Developing a child health survey for a Pacific Island nation. Integrating the Delphi method with Pacific methodologies

Introduction: There is minimal information available that describes the health of children of primary school age (5-12 years) living in the Pacific. Current tools that exist for measurement of health have not been developed with Pacific paradigms in mind. Our objective was to describe the development of a culturally and contextually appropriate health survey to enable measurement of the health status of 5-12 year olds living in a Pacific Island Nation. Methods: Integrating a Delphi method with Pacific methodologies, two rounds of online questionnaires involving 33 panel members reviewed what to include in a health survey for primary school-aged children living in Tonga. The panel consisted of paediatric clinicians and academics, teachers and parents from Tonga, New Zealand, USA, and the UK. Results: Panel consensus was met on a range of domains to be included in the survey including: general demographics (80%), environment (80%), resilience and risk (88%), household economics (80%), psychological functioning (92%), social functioning (92%), physical functioning (88%), cognitive functioning (92%) and individual health conditions (84%). Particular importance was placed on including questions that described exposure of children to violence and abuse (93%). Conclusions: Based upon the consensus of a diverse expert panel, the domains that are necessary for the measurement of health in primary school-aged children living in Tonga were identified. The Delphi method proved a valid and useful technique to assist with the development of such a health survey and enabled the incorporation of a Pacific lens – a Tongan understanding of measuring children’s health.