If parents perceive the neighborhood as child friendly, they will allow their children more independent travel and play. Parental perception of child friendliness is therefore an important prerequisite for designing neighborhoods that promote children's health and wellbeing. However, there is currently no comprehensive and practical instrument to measure it. This study develops and empirically validates a measurement instrument for parental perception of child friendliness in neighborhoods. Survey data was collected from 309 parents in the Netherlands. The data was randomly divided into a calibration (n = 155) and a validation sample (n = 154). The factorial validity of parental perception of child friendliness in neighborhoods was examined using exploratory and confirmatory factor analysis. The construct validity was tested by using structural equation modelling (SEM) of assumed relationships between parental perception of child friendliness in neighborhoods and variables influencing this perception (antecedents) and children's physical activity (consequence). Overall, the results provided good reliability and validity for the instrument. This instrument does not only offer a practical tool; it also provides practical guidelines for designing child-friendly neighborhoods as perceived by parents. It suggests that measures, such as providing green spaces, care facilities and recreation facilities, can enhance child friendliness of neighborhoods as perceived by parents.
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Background Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal-setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision-making about children's communicative participation goals. We used co-design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co-design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims To provide a detailed description of the co-design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal-setting. Methods & Procedures The Design Council's Double Diamond model was used to develop a tool in co-design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal-setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10-point scale by 64 SLTs. Outcomes & Results The co-design process resulted in the development of a physical prototype of the tool called ‘ENGAGE’, consisting of a metal ‘tree trunk’ on which parents can stick magnetic ‘leaves’ containing potential participation goals for their child. The ‘tree’ shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user-friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user-friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications As researchers we usually develop pen-and-paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs’ perspectives in the design process resulted in a tree-shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end-users in developing innovative user-centred tools for speech and language therapy and we hope that this will become widespread practice.
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