Main Article Content
Delphi Technique, child health, Health surveys, Tonga, Pacific Island
Introduction: There is minimal information available that describes the health of children of primary school age (5-12 years) living in the Pacific. Current tools that exist for measurement of health have not been developed with Pacific paradigms in mind. Our objective was to describe the development of a culturally and contextually appropriate health survey to enable measurement of the health status of 5-12 year olds living in a Pacific Island Nation.
Methods: Integrating a Delphi method with Pacific methodologies, two rounds of online questionnaires involving 33 panel members reviewed what to include in a health survey for primary school-aged children living in Tonga. The panel consisted of paediatric clinicians and academics, teachers and parents from Tonga, New Zealand, USA, and the UK.
Results: Panel consensus was met on a range of domains to be included in the survey including: general demographics (80%), environment (80%), resilience and risk (88%), household economics (80%), psychological functioning (92%), social functioning (92%), physical functioning (88%), cognitive functioning (92%) and individual health conditions (84%). Particular importance was placed on including questions that described exposure of children to violence and abuse (93%).
Conclusions: Based upon the consensus of a diverse expert panel, the domains that are necessary for the measurement of health in primary school-aged children living in Tonga were identified. The Delphi method proved a valid and useful technique to assist with the development of such a health survey and enabled the incorporation of a Pacific lens – a Tongan understanding of measuring children’s health.
(2) Duke T, Kado JH, Auto J, Amini J, Gilbert K. Closing the gaps in child health in the Pacific: an achievable goal in the next 20 years. J Paediatr Child Health 2015;51(1):54-60.
(3) McCormick MC. Issues in measuring child health. Ambul Pediatr 2008;8(2):77-84.
(4) Taylor R, Bampton D, Lopez AD. Contemporary patterns of Pacific Island mortality. Int J Epidemiol 2005;34(1):207-214.
(5) World Health Organization, Centers for Disease Control and Prevention (CDC. Global school-based student health survey (GSHS). 2013.
(6) Stein REK. A measured approach to child health. Acad Pediatr 2011;11:240.
(7) Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care 2007;45(5 Suppl 1):S3.
(8) Spencer NJ, Coe C. The development and validation of a measure off parent‐reported child health and morbidity: The Warwick Child Health and Morbidity Profile. Child Care Health Dev 1996;22(6):367-379.
(9) Starfield B, Riley A. Profiling health and illness in children and adolescents. In: Drotar D, editor. Measuring health-related quality of life in children and adolescents. 1st ed. Mahwah, NJ: Lawrence Erlbaum, New Jersey; 1998. p. 85-104.
(10) Varni JW, Seid M, Kurtin PS. PedsQL (TM) 4.0: Reliability and validity of the Pediatric Quality of Life Inventory (TM) version 4.0 Generic Core Scales in healthy and patient populations. Med Care 2001;39(8):800-812.
(11) Robitail S, Ravens-Sieberer U, Simeoni M, Rajmil L, Bruil J, Power M, et al. Testing the structural and cross-cultural validity of the KIDSCREEN-27 quality of life questionnaire. Qual Life Res 2007;16(8):1335-1345.
(12) Waters EB, Salmon LA, Wake M, Wright M, Hesketh KD. The health and well-being of adolescents: a school-based population study of the self-report Child Health Questionnaire. J Adolesc Health 2001;29(2):140-149.
(13) Lohr KN. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 2002;11(3):193-205.
(14) Suaalii-Sauni T, Wheeler A, Saafi E, Robinson G, Agnew F, Warren H, et al. Exploration of Pacific perspectives of Pacific models of mental health service delivery in New Zealand. Pacific health dialog 2009;15(1):18-27.
(15) Vaioleti TM. Talanoa research methodology: a developing position on pacific research. Waikato Journal of Education 2006;12:21.
(16) Halapua S. Talanoa process: The case of Fiji. 2000; Available at: http://unpan1.un.org/intradoc/groups/public/documents/un/unpan022610.pdf. Accessed 4/26, 2013.
(17) Malakai Mahuniu 'Ofanoa. Loto'i Tonga: A community development/health promotion model for Tongans living in urban areas. University of Auckland: University of Auckland; 2009.
(18) Thaman K. Ako and faiako: cultural values, educational ideas and teachers role perceptions in Tonga. Unpublished PhD theses, the University of the South Pacific, Suva 1988.
(19) Keeney S, Hasson F, McKenna H. The Delphi Technique in nursing and health research. Chichester: Blackwell publishing; 2011.
(20) Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: A systematic review. PLoS ONE 2011;6(6).
(21) Boulkedid R, Sibony O, Goffinet F, Fauconnier A, Branger B, Alberti C. Quality indicators for continuous monitoring to improve maternal and infant health in maternity departments: a modified Delphi survey of an international multidisciplinary panel. PLoS ONE 2013;8(4).
(22) Author A, Author B, Author C, Author D, Author E, Author F. Child morbidity as described by hospital admissions for primary school aged children in Tonga 2009-2013. N Z Med J 2017 Nov 10;130(1465):29-43.
(23) Schmitz C. LimeSurvey: An Open Source survey tool /LimeSurvey Project Hamburg, Germany. . 2015; Available at: URL http://www.limesurvey.org.
(24) Vogel I, Brug J, van der Ploeg CP, Raat H. Strategies for the prevention of MP3-induced hearing loss among adolescents: expert opinions from a Delphi study. Pediatrics 2009 May;123(5):1257-1262.
(25) Author A. In our own backyard. Investigating the health status of primary school children in Tonga. Auckland: University of Auckland; 2018.
(26) 'Ofanoa M, Percivala T, Huggarda P, Buetowa S. Talanga: the Tongan way enquiry. Sociology 2015;5(4):334-340.
(27) Tiatia J. Pacific cultural competencies: A literature review. 2008; Available at: https://www.health.govt.nz/system/files/documents/publications/pacific-cultural-competencies-may08-2.pdf. Accessed 4/15, 2013.
(28) Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005 Nov;15(9):1277-1288.
(29) Nunn PD, Mulgrew K, Scott-Parker B, Hine DW, Marks AD, Mahar D, et al. Spirituality and attitudes towards Nature in the Pacific Islands: insights for enabling climate-change adaptation. Clim Change 2016;136(3-4):477-493.
(30) Gagnon AJ, DeBruyn R, Essén B, Gissler M, Heaman M, Jeambey Z, et al. Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process. BMC Pregnancy Childbirth 2014;14(1):1.
(31) Fry M, Burr G. Using the Delphi technique to design a self-reporting triage survey tool. Accid Emerg Nurs 2001;9(4):235-241.
(32) Paine CW, Scribano PV, Localio R, Wood JN. Development of guidelines for skeletal survey in young children with intracranial hemorrhage. Pediatrics 2016 Apr;137(4):2015-3024.
(33) Wood JN, Fakeye O, Mondestin V, Rubin DM, Localio R, Feudtner C. Development of hospital-based guidelines for skeletal survey in young children with bruises. Pediatrics 2015 Feb;135(2):e312-20.
(34) Wood JN, Fakeye O, Feudtner C, Mondestin V, Localio R, Rubin DM. Development of guidelines for skeletal survey in young children with fractures. Pediatrics 2014 Jul;134(1):45-53.
(35) Broome ME, Woodring B, O'Connor-Von S. Research priorities for the nursing of children and their families: A Delphi study. J Pediatr Nurs 1996;11(5):281-287.
(36) Downie J, Henderson S, Juliff D, Munns A, Wichmann H. Community health nursing research priorities: a Delphi investigation. Neonatal, Paediatric & Child Health Nursing 2006;9(1):12-21.
(37) Skulmoski GJ, Hartman FT, Krahn J. The Delphi method for graduate research. Journal of information technology education 2007;6:1-21.
(38) Glomb NW, Shah MI, Cruz AT. Prioritising minimum standards of emergency care for children in resource-limited settings. Paediatr Int Child Health 2016;37(2):116-120.