DOI: 10.3886/icpsr39517
title: Computer-Administered Animation as a New Method for Measuring Young Children's Health Outcomes [Methods Study], Orange County, California, 2013-2018
title: Archival Version

description: Patients often take surveys about their health or quality of life. Results from these surveys can help doctors meet patients' needs. Young children can't fill out surveys by themselves. They may not be able to read or understand the questions. Most often, parents or hospital staff read the questions aloud, or parents answer the questions for their children. But this method may not give accurate results.

In this study, the research team tested three surveys for children ages 4 to 12 who are going to have or who recently had surgery. The first survey asks about general health. The second survey asks about feeling worried before surgery. The third survey asks about pain after surgery. A computer program reads the survey questions aloud. The surveys are animated and choices for the answers appear as cartoons.


The team wanted to learn if the surveys were

Accurate, or correctly capturing how the children were feeling
Reliable, or if children answered in a consistent way when asked similar questions
description: To assess the reliability and validity of the Child Health Rating Inventories (CHRIs) general health status measure and two newly developed preoperative anxiety and postoperative pain management measures among children ages 4-12 undergoing surgery.
description: In a previous study, researchers developed the CHRIs measure of general health status for children ages 4-12, with age-appropriate vocabulary and response formats. The measure included animated cartoon survey response options and computer audio instructions. In this study, researchers developed two new CHRIs measures for children's preoperative anxiety and postoperative pain management and assessed the reliability and validity of all three CHRIs measures.
Researchers recruited 725 families with children having surgery at Children's Hospital of Orange County, California. Among parents, 66% were Hispanic, 25% were white and 9% were other races. The average age of parents was 37, and 86% were female. Among children, 71% were Hispanic, 21% were white, and 8% were other races. The average age of children was 7, and 60% were male.
Researchers enrolled eligible parent-child dyads to complete surveys preoperatively and at two and seven days postoperatively. Children completed the animated measures. Parents completed nonanimated CHRIs measures along with a variety of other measures. Of the dyads, 420 completed CHRIs preoperatively, and 242 completed CHRIs postoperatively.
Researchers assessed the internal consistency reliability of CHRIs measures using Cronbach's alpha and the construct validity using exploratory factor analysis (EFA). To validate the child-reported CHRIs measures, the team examined their correlations with parent-reported CHRIs measures and legacy measures, including Pediatric Quality of Life (PedsQL), Functional Disability Index (FDI), State-Trait Anxiety Inventory for Children (STAI-CH), and Parents' Postoperative Pain Measure (PPPM). The team also examined the correlations between child-reported CHRIs measures and parent-reported healthcare utilization and days missed from school.
Two advisory groups including clinicians, hospital administrators, and parents of children treated at the hospital made recommendations on the study design and provided feedback on the animated survey questions.
description: Datasets: 
DS1: Computer-Administered Animation as a New Method for Measuring Young Children's Health Outcomes [Methods Study], Orange County, California, 2013-2018
description: Children ages 4-12 undergoing surgery at the Children's Hospital of Orange County, and their parents.