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Questionnaires were checked for comprehension and ease of completion by a lay research advisor.For the case-control studies, most questionnaires were posted to participants and returned by post, but among cases a small number were completed in the ED with a researcher.
Participants were not told that they were taking part in a validation study: the home visit was explained in terms of finding out more about home safety generally.
Participants were asked to guide the researcher(s) on a tour of their home as required by the checklist, during which observations were made of the relevant safety behaviours, safety equipment use and hazards.
The sample size was calculated based on an estimated sensitivity of 80% (the number of participants reporting a specific exposure divided by the number observed to have the exposure).
Assuming a minimum of 20% of participants had the exposure, and to estimate the sensitivity with a 95% CI of ±20%, then 16 exposed participants would be needed and so 80 home visits were required.
This included, where appropriate, measurements of stair steepness and width of the biggest gap between banister rails.
As well as conducting observations of current exposures, researchers asked about changes pertaining to exposures which had been made within the previous 3 months.
All parents participating in the case-control studies were asked whether they would be interested in taking part in further research.
The answers to 78 of the questionnaire items which could be ascertained by observation were assessed during home visits to a subset of case-control study participants who expressed interest in taking part in further research.
Only 3 safety practices (stair gate at the top of stairs, stair gate at the bottom of stairs, stairs are carpeted) had substantial agreement based on the κ statistic (k=0.65, 0.72, 0.74, respectively).
Sensitivity was high (≥70%) for 19 of the 30 safety practices, and specificity was high (≥70%) for 20 of the 30 practices.