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Content Validity of a Questionnaire Specifically Designed to Clinically Identify Pediatric Environmental Exposures Open Access


Other title
Content validity
health history
Type of item
Degree grantor
University of Alberta
Author or creator
Jaggi, Parneet K
Supervisor and department
Osornio-Vargas, Alvaro (Pediatrics)
Examining committee member and department
Cui, Ying (Education)
Vohra, Sunita (Pediatrics)
Osornio-Vargas, Alvaro (Pediatrics)
Buka, Irena (Pediatrics)
Johnson, Jeffrey (Public Health)
Medical Sciences-Paediatrics

Date accepted
Graduation date
Master of Science
Degree level
Various clinical questionnaires exist to assist clinicians with the diagnosis, prognosis, long-term follow up of a disease, or even to assess quality of life. However, any questionnaire must be evaluated for its validity and reliability before application. Invalid or unreliable questionnaires can lead to bias or outcome misinterpretations. The Pediatric Environmental Health History (PEHH) questionnaire developed for clinical use is no exception and underwent a fundamental validation step, content validity. For the first phase, a modified Delphi technique was used to collect expert consensus for the original PEHH (200 questions spanning 9 sections). Experts were identified throughout the Pediatric Environmental Health Specialty Units (PEHSUs) network and the World Health Organization (WHO). Percent Agreement (PA) is an average percent of experts rating an individual question as relevant (e.g. “agree”) per section. A PA of 90% was used as a criterion for the number of rounds required. After two rounds, excellent expert consensus for question relevancy was achieved for the nine domains indicated by a PA greater than 90%. Experts indicated agreement with the comprehensiveness of each PEHH section. A final version was generated based on the expert suggestions, consisting of 161 refined questions. In the second phase of the study, parents/guardians assessed PEHH usability through examining ease of answering questions, comprehension, and respondent burden. Pediatricians assessed PEHH usefulness for the clinical setting. After PEHH completion, 44 parents/guardians indicated good usability for all of the survey questions and were satisfied with the length and time taken to complete it. Upon PEHH review, 15 pediatricians indicated good usefulness, but were dissatisfied with its length and anticipated administration time suggesting need for a shorter version. Through these study phases, content validity for the PEHH has been established ensuring an evaluation of question/item relevancy and comprehensiveness, and usability and usefulness. A relevant and comprehensive set of questions to clinically explore environmental risk factors for the pediatric population is available for future data collection, which can undergo further validation (e.g. construct validity).
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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