Objective: Due to a proliferation of measures for different components of the home environment related to childhood obesity, the purpose of the present systematic review was to examine these tools and the degree to which they can validly and reliably assess the home environment. Design: Relevant manuscripts published between 1998 and 2010 were obtained through electronic database searches and manual searches of reference lists. Manuscripts were included if the researchers reported on a measure of the home environment related to child eating and physical activity (PA) and childhood obesity and reported on at least one psychometric property. Results: Of the forty papers reviewed, 48 % discussed some aspect of parenting specific to food. Fifty-per cent of the manuscripts measured food availability/ accessibility, 18 % measured PA availability/accessibility, 20 % measured media availability/accessibility, 30 % focused on feeding style, 23 % focused on parenting related to PA and 20 % focused on parenting related to screen time. Conclusions: Many researchers chose to design new measures for their studies but often the items employed were brief and there was a lack of transparency in the psychometric properties. Many of the current measures of the home food and PA environment focus on one or two constructs; more comprehensive measures as well as short screeners guided by theoretical models are necessary to capture influences in the home on food and PA behaviours of children. Finally, the current measures of the home environment do not necessarily translate to specific subpopulations. Recommendations were made for future validation of measures in terms of appropriate psychometric testing.
Keywords
Child obesity Home environment Measurement PsychometricsThe prevalence and severity of childhood overweight have increased significantly in the past three decades (1)(2)(3) . Negative sequalae from being overweight during childhood include being at a higher risk for a number of chronic and acute conditions (4) as well as negative social and psychological outcomes (5) . The source for the majority of childhood obesity cases can be attributed to energy imbalance which has been linked to changes in the food and physical activity (PA) environments (6,7) . The home environment has been documented as one that can either facilitate or inhibit healthful eating and PA, and caregivers play a key role in the development of the social and physical environment within a household (8,9) . From a social environment perspective, caregivers serve as role models for PA, dietary and media behaviours and influence the child's health behaviours and weight status through parenting strategies and feeding styles (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) . In addition, a child participates in more PA when a greater amount of space and active toys are available in the home (22,23) . Likewise, access to food items can impact consumption (24,25) . Similarly, when more screen opportunities are available, children are more likely to engage i...