Validation of the Warwick Child Health and Morbidity Profile in routine child health surveillance

Objective To further validate a simple instrument for the measurement of parent-reported health and morbidity in infancy and childhood when used in routine child health surveillance as part of a whole year birth cohort study. Setting The socially and ethnically diverse city of Coventry. Methods Health visitors administered the Warwick Child Health and Morbidity profile (WCHMP), incorporated into the Parent Held Record (PHR), to the parents of infants born in 1996 and enrolled in the Coventry Cohort study as part of routine child health surveillance at 8 weeks and 8 months. Criterion validity was estimated for Hospital admission status and immunization status against health records and validity against medically plausible constructs was tested by comparing responses between domains and between the two data collection points for the whole cohort. Results Criterion validity for parental reporting of immunization status (Kappa 0.824 [95% CIs, 0.708, 0.940]) and hospital admission (Weighted Kappa 0.987 [95% CIs, 0.977, 0.997]) were high. There was a high level of concordance between parental responses to related domains and the medically plausible constructs. The proportion of parents reporting chronic illness, acute significant illness, chronic illness and accidents increased as expected between 8 weeks and 8 months. As expected, adverse outcomes at 8 weeks were associated with an increased risk of the same outcomes at 8 months. Conclusions The WCHMP is a simple measure of parent-reported health and illness which was shown to be reliable and valid with low inter-observer variation on initial field-testing. Further validation of the WCHMP, incorporated into the PHR, in a routine child health surveillance programme demonstrates its suitability for use in infancy to collect cross-sectional and longitudinal health and morbidity data for research and service planning purposes.