Archive | 2021
Daily Tackling Heath Inequalities: French Child Individual-Level Deprivation Index Development and Validation
Abstract
\n The purpose of this study was to develop and validate a pediatric individual-level index for deprivation, usable in clinical practice and in public health. The index had a 4 phases development: items generation with literature review and experts interviews, items reduction with steering committee consensus, index derivation with multivariate analysis, and index validation with psychometric and Pearson analysis. French Child Individual-Level Deprivation Index (FrenChILD-Index) was addressed by untrained healthcare professionals in a cross-sectional multicentric study. The deprivation burden was blindly evaluated in every domain of lifestyle by an expert. Children in need of one specific type of healthcare for deprived children were: moderately deprived. Children in need of referral to a socio-medical unit for access to healthcare were: severely deprived. The main outcome measure was the agreement between FrenChILD-Index results and expert evaluation.Development phases produced a 12-item instrument. Validation phases were carried out in a 986 children sample. FrenChILD-Index fulfilled the Terwee validity criterion for screening instruments. For moderate deprivation, sensitivity was 96.0% [92.6; 98.7] and specificity 68.3% [65.2; 71.4]. For severe deprivation, sensitivity was 96.3% [92.7; 100] and specificity 91.1% [89.2; 92.9]. It correlated with the number of lifestyle deprived domains 0.80 [0.77; 0.83] and the amount of specific healthcare for children 0.86 [0.83; 0.88].Conclusions: FrenChILD-Index is the first pediatric individual-level index of deprivation, methodologically validated in Europe. FrenChILD-Index enables individual appropriate referral for deprived children. It enables considering social determinants of health into account in epidemiological adjustment, patient sample stratification and program impact measurement. (NCT03640715, 21/08/2018)