Reliability and validity of the children's health survey for asthma-child version

Background: Updated asthma guidelines stress the importance of obtaining patient-reported information about symptoms and limitations to develop effective treatment and education plans. In pediatrics, reporting has often relied on parent proxy but there is increasing recognition that children can provide input on their own health status. The Children's Health Survey for Asthma (CHSA) has become a well-recognized tool for parent report of child asthma-related health status. To collect data directly from children and adolescents, we developed a companion pencil-and-paper instrument, the CHSA-Child Version (CHSA-C). Objective: Report statistical properties of the CHSA-C, a measure for children 7-16 years. Methods: The CHSA-C includes three scales - Physical Health, Child Activities, and Emotional Health (scoring 0-100; higher scores = better/more positive outcomes). We evaluated reliability (internal consistency; test-retest) and validity. Variations were examined by gender, income, and race/ethnicity. Results: 414 parent/child pairs; mean child age = 11.5 years; 45% African American. Descriptive Statistics: observed scores ranged from 4.71 (Child Activities) to 100.0 (Physical Health, Child Activities, Emotional Health); mean completion time = 9.4 min. Reliability (Internal Consistency): The majority of reliability estimates for CHSA-C scales were ≥.70. Reliability (Test-Retest): Correlation between forms ranged from .83 (Physical Health, Child Activities) to .89 (Emotional Health); intraclass correlation coefficients from .88 (Physical Health) to .91 (Child Activities). Validity: Lower CHSA-C scores were observed among children with more symptom days. Reliability and validity estimates by child gender, race/ethnicity, and income paralleled the overall sample. Conclusion: The CHSA-C, when tested with a diverse sample of children was a valid and reliable instrument and appears well suited as a tool to obtain child report of asthma-related health.