The Validity, Reliability, and Feasibility of Measurement Tools Used to Assess Sleep of Pre-school Aged Children: A Systematic Rapid Review

Abstract

Background: Sleep of pre-school aged children is important for their health and development, but there are currently no standards for measuring sleep in this age group. We aimed to examine the validity, reliability and feasibility of tools used to assess sleep of pre-school aged children.Methods: Studies were eligible for inclusion if they examined the validity and/or reliability and/or feasibility of a measurement tool used to examine sleep of pre-school aged children (aged 3–7 years). We systematically searched six electronic databases, grey literature and trial registries. We manually searched topic specific journals, reference and citations of included studies, and reference lists of existing reviews. We extracted data and conducted a risk of bias assessment on the included studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. We used a narrative synthesis to present the results.Results: Sixteen studies met the inclusion criteria: these explored accelerometers (n = 3) and parental reported tools (n = 13; nine questionnaires, six diaries). Studies assessed construct validity (n = 3), criterion validity (n = 1), convergent validity (n = 13), test-retest reliability (n = 2), internal consistency (n = 4) and feasibility (n = 12). Most studies assessed the convergent validity of questionnaires and diaries compared with accelerometers, but the validity of accelerometers for sleep in this age group is unknown. Of studies with a low risk of bias, one sleep diary was shown to be valid for measuring sleep duration. No measurement tools were appropriate for determining sleep quality. Reporting of reliability and feasibility was minimal.Discussion: The evidence base in this field is limited, and most studies had high risk of bias. Future research on sleep in pre-school aged children should focus on assessing the validity, reliability and feasibility of accelerometers, which in turn will improve the quality of studies that assess questionnaires and diaries against accelerometers.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021230900; PROSPERO: CRD42021230900.

Parental Views on the Acceptability and Feasibility of Measurement Tools Used to Assess Movement Behaviour of Pre-School Children: A Qualitative Study

“…To our knowledge, this is the first study to assess the acceptability and feasibility of a range of measurement tools used to examine the movement behaviours of pre-school children from the perspective of parents and carers [ 22 , 23 ]. This study used a novel methodology for the measurement field that is largely based on quantitative studies only.…”

“…Through this, the study has highlighted practical issues and helpful insights that researchers may wish to consider when designing studies and selecting materials to use for measuring the movement behaviours of pre-school children, for example for intervention evaluation [ 63 ]. Moreover, the recruitment strategy was used to deliberately draw from groups whose views are often underrepresented in measurement literature [ 22 , 23 ]. Although this study included a small sample size, the study offers practical insights and strategies into the design of studies examining movement behaviours of pre-school children that may be generalisable through transferability; however, we will leave this at the discretion of the reader as to whether the findings apply to their group of interest [ 64 ].…”

“…There are currently no practical recommendations for the measurement of movement behaviours of pre-school children and limited research exploring the acceptability and feasibility of tools used for this purpose [ 22 , 23 ]. Studies examining acceptability have primarily used survey based research, whereby parents or researchers rate sentences such as ‘ the device was uncomfortable to wear ’ [ 24 , 25 , 26 , 27 , 28 ] or through researcher observation [ 29 ].…”

Comparison of actigraphy‐measured and parent‐reported sleep in association with weight status among preschool children

“…Accurate assessment tools are needed to better understand the relation between health outcomes and sleep timing and quality among children (Hjorth et al, 2012; Miller et al, 2018; Phillips et al, 2021). Epidemiological studies have often relied on reported sleep or heuristic algorithms developed three decades ago that require guidance from subjective sleep logs to identify sleep onset and wake‐up times (Cole et al, 1992; Sadeh et al, 1994).…”

Changes in sleep patterns during COVID-19 lockdown: correspondence

“…A basic concern on the present study is on the reliability of the sleep diaries study. If there is a good control of bias, sleep diary might be acceptable for assessment of duration but not other parameters [ 2 ]. Nevertheless, there might also be an association with the phase of the outbreak in the study setting.…”