Objective: Due to a proliferation of measures for different components of the home environment related to childhood obesity, the purpose of the present systematic review was to examine these tools and the degree to which they can validly and reliably assess the home environment. Design: Relevant manuscripts published between 1998 and 2010 were obtained through electronic database searches and manual searches of reference lists. Manuscripts were included if the researchers reported on a measure of the home environment related to child eating and physical activity (PA) and childhood obesity and reported on at least one psychometric property. Results: Of the forty papers reviewed, 48 % discussed some aspect of parenting specific to food. Fifty-per cent of the manuscripts measured food availability/ accessibility, 18 % measured PA availability/accessibility, 20 % measured media availability/accessibility, 30 % focused on feeding style, 23 % focused on parenting related to PA and 20 % focused on parenting related to screen time. Conclusions: Many researchers chose to design new measures for their studies but often the items employed were brief and there was a lack of transparency in the psychometric properties. Many of the current measures of the home food and PA environment focus on one or two constructs; more comprehensive measures as well as short screeners guided by theoretical models are necessary to capture influences in the home on food and PA behaviours of children. Finally, the current measures of the home environment do not necessarily translate to specific subpopulations. Recommendations were made for future validation of measures in terms of appropriate psychometric testing. Keywords Child obesity Home environment Measurement PsychometricsThe prevalence and severity of childhood overweight have increased significantly in the past three decades (1)(2)(3) . Negative sequalae from being overweight during childhood include being at a higher risk for a number of chronic and acute conditions (4) as well as negative social and psychological outcomes (5) . The source for the majority of childhood obesity cases can be attributed to energy imbalance which has been linked to changes in the food and physical activity (PA) environments (6,7) . The home environment has been documented as one that can either facilitate or inhibit healthful eating and PA, and caregivers play a key role in the development of the social and physical environment within a household (8,9) . From a social environment perspective, caregivers serve as role models for PA, dietary and media behaviours and influence the child's health behaviours and weight status through parenting strategies and feeding styles (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) . In addition, a child participates in more PA when a greater amount of space and active toys are available in the home (22,23) . Likewise, access to food items can impact consumption (24,25) . Similarly, when more screen opportunities are available, children are more likely to engage i...

Few comprehensive measures exist to assess contributors to childhood obesity within the home, specifically among low-income populations. The current study describes the modification and psychometric testing of the Comprehensive Home Environment Survey (CHES), an inclusive measure of the home food, physical activity, and media environment related to childhood obesity. The items were tested for content relevance by an expert panel and piloted in the priority population. The CHES was administered to low-income parents of children 5 to 17 years (N = 150), including a subsample of parents a second time and additional caregivers to establish test-retest and interrater reliabilities. Children older than 9 years (n = 95), as well as parents (N = 150) completed concurrent assessments of diet and physical activity behaviors (predictive validity). Analyses and item trimming resulted in 18 subscales and a total score, which displayed adequate internal consistency (α = .74-.92) and high test-retest reliability (r ≥ .73, ps < .01) and interrater reliability (r ≥ .42, ps < .01). The CHES score and a validated screener for the home environment were correlated (r = .37, p < .01; concurrent validity). CHES subscales were significantly correlated with behavioral measures (r = -.20-.55, p < .05; predictive validity). The CHES shows promise as a valid/reliable assessment of the home environment related to childhood obesity, including healthy diet and physical activity.

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