Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya

Frontiers in Psychology

David Ayuku¹  Eve S. Puffer²  Elsa Friis-Healy²  Ali Giusto²  Amber D. Rieder³  Eric P. Green³ 

[1] Department of Behavioral Sciences, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya;Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC, United States;Duke Global Health Institute, Duke University, Durham, NC, United States;Duke Global Health Institute, Duke University, Durham, NC, United States;

关键词: family functioning;    assessment;    diagnostic accuracy;    Kenya;    low- and middle income countries;    measure validation;    global mental health;    child mental health;   

DOI  :  10.3389/fpsyg.2021.662991

来源: Frontiers

【 摘 要 】

Family functioning is an important target of clinical intervention and research given its close ties with mental health outcomes of both children and adults. However, we lack family functioning measures validated for use in many low- and middle-income country (LMIC) settings. In this mixed-methods prospective diagnostic accuracy study, we first used formative qualitative data to develop an extensive battery of screening items to measure family functioning in Kenya. We then recruited 30 Kenyan families (N = 44 adults; 30 youth aged 8–17 years) to complete the questionnaires and participate in clinical interviews conducted by local interviewers. Quantitative and qualitative analyses were then conducted to select a subset of screening items that balanced conceptual understanding of family distress with diagnostic efficiency and accuracy to yield a brief but valid scale. The final index test consisting of 30 items correctly identified distressed families in 89% of cases according to adult-report and 76% of cases according to child-report. The optimal cutoffs are associated with estimates of sensitivity/specificity of 0.88/0.90 and 0.75/0.77 for adult-report and child-report measures, respectively. The final measure—the Family Togetherness Scale (FTS)—assesses global family functioning, including items related to family organization, emotional closeness, and communication/problem-solving. In addition to general items, the scale also includes items explicitly assessing family responses to stressors common in LMIC settings. Results establish a strong rationale for larger-scale validation studies.

【 授权许可】

CC BY