Development and Validation of a Self-Administered Questionnaire to Measure Water Exposures in Children

Objective.-To develop and validate a questionnaire to measure water exposures in children. Methods.-Caregivers of children younger than 18 years old evaluated in a pediatric emergency department completed a self-administered questionnaire with items about the child's exposure to water for drinking (15 items), hygiene (4 items), and recreation (5 items); other beverages (11 items); and other risk factors (11 items). Test-retest reliability was measured by administering the questionnaire to the same respondent within 48 hours. Concurrent validity was measured by having a second caregiver, when available, complete the same questionnaire independently. Agreement of paired responses was calculated by kappa (kappa) for categorical variables or Spearman rho (rho) correlation coefficient along with percentage mean difference for continuous variables. Results.-Ninety-four initial surveys were completed (45 subjects with diarrhea). All 94 completed retesting, while 23 had a second independently completed survey. Test-retest reliability (kappa or rho > 0.6) was acceptable for 84% of items, and concurrent agreement was acceptable (kappa or rho > 0.5) for 91% of items. Conclusions.-This questionnaire has excellent test-retest and concurrent validity in measuring water exposures and other risk factors for gastrointestinal illness in children.