Validity of self reported home safety practices

Abstract
Objectives: To examine the validity of self reported data on parents’ home safety practices of using smoke alarms and stair gates, and having syrup of ipecac. Setting: Families from a pediatric continuity clinic in a large, urban teaching hospital with infants from birth to 6 months were enrolled in the study. Methods: As part of a randomized controlled trial to promote home safety, parents’ responses to personal interviews were compared to observations made in the respondents’ homes two to four weeks after the interview. Positive and negative predictive values, sensitivity, and specificity were computed and compared between the intervention and control group families. Results: Sensitivities were high among the four safety practices. Specificities were much lower and fell into a much wider range than sensitivities. The positive predictive values were low and the negative predictive values were high. No differences in these indicators of validity were found between intervention and control group families. Conclusions: If the main interest in an evaluation is on the relative difference between study groups, rather than the absolute value of the outcome measure, our results suggest that self reported data may be of acceptable validity. However, when assessing a patient’s risk, clinicians need to recognize the problem of over-reporting of safety practices.