Development Of A Brief Risk Questionnaire For Fall-induced Injury Of Urban Preschoolers Aged3-6Years

OBJECTIVES:To develop a brief risk questionnaire for fall-induced injury of urban preschoolers aged3-6years.METHODS:The questionnaire was developed based on the theories of child and adolescent health, developmental psychology and injury prevention. Literature review and case study were used to collect the related domestic and overseas scales. The initial questionnaire was shaped on the basis of findings of focus groups, interviews and expert consulting.179urban preschoolers were recruited for pilot test using stratified cluster sampling. Good-poor (G-P) analysis, correlation analysis and factor analysis were used for item selection. Exploratory factor analysis was used to explore potential dimensions of questionnaire.478urban preschoolers were recruited for reliability and validity assessment using multi-stage stratified cluster sampling. Cronbach’s a coefficient and Spearman-Brown coefficient was used to assess the questionnaire’s reliability, respectively. Expert consulting, focus group, survey feedbacks, t test, multitrait/multitem correlation analysis and confirmatory factor analysis were used to assess the validity of questionnaire. Percentile method was used to determine the evaluation criteria of total risk score of questionnaire. Anchor-based method and distribution-based method were used to decide the minimum clinically important difference (MCID) of the questionnaire.RESULTS:The final questionnaire was developed to assess the risk of fall-induced injury of urban preschoolers aged3-6years, containing6dimensions and20items. These six dimensions included:fall risk from height, comprehensive fall risk, indoor fall risk, fall risk during walking, environmental protection, and fall risk during playing. Each item included4options, in accordance with1to4score. The high score accorded with great fall risk.The Cronbach’s a Coefficient of the questionnaire was0.731and the Spearman-Brown coefficient was0.768. The mean score of fall risk was higher in children with fall-induced injury in the prior12months than in children without fall-induced injury (P＜0.05). The x2/df value, CFI, NFI, IFI, RMSEA for confirmatory factor analysis were3.25,0.887,0.856,0.889and0.070, respectively. The multi-trait/multi-item correlation analysis showed correlation coefficients of0.402to0.852between each item and the dimension that it belonged to, and of0.008to0.394between each item and the dimensions that it did not belong to.The average score of questionnaire was30.9for478children. The evaluation criteria of total risk score was determined using percentile method:≤27points, low risk;27-33points, moderate risk;>33points, high risk. A MCID of5.5was defined using distribution method.CONCLUSIONS:A brief risk questionnaire for fall-induced injury of urban preschoolers aged3-6years was developed, and determined the evaluation criteria. The questionnaire was proved to be reliable and valid and could be used to assess the fall-induced injury risk of urban preschoolers aged3-6years.