scholarly journals A Novel Household Water Insecurity Scale: Procedures and Psychometric Analysis among Postpartum Women in Western Kenya

2018 ◽  
Author(s):  
Godfred O. Boateng ◽  
Shalean M. Collins ◽  
Patrick Mbullo ◽  
Pauline Wekesa ◽  
Maricianah Onono ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Food Insecurity ◽  
Discriminant Validity ◽  
Critical Role ◽  
Microbiological Quality ◽  
Psychosocial Health ◽  
Water Insecurity ◽  
Western Kenya ◽  
Household Level ◽  
Household Water

AbstractOur ability to measure household-level food insecurity has revealed its critical role in a range of physical, psychosocial, and health outcomes. Currently, there is no analogous, standardized instrument for quantifying household-level water insecurity, which prevents us from understanding both its prevalence and consequences. Therefore, our objectives were to develop and validate a household water insecurity scale appropriate for use in our cohort in western Kenya. We used a range of qualitative techniques to develop a preliminary set of 29 household water insecurity questions, and administered those questions at 15 and 18 months postpartum, concurrent with a suite of other survey modules. These data were complemented by data on quantity of water used and stored, and microbiological quality. Inter-item and item-total correlations were performed to reduce scale items to 20. Exploratory factor and parallel analyses were used to determine the latent factor structure; a unidimensional scale was hypothesized and tested using confirmatory factor and bifactor analyses, along with multiple statistical fit indices. Reliability was assessed using Cronbach’s alpha and the coefficient of stability, which produced a coefficient alpha of 0.97 at 15 and 18 months postpartum and a coefficient of stability of 0.62. Predictive, convergent and discriminant validity of the final household water insecurity scale were supported, based on relationships with food insecurity, perceived stress, per capita household water use, and time and money spent acquiring water. The resultant scale is a valid and reliable instrument. It can be used in this setting to test a range of hypotheses about the role of household water insecurity in numerous physical and psychosocial health outcomes, to identify the households most vulnerable to water insecurity, and to evaluate the effects of water-related interventions. To extend its applicability, we encourage efforts to develop a cross-culturally valid scale using robust qualitative and quantitative techniques.

scholarly journals Development and validation protocol for an instrument to measure household water insecurity across cultures and ecologies: the Household Water InSecurity Experiences (HWISE) Scale

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023558 ◽  
Author(s):  
Sera L Young ◽  
Shalean M Collins ◽  
Godfred O Boateng ◽  
Torsten B Neilands ◽  
Zeina Jamaluddine ◽  
...  
Keyword(s):  
Discriminant Validity ◽  
Policy Research ◽  
Well Being ◽  
Face Validity ◽  
Structure Identification ◽  
Water Insecurity ◽  
Household Level ◽  
Wide Range ◽  
Household Water ◽  
Being There

IntroductionA wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.Methods and analysisAfter domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess water and issues with quality), with a target of at least 250 participants from each site. Scale development will draw on analytic methods from both classical test and item response theories and include item reduction and factor structure identification. Scale evaluation will entail assessments of reliability, and predictive, convergent, and discriminant validity, as well as the assessment of differentiation between known groups.Ethics and disseminationStudy activities received necessary ethical approvals from institutional review bodies relevant to each site. We anticipate that the final HWISE Scale will be completed by late 2018 and made available through open-access publication. Associated findings will be disseminated to public health professionals, scientists, practitioners and policymakers through peer-reviewed journals, scientific presentations and meetings with various stakeholders. Measures to quantify household food insecurity have transformed policy, research and humanitarian aid efforts globally, and we expect that an analogous measure for household water insecurity will be similarly impactful.

scholarly journals Water Insecurity is Associated with Lack of Viral Suppression and Greater Odds of AIDS-Defining Illnesses Among Adults with HIV in Western Kenya

2021 ◽  
Author(s):  
Jason M. Nagata ◽  
Joshua D. Miller ◽  
Craig R. Cohen ◽  
Edward A. Frongillo ◽  
Elly Weke ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Controlled Trial ◽  
Social Determinant ◽  
Hiv Treatment ◽  
Baseline Data ◽  
Water Insecurity ◽  
Cross Sectional ◽  
Western Kenya ◽  
Cd4 Cell Count ◽  
Household Water

AbstractReliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June 2016 to December 2017. We assessed associations between water insecurity and HIV-related outcomes, adjusting for clinical and behavioral confounders, including food insecurity. Each five-unit higher household water insecurity score (range: 0–51) was associated with 1.21 higher odds of having a viral load ≥ 1000 copies/mL (95% CI 1.07, 1.36) and 1.26 higher odds of AIDS-defining illness (95% CI 1.11, 1.42). Household water insecurity was not associated with CD4 cell count (B: 0.27; 95% CI −3.59, 13.05). HIV treatment and support programs should consider assessing and addressing water insecurity in addition to food insecurity to optimize HIV outcomes.

scholarly journals A novel household water insecurity scale: Procedures and psychometric analysis among postpartum women in western Kenya

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198591 ◽  
Author(s):  
Godfred O. Boateng ◽  
Shalean M. Collins ◽  
Patrick Mbullo ◽  
Pauline Wekesa ◽  
Maricianah Onono ◽  
...  
Keyword(s):  
Psychometric Analysis ◽  
Postpartum Women ◽  
Water Insecurity ◽  
Western Kenya ◽  
Household Water

scholarly journals Cross-sectional study to measure household water insecurity and its health outcomes in urban Mexico

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040825
Author(s):  
Wendy E Jepson ◽  
Justin Stoler ◽  
Juha Baek ◽  
Javier Morán Martínez ◽  
Felipe Javier Uribe Salas ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Outcomes ◽  
Dengue Fever ◽  
Perceived Stress ◽  
Low Income ◽  
Urban Areas ◽  
Short Form ◽  
Water Insecurity ◽  
Cross Sectional ◽  
Household Water

ObjectiveTo assess the links between structural and household determinants of household water insecurity and test three water insecurity measures against self-reported diarrhoea, dengue fever and perceived stress in the middle-income and low-income urban areas of Torreón, Mexico.DesignCross-sectional household survey conducted in two waves (rainy and dry seasons).Participants500 households selected via multistage cluster sample in selected communities. Socioeconomic status determined the selection of participant neighbourhoods; five were identified in low socioeconomic status neighbourhoods and five in low-medium socioeconomic status neighbourhoods. We examine how the context of urban water provision is related to a new cross-culturally valid Household Water Insecurity Experiences (HWISE) Scale.Primary outcome measuresThe HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale.ResultsWater system intermittency (adjusted OR (AOR) 3.96, 95% CI 2.40 to 6.54, p<0.001), unpredictability (AOR 2.24, 95% CI 1.34 to 3.74, p=0.002) and the dry season (AOR 3.47, 95% CI 2.18 to 5.52, p<0.001) were structural correlates of the HWISE Scale. This study also found that the HWISE Scale was associated with two health outcomes, self-reported diarrhoea (AOR 1.09, 95% CI 1.03 to 1.15, p=0.002) and perceived stress (β=0.28, SE=0.07, t=4.30, p<0.001), but not self-reported dengue fever (AOR 1.02, 95% CI 0.98 to 1.06). A 3-item hygiene subscore and a 3-item water worry subscore were also both positively associated with self-reported diarrhoea and perceived stress.ConclusionShort-form screeners of water insecurity may be useful for assessing certain health risks by lay survey workers in settings with limited healthcare resources, particularly in lieu of more expensive microbiological tests that require specialised training and facilities.

scholarly journals Away-from-home drinking water consumption practices and the microbiological quality of water consumed in rural western Kenya

2011 ◽  
Vol 9 (4) ◽  
pp. 628-636 ◽  
Author(s):  
W. Onyango-Ouma ◽  
Charles P. Gerba
Keyword(s):  
Drinking Water ◽  
Water Consumption ◽  
Microbiological Quality ◽  
Cross Sectional ◽  
Western Kenya ◽  
Household Level ◽  
Point Of Use ◽  
Quality Of Water ◽  
Consumption Practices

A cross-sectional descriptive study was conducted to examine away-from-home drinking water consumption practices and the microbiological quality of water consumed in rural western Kenya. The study involved adults and schoolchildren. Data were collected using focus group discussions, questionnaire survey, observations, diaries and interviews. The findings suggest that away-from-home drinking water consumption is a common practice in the study area; however, the microbiological quality of the water consumed is poor. While some respondents perceive the water to be safe for drinking mainly because of the clear colour of the water, others are forced by circumstances to drink the water as it is owing to a lack of alternative safe sources. It is concluded that there is a need for new innovative approaches to address away-from-home drinking water consumption in resource-poor settings in order to complement and maximize the benefits of point-of-use water treatment at the household level.

scholarly journals ‘I know how stressful it is to lack water!’ Exploring the lived experiences of household water insecurity among pregnant and postpartum women in western Kenya

2018 ◽  
Vol 14 (5) ◽  
pp. 649-662 ◽  
Author(s):  
Shalean M. Collins ◽  
Patrick Mbullo Owuor ◽  
Joshua D. Miller ◽  
Godfred O. Boateng ◽  
Pauline Wekesa ◽  
...  
Keyword(s):  
Lived Experiences ◽  
Postpartum Women ◽  
Water Insecurity ◽  
Western Kenya ◽  
Know How ◽  
Household Water

scholarly journals The Household Water InSecurity Experiences (HWISE) Scale: development and validation of a household water insecurity measure for low-income and middle-income countries

2019 ◽  
Vol 4 (5) ◽  
pp. e001750 ◽  
Author(s):  
Sera L Young ◽  
Godfred O Boateng ◽  
Zeina Jamaluddine ◽  
Joshua D Miller ◽  
Edward A Frongillo ◽  
...  
Keyword(s):  
Low Income ◽  
Discriminant Validity ◽  
Population Level ◽  
Well Being ◽  
Random Coefficient Models ◽  
Water Insecurity ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Household Water

ObjectiveProgress towards equitable and sufficient water has primarily been measured by population-level data on water availability. However, higher-resolution measures of water accessibility, adequacy, reliability and safety (ie, water insecurity) are needed to understand how problems with water impact health and well-being. Therefore, we developed the Household Water InSecurity Experiences (HWISE) Scale to measure household water insecurity in an equivalent way across disparate cultural and ecological settings.MethodsCross-sectional surveys were implemented in 8127 households across 28 sites in 23 low-income and middle-income countries. Data collected included 34 items on water insecurity in the prior month; socio-demographics; water acquisition, use and storage; household food insecurity and perceived stress. We retained water insecurity items that were salient and applicable across all sites. We used classical test and item response theories to assess dimensionality, reliability and equivalence. Construct validity was assessed for both individual and pooled sites using random coefficient models.FindingsTwelve items about experiences of household water insecurity were retained. Items showed unidimensionality in factor analyses and were reliable (Cronbach’s alpha 0.84 to 0.93). The average non-invariance rate was 0.03% (threshold <25%), indicating equivalence of measurement and meaning across sites. Predictive, convergent and discriminant validity were also established.ConclusionsThe HWISE Scale measures universal experiences of household water insecurity across low-income and middle-income countries. Its development ushers in the ability to quantify the prevalence, causes and consequences of household water insecurity, and can contribute an evidence base for clinical, public health and policy recommendations regarding water.

scholarly journals Household water insecurity is associated with a range of negative consequences among pregnant Kenyan women of mixed HIV status

2016 ◽  
Vol 14 (6) ◽  
pp. 1028-1031 ◽  
Author(s):  
Natalie R. Krumdieck ◽  
Shalean M. Collins ◽  
Pauline Wekesa ◽  
Patrick Mbullo ◽  
Godfred O. Boateng ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Pregnant Women ◽  
Psychosocial Outcomes ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Hiv Status ◽  
Water Insecurity ◽  
Household Water ◽  
Kenyan Women ◽  
Living With Hiv

Water insecurity (WI) is a serious and worsening problem worldwide, but its role in health outcomes among people living with HIV or pregnant women is unknown. We assessed experiences of WI in a cohort of 323 pregnant Kenyan women of mixed HIV status. The majority (77.7%) had at least one experience of WI in the previous month; it was associated with negative economic, nutrition, disease, and psychosocial outcomes. A standardized cross-culturally valid household WI scale would facilitate assessment of the prevalence and consequences of WI, and increased attention to WI could reveal an overlooked, but modifiable, cause of adverse HIV outcomes.

scholarly journals The Household Water Insecurity Experiences (HWISE) Scale: comparison scores from 27 sites in 22 countries

2021 ◽  
Author(s):  
Justin Stoler ◽  
Joshua D. Miller ◽  
Ellis A. Adams ◽  
Farooq Ahmed ◽  
Mallika Alexander ◽  
...  
Keyword(s):  
Household Survey ◽  
Sustainable Development Goal ◽  
Water Insecurity ◽  
Middle Income ◽  
Future Studies ◽  
Household Level ◽  
Household Water ◽  
Scale Scores ◽  
Household Survey Data ◽  
Sustainable Development Goal 6

Abstract Household survey data from 27 sites in 22 countries were collected in 2017–2018 in order to construct and validate a cross-cultural household-level water insecurity scale. The resultant Household Water Insecurity Experiences (HWISE) scale presents a useful tool for monitoring and evaluating water interventions as a complement to traditional metrics used by the development community. It can also help track progress toward achievement of Sustainable Development Goal 6 ‘clean water and sanitation for all’. We present HWISE scale scores from 27 sites as comparative data for future studies using the HWISE scale in low- and middle-income contexts. Site-level mean scores for HWISE-12 (scored 0–36) ranged from 1.64 (SD 4.22) in Pune, India, to 20.90 (7.50) in Cartagena, Colombia, while site-level mean scores for HWISE-4 (scored 0–12) ranged from 0.51 (1.50) in Pune, India, to 8.21 (2.55) in Punjab, Pakistan. Scores tended to be higher in the dry season as expected. Data from this first implementation of the HWISE scale demonstrate the diversity of water insecurity within and across communities and can help to situate findings from future applications of this tool.

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