Development and content validation of an injury risk assessment tool for children one to five years old (ChIP-C) in primary care: child injury prevention initiative

Childhood home injuries are very common and contribute to considerable morbidity and mortality among children in Malaysia. Awareness among parents’ regarding injury prevention for their children is important to reduce the prevalence of childhood injuries. Currently, there are no instruments in use to assess the risk of child injuries and structured guidelines on childhood injury prevention in Malaysia. This study aims to develop and content-validate a Malay-language questionnaire as a screening tool for assessing the risk of unintentional child injuries in the primary care setting. This instrument was developed in Malay language to assess the risk of child injuries based on an extensive literature review. A content validation process using a modified Delphi approach was employed to determine the questions intended for parents of children aged of 1 to 5 years. The first round of content validation was performed by ten experts in this field to evaluate the clarity and appropriateness of the questions. A second round was conducted by a panel of eleven investigators consisting of Family Medicine Specialists. Parents of the similar characteristics with the study participants were selected for each questionnaire to assess the face validity. The questionnaire had 4 domains, which were identified through literature search: road traffic injury; fall; electrocution/ sharp injury/ poisoning/ burn; and suffocation/choking/drowning. The items were organised in an appropriate format and a six-point Likert Scale method was used to assess the risk of child injury. The instrument had a good content validity index of 0.848. Ten items were revised due to eight with Content Validity Ratio (CVR) below 0.75 and one with a CVR below 0.2. Consensus of all 42 items was reached after the second round of content validation. Feedback from 27 parents during face validation led to minor revisions to enhance clarity for the target audience. The instrument is a scale made up of a total of four domains and 42 items. This tool has excellent content validity. This tool is validated and ready to be tested in a pilot study to assess its psychometric properties.