Development of the CHILD‐SHOE Reporting Checklist: A Scoping Review and Modified Delphi Study to Support Reporting in Children's Footwear Research
How can we make sure all scientists studying children's shoes are measuring and reporting the same things, so we can actually figure out what makes a good shoe for kids?
College of Health researcher(s)
College unit(s)
Abstract
Background
Inconsistent reporting of interventions and outcomes is a key barrier to research translation. Children's footwear research is often inconsistently reported as there are no standards or recommendations on what to report or consensus on which outcomes are important. The primary aim of this research was to develop expert consensus in children's footwear features and descriptions for research reporting. The secondary aim focused on consensus building of outcome measures relating to footwear in research in children. The outcome of this study was to develop a reporting checklist and guidance for researchers who are conducting children's footwear studies.
Methods
This was a three-round modified Delphi survey informed by a scoping review. We searched four databases to enable data extraction from 109 records related to children's footwear research. These data established the basis for Round 1. Authors were identified through the scoping review and invited to participate. In Round 1, participants rated the appropriateness of domains relating to reporting footwear descriptions and features and outcomes. Outcome measures were organised against a childhood adaptation of the International Classification of Functioning, Disability and Health (ICF)—F-words in childhood disability domains. Consensus and agreement levels were set at 70%. Where 50%–69% of participants agreed, the item was returned for rating in Rounds 2 and 3.
Results
There were 33 participants who responded to Round 1 and 29 (88%) in both subsequent rounds. Participants agreed on 20 statements that researchers should use to describe children's footwear and their features. All ICF domains met consensus for outcome collection. There were 17 outcome measures that participants agreed should be used in the future when a researcher's aim aligns with specific domains. Where no specific outcome measures reached consensus or agreement within a domain, a statement was developed to guide researcher choice in the subsequently developed checklist.
Conclusion
Participants reached consensus on the essential footwear characteristics and descriptions that should be consistently reported in children's footwear research. This enabled us to produce a list of preferred outcome measures. Using this checklist can support future research through collection and reporting of comparable data.
FAQ: CHILD-SHOE Reporting Checklist for Children's Footwear Research
What is the primary purpose of the CHILD-SHOE Reporting Checklist?
The primary purpose of the CHILD-SHOE Reporting Checklist is to standardize the reporting of children's footwear research by providing expert-agreed-upon guidelines for describing footwear features and collecting relevant outcome measures. This aims to overcome the current inconsistencies in reporting that hinder research synthesis and translation, ultimately supporting the collection and reporting of comparable data in future studies.
Why was the CHILD-SHOE Reporting Checklist developed?
The checklist was developed because current children's footwear research often lacks consistent reporting standards for interventions and outcomes. This inconsistency makes it difficult for researchers to compare and synthesize findings, limiting the ability to determine optimal methods and provide evidence-based recommendations for children's footwear. Unlike adult footwear research, there were no existing standardized tools or recommended outcome measures for pediatric populations.
How was the CHILD-SHOE Reporting Checklist created?
The CHILD-SHOE Reporting Checklist was created using a three-round modified Delphi survey method, informed by an initial scoping review. The scoping review identified existing children's footwear research and helped formulate the initial questions for Round 1. Experts in the field, identified through their peer-reviewed publications, were invited to participate. They rated the appropriateness of footwear descriptions, features, and outcome measures in sequential rounds, with a 70% consensus threshold for inclusion. This iterative process allowed for the refinement of items and the development of the final checklist.
What key elements are considered essential for describing children's footwear in research?
The expert panel reached consensus on several essential elements for describing children's footwear in research. These include:
- Footwear descriptions: Brand name, an image of the footwear, and its commercial availability.
- Footwear features: Footwear type (e.g., sandal, slipper, athletic shoe), components of the footwear (e.g., heel counter presence, upper coverage, sole flexibility, insole materials, topline in relation to the ankle, mass, fixtures, toe box, pitch/drop/stack), and composition of the footwear (e.g., upper material, sole material).
How does the CHILD-SHOE Reporting Checklist categorize and recommend outcome measures?
The checklist categorizes outcome measures based on a childhood adaptation of the International Classification of Functioning, Disability and Health (ICF), referred to as the "F-words": Function, Family, Fitness, Fun, and Future. For each domain, specific outcome measures or guidance for researcher choice are provided:
- Function: Spatiotemporal measures (e.g., velocity, cadence, stride length, step length), kinematics and kinetics (e.g., hip/knee/ankle/foot angles, ground reaction force), plantar pressure (researcher preference), foot features (e.g., foot size), balance and gross motor skill (researcher preference), and presence of infection.
- Fitness: Physical activity outcome measurement (e.g., steps per day), electromyography (EMG; researcher preference), or endurance (researcher preference).
- Friendship: Quality of life measures (tool based on age/developmental stage and research aim).
- Fun: Comfort (shoe fit measured with a device, footwear comfort) and body image perception relating to feet appearance (tool chosen by researcher based on age/stage/aim).
- Family: Social factors, specifically wear time.
- Future: School attendance and longitudinal impact of footwear on foot shape.
What are the main benefits of using the CHILD-SHOE Reporting Checklist for future research?
Using the CHILD-SHOE Reporting Checklist offers several benefits for future children's footwear research:
- Consistency: It promotes consistent measurement and reporting of footwear descriptions and outcomes, making research findings more comparable.
- Research Synthesis: It facilitates the pooling of data and the synthesis of research, strengthening future recommendations.
- Relevance: By aligning outcome measures with the ICF's "F-words," it encourages researchers to consider broader impacts of footwear that are relevant to children and families.
- Guidance: It provides clear guidance for researchers during study design and publication, potentially leading to more robust and impactful evidence.
What are some of the limitations or areas for future refinement identified for the checklist?
Despite its strengths, the study acknowledges several limitations and areas for future refinement. The initial scoping review lacked forward and backward searching, potentially introducing bias. The checklist is based solely on expert opinion, with no direct consumer involvement in its development, although many researchers involved are also parents. There was also a geographical bias, with 60% of the panel from Europe or Oceania, which might have influenced choices based on cultural footwear practices. Future refinements may include defining specific elements where nomenclature remains inconsistent (e.g., minimalist footwear definitions), standardizing reporting for measures like foot size (metric vs. imperial), and incorporating new technologies like 3D scanning or wearable sensors. The checklist may also be refined to narrow down essential descriptions and outcome measures to reduce the burden on researchers as adherence to the checklist grows.
How does the new checklist contribute to the existing body of knowledge in children's footwear research?
The CHILD-SHOE Reporting Checklist builds upon existing recommendations and guidelines in children's footwear research by offering the first comprehensive, expert-derived guidance for consistent measurement and reporting. It complements previous efforts such as international taxonomies for nomenclature and consensus recommendations for therapeutic footwear classification. By standardizing what and how data are reported, the checklist addresses a critical gap that has historically hampered research synthesis and the development of evidence-based policies related to children's footwear, ultimately making research more meaningful for consumers, manufacturers, retailers, and policymakers.