boateng, Godfred O.
AU - Collins, Shalean M.
AU - Mbullo, Patrick
AU - Wekesa, Pauline
AU - Onono, Maricianah
AU - Neilands, Torsten B.
AU - Young, Sera L.
N1 - Funding Information:
This project is supported by Competitive Research Grants to Develop Innovative Methods and Metrics for Agriculture and Nutrition (IMMANA). This research was supported by K01 MH098902 and R21-MH108444 from the National Institute of Mental Health, https://projectreporter. nih.gov/project_info_details.cfm?aid= 9230436&icde=34460767&ddparam=&ddvalue= &ddsub=&cr=2&csb=default&cs=ASC&pball=. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We are grateful to the dedicated mothers and babies of the Pith Moromo and Pii En Ngima Study cohort, whose participation has given us a new insight to household water insecurity. A thousand thanks to our study nurses: Joy China, Joyce Bonke, and Tobias Odwar; and also to our study trackers: Benter Ogwana, Teresa Owade, and Sarah Obaje. We also wish to thank Drs. Ruth Richardson and Yolanda Brooks of Cornell University for their work on evaluating the quality of water for the presence of E.coli. We are grateful to Dr. Mallory Johnson for his contribution to this study. We appreciate the immense support provided by the Atkinson Cen-tre for Sustainable Future. The content of this paper is solely the responsibility of the authors. We also acknowledge the support of the Director of the Kenya Medical Research Institute (KEMRI), and KEMRI collectively, who supervised in-country ethics review and provided logistic and technical support. Research activities and SLY were supported by the National Institute of Mental Health (NIH/NIMH K01 MH098902 and NIH/NIMH R21-MH108444). The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health.
Publisher Copyright:
© 2018 Boateng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2018/6
Y1 - 2018/6
N2 - Our ability to measure household-level food insecurity has revealed its critical role in a range of physical, psychosocial, and health outcomes. Currently, there is no analogous, standardized instrument for quantifying household-level water insecurity, which prevents us from understanding both its prevalence and consequences. Therefore, our objectives were to develop and validate a household water insecurity scale appropriate for use in our cohort in western Kenya. We used a range of qualitative techniques to develop a preliminary set of 29 household water insecurity questions and administered those questions at 15 and 18 months postpartum, concurrent with a suite of other survey modules. These data were complemented by data on quantity of water used and stored, and microbiological quality. Inter-item and item-total correlations were performed to reduce scale items to 20. Exploratory factor and parallel analyses were used to determine the latent factor structure; a unidimensional scale was hypothesized and tested using confirmatory factor and bifactor analyses, along with multiple statistical fit indices. Reliability was assessed using Cronbach’s alpha and the coefficient of stability, which produced a coefficient alpha of 0.97 at 15 and 18 months postpartum and a coefficient of stability of 0.62. Predictive, convergent and discriminant validity of the final household water insecurity scale were supported based on relationships with food insecurity, perceived stress, per capita household water use, and time and money spent acquiring water. The resultant scale is a valid and reliable instrument. It can be used in this setting to test a range of hypotheses about the role of household water insecurity in numerous physical and psychosocial health outcomes, to identify the households most vulnerable to water insecurity, and to evaluate the effects of water-related interventions. To extend its applicability, we encourage efforts to develop a cross-culturally valid scale using robust qualitative and quantitative techniques.
AB - Our ability to measure household-level food insecurity has revealed its critical role in a range of physical, psychosocial, and health outcomes. Currently, there is no analogous, standardized instrument for quantifying household-level water insecurity, which prevents us from understanding both its prevalence and consequences. Therefore, our objectives were to develop and validate a household water insecurity scale appropriate for use in our cohort in western Kenya. We used a range of qualitative techniques to develop a preliminary set of 29 household water insecurity questions and administered those questions at 15 and 18 months postpartum, concurrent with a suite of other survey modules. These data were complemented by data on quantity of water used and stored, and microbiological quality. Inter-item and item-total correlations were performed to reduce scale items to 20. Exploratory factor and parallel analyses were used to determine the latent factor structure; a unidimensional scale was hypothesized and tested using confirmatory factor and bifactor analyses, along with multiple statistical fit indices. Reliability was assessed using Cronbach’s alpha and the coefficient of stability, which produced a coefficient alpha of 0.97 at 15 and 18 months postpartum and a coefficient of stability of 0.62. Predictive, convergent and discriminant validity of the final household water insecurity scale were supported based on relationships with food insecurity, perceived stress, per capita household water use, and time and money spent acquiring water. The resultant scale is a valid and reliable instrument. It can be used in this setting to test a range of hypotheses about the role of household water insecurity in numerous physical and psychosocial health outcomes, to identify the households most vulnerable to water insecurity, and to evaluate the effects of water-related interventions. To extend its applicability, we encourage efforts to develop a cross-culturally valid scale using robust qualitative and quantitative techniques.
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U2 - 10.1371/journal.pone.0198591
DO - 10.1371/journal.pone.0198591
M3 - Article
C2 - 29883462
AN - SCOPUS:85048153253
VL - 13
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 6
M1 - e0198591
ER -
