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

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 p...

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Autores principales: Puffer, Eve S., Giusto, Ali, Rieder, Amber D., Friis-Healy, Elsa, Ayuku, David, Green, Eric P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217654/
https://www.ncbi.nlm.nih.gov/pubmed/34168594
http://dx.doi.org/10.3389/fpsyg.2021.662991
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author Puffer, Eve S.
Giusto, Ali
Rieder, Amber D.
Friis-Healy, Elsa
Ayuku, David
Green, Eric P.
author_facet Puffer, Eve S.
Giusto, Ali
Rieder, Amber D.
Friis-Healy, Elsa
Ayuku, David
Green, Eric P.
author_sort Puffer, Eve S.
collection PubMed
description 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.
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spelling pubmed-82176542021-06-23 Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya Puffer, Eve S. Giusto, Ali Rieder, Amber D. Friis-Healy, Elsa Ayuku, David Green, Eric P. Front Psychol Psychology 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. Frontiers Media S.A. 2021-06-08 /pmc/articles/PMC8217654/ /pubmed/34168594 http://dx.doi.org/10.3389/fpsyg.2021.662991 Text en Copyright © 2021 Puffer, Giusto, Rieder, Friis-Healy, Ayuku and Green. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Puffer, Eve S.
Giusto, Ali
Rieder, Amber D.
Friis-Healy, Elsa
Ayuku, David
Green, Eric P.
Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya
title Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya
title_full Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya
title_fullStr Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya
title_full_unstemmed Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya
title_short Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya
title_sort development of the family togetherness scale: a mixed-methods validation study in kenya
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8217654/
https://www.ncbi.nlm.nih.gov/pubmed/34168594
http://dx.doi.org/10.3389/fpsyg.2021.662991
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