Adapting physical activity survey instruments for Inclusive Education Settings

UEF // University of Eastern Finland
Kwok Ng, School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland;
Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
Piritta Asunta, LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
Eija Kärnä, University of Eastern Finland, Joensuu, Finland
Sami Kokko, University of Jyväskylä, Jyväskylä, Finland
Pauli Rintala, University of Jyväskylä, Jyväskylä, Finland.
ECER 2019, Hamburg
@kwokwng
Adapting physical activity survey
instruments for Inclusive
Education Settings
https://bit.ly/ECERkwok

Outline
• Background to including children in surveys
• Conversion for self-report
• Organising the study in special education settings
• Results of timing and Feasibility
• Discussions
Kwok Ng – Testing self-report CFM
ECER2019| @kwokwng

Overall Project aim
• Given that Finland only ratified the CRPD in 2016, it
was important that future data collection for national
monitoring purposes would collect data as normal with
the possibility to disaggregate by disability.
• The project, “Tutka” was funded by the Finnish Ministry
of Education and Culture, with one of the aims to
• Have suitable data for the National Report Cards that
include children with disabilities
ECER2019| @kwokwng

Data Sources
• Finland has a long history of collecting health related
survey data from children
– 1977 - NTTT (health behaviour of young Finns) –
biennial
– 1983/4 – HBSC (health behaviour of school aged
children) – quadrennial; international survey, currently
49 member countries
– 1996/7 – SHP (school health promotion study) – biennial
– 2014 – F-SPA (Finnish school-aged physical activity
study) – biennial
• Until recently, children with disabilities have been
excluded from participating in such surveys
ECER2019| @kwokwng

Children have a voice, that should be heard
• The HBSC study goals are to increase the
understanding of adolescent health and well-being
by identifying related health behaviours, life styles
and contexts and describe adolescent health
behaviour between countries. (Boyce et al, 2009)
• Issues to developing items for HBSC
– A short set of questions
– Items need to remain comparable between collection
years and between countries
– It must compliment other mandatory questions
– Advantageous to be comparable with Census
questionnaires
ECER2019| @kwokwng

Principles for item development (Coolican, 2004)
I. only ask what is needed (low number of questions)
II. ensure the questions can be answered (appropriate
question language)
III. enable truthful answering to questions (appropriate
response scales); and,
IV. reduce the number of items that cannot be refused or
unanswered
ECER2019| @kwokwng

Example of conversion of ‘disability’
Changes towards Washington Group/Child Functioning Module
ECER2019| @kwokwng

HBSC study in Finland
• If yes, (check box) what difficulties
– Seeing
– Hearing
– Speaking
– Moving around
– Handling objects
– Breathing
– Epileptic Seizures (Fits)
2002 2006 2010 2014 2018
Long term illnesses or Disabilities (Yes | No)
• Do you have difficulty..
• in seeing, even with glasses?
• hearing, even with a hearing aid?
• In speaking fluently?
• In moving?
• In handling objects?
• In breathing, for example, shortness of breath?
• In remembering things?
• In concentrating?
• In sitting still during lessons?
No difficulties
Difficulties do not affect functioning
Difficulties affect functioning somewhat
Difficulties affecting functioning a lot
Difficulties affect functioning very much
Self-reported CFM
2016 F-SPA
Seeing
Hearing
Speaking
Moving
Breathing
Remembering or
concentration
(Osteras et al, 2008)
ECER2019| @kwokwng

HBSC 2014 (left) and WG themes (right)
• seeing things
• hearing others?
• speaking to others?
• moving around?
• handling objects?
• breathing?
• Epileptic seizures (fits)?
• Remembering?
• Concentrating?
• Sitting Still?
• Vision (seeing)
• Hearing
• Walking (mobility)
• Communication
• Learning
• Playing
• Relationship
• Self-care
• Emotion
• Behaviour
• Attention
• Coping with Change
Other HBSC
Items
ECER 2019 | @kwokwng

Child Functioning Module in 2018
Do you have difficulty seeing, even if wearing your glasses or contact lenses?
Do you have difficulty hearing sounds like people’s voices, even if using a hearing aid?
Do you have difficulty walking 100 yards/meters on level ground, even if you use any
equipment or receive assistance? That would be about the length of a football field [or insert
country specific example]
Do you have difficulty with self-care such as feeding or dressing yourself?
When you speak, do you have difficulty being understood by people outside of your home?
Compared with students of the same age, do you have difficulty learning things?
Compared with students of the same age, do you have difficulty remembering things?
Do you have difficulty concentrating on an activity that you enjoy doing?
Do you have difficulty accepting changes in your routine?
Compared with students of the same age, do you have difficulty controlling your behaviour?
Do you have difficulty making friends?
https://data.unicef.org/resources/module-child-functioning-concept-note/
None Some A lot Cannot do
ECER2019| @kwokwng

What about emotional difficulties?
Child Functioning Module
• How often does (name) seem very
anxious, nervous or worried?
– Would you say: daily, weekly, monthly, a
few times a year or never?
• How often does (name) seem very sad or
depressed?
– Would you say: daily, weekly, monthly, a
few times a year or never?
HBSC Symptoms Checklist
• In the last 6 months: how often have you
had the following....?
– Feeling low
– Irritability or bad temper
– Feeling nervous
• About every day, More than once a week,
About every week, About every month,
Rarely or never
?
?
?

A tool for teachers to choose the right version
L-version
(standard language)
M-version
(easy-to-read language)
S-version
(easy-to-read language)
➢ challenges in being physically
active, hearing, seeing, or
behaving
➢ mild challenges in attention
deficit or regulating one’s
activity
➢ mild challenges in
understanding and learning
➢ cognitive challenges
➢ severe challenges in attention
deficit or regulating one’s
activity
General support Intensified support Special support
The level of support is minimal The level of support is maximal
ECER2019| @kwokwng

Questionnaire items were …
• aided by images
• modified to easy-to-read language
ECER2019| @kwokwng

Project Overview
Can students complete the survey in time?
ECER2019| @kwokwng

Fall 2017
Spring
2018
HBSC study
n=92
SPA study, n=31
SECS-study paper, n=71
SECS study online, n=60
SECS study (L)
Young (n=68 )
Old (n=72)
Easy to read-
survey (M)
Young (n=68 )
Old (n= 72)
S-survey
(n=28)
1a. Pilot (A and B versions)
1b. Pilot (electronic version)
2. Pilot (test-retest)
3. Pilot (S-questionnaire
developement)
4. National Data Collection
Focus group of
children
Expert group:
meetings and
webropol survey
The Finnish Centre
for Easy to Read
Online survey
n= number of questions in the survey
L-survey
10-13y (n=49)
14-18y (n=56)
M-survey
10-13y (n=36)
14-18y (n=40)
S-survey
7-18y (n=24)
Ng, Asunta, Kärnä, Rintala (in progress)
Overall SECS Questionnaire development
ECER2019| @kwokwng
Teacher feedback

Time for completion
Study Questions Students (n) Setting Time Range Median
1a – Paper 71 12 SEC <45min n/a
1b – Online 60 8 SES 12-36min 25min
2 – Test-Retest 68-72 70 SEC 5-56min 16min
3 – S- survey 28 11 SEC 11-41min 21min
4 – National S = 24
M=36-49
L=40-56
889 SECS 4min – 3hr 10min (S)
19min (M)
21min (L)
ECER2019| @kwokwng

Teacher Feedback
•Most teachers responded (n=40/58, 69.8% response rate)
•Teacher guide was understandable and easy to use (66%)
•Visuals made it easier for the students to understand (80%)
•A few teachers reported they were regularly reading out aloud the
question and response options for the student
•A teacher stated that the child fits across the spectrum and did not
know which survey to use.

Discussions
•A four-step process was used to convert national self-report surveys
from general schools settings to SECS settings. Data merging is
possible on key PA indicators for future report cards.
•The number of items in the surveys were reduced to half (HBSC=92
questions, LY=49 questions) and there were visual analogue scales
(Shields et al, 2003), but audio guides were missing.
•A teacher guide was provided to enable classroom administration
under researcher protocols. This is important to keep costs of data
collection to a minimum.
•Further developments are needed for full picture (i.e. areas in Matrix)
ECER2019| @kwokwng

Overall Physical Activity
Organized Sport Participation
Active Play
Active Transportation
Sedentary Behavior
Family and Peers, School
Community and the Built Environment
Government Strategies and Investments
49 countries38 countries15 countries
2 countries disabilities data
Call for disabilities data
xx countries
Is your country ready for
disability data?

UEF // University of Eastern Finland ECER 2019 | @kwokwng
Elche (Spain), 21-23 October
Adapted Physical Activity for Health
Greetings and welcomes!
https://jyu.fi/isapa2021
https://ifapa.net
https://eufapa.eu
(redeveloping site)

Thank you!
uef.fiul.iejyu.fi

Adapting physical activity survey instruments for Inclusive Education Settings

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