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There were 124 participants in the first cohort and 132 participants in the second cohort. The repeated measures subgroup was comprised of 29 participants from the second cohort. The internal consistency statistic (Cronbach’s alpha) was 0.93 for the first and second cohorts. The test–retest reliability ICC was 0.94 (95% CI 0.86–0.97) for the ACHWM summary scores based on the repeated measures subgroup.
These results establish the internal consistency and the test–retest validity of the ACHWM. This important finding will enable Aboriginal communities to use this measure with confidence and promote the voices of their children in reporting their health. The ACHWM is an essential data-gathering tool that enables evidence-based health care for Aboriginal communities.
Aboriginal children experience substantial and persistent health disparities compared with their mainstream peers; innovative methods are needed to assess the effectiveness of new interventions. Health leaders in Wiikwemkoong Unceded Territory engaged with a team of scientists at Laurentian University to address these disparities, and developed a strong and respectful engagement. This collaboration began with the Outdoor Adventure Leadership Experience project (https://oalevideo.laurentian.ca) and led to the development of a culturally relevant measure of health for children 8 to 18 years of age: the Aboriginal Children’s Health and Well-being Measure (ACHWM). In this paper, we share the lessons learned through a community-engaged project to evaluate a new intervention for health promotion.
A total of 293 children completed the ACHWM. The screening tool identified 35% with potential risk. Mental health workers confirmed 18% of all participants as being at-risk, and all were referred for support. The sensitivity of the tool was 75% while specificity was 79%. Improvements to the screening algorithm resulted in a specificity of 97% and negative predictive value of 95%, with no loss of sensitivity. Responsible population health surveys require a process to recognize and respond to answers indicative of health risks. This paper provides an example of a screening and triage process that enabled our survey team to screen responses in real time, respond to potential risk immediately, and connect participants to local support services. This process proved essential to conducting an ethical survey. The high specificity and negative predictive value make it an effective triage tool that is particularly valuable in Aboriginal communities and with higher-risk populations.
This research was conducted in 2014 and 2015 at four sites. Interviews with 23 children and 21 caregivers were completed. Key lessons were learned in all communities that enabled the team to improve the ACHWM in subtle but important ways. A total of 12 questions were revised, and four new questions were added during the process. This produced a 62-question version of the ACHWM, which was endorsed by all communities.
The ACHWM has been improved through a detailed review process in four additional communities/agencies and resulted in a stable 62-question version of the survey. This process has demonstrated the relevance of the ACHWM to a variety of Aboriginal communities. This survey provides Aboriginal communities with a culturally appropriate tool to assess and track their children’s health outcomes, enabling them to gather new evidence of child health needs and the effectiveness of programs in the future.
