Developing a direct observational measure of family functioning for low-resource settings: Establishing reliability and validity in a Kenyan sample
Family environments can be powerful risk or protective factors for the mental health outcomes of children and adolescents, making family-based interventions important for prevention and treatment of mental health disorders. A major barrier to conducting rigorous trials of family interventions in low- and middle-income countries is the lack of tools for assessing family functioning. Based on a previous qualitative study, we have developed a direct observational tool to assess family interaction patterns. In the assessment, families participate in structured activities that are videotaped and coded on multiple categories of family functioning.
In this application, we propose assessing the criterion validity of this tool by comparing its results with results of in-depth interviews with the families in this study. Participants will include 200 families with a target child between 10 and 17 years of age. Children and caregivers will be administered the interview, observational measure, and survey measures that will be validated concurrently. The expected outcome is a direct observational measure of family functioning that is feasible and validated in a low-resource setting. If results support validity, a second objective of the study is to manualize all materials, including procedures, the coding system, training materials, and adaptation guidelines to facilitate testing of the measure in other contexts.
The observational tool developed in this study will be designed for use in clinical practice for identifying families in need of intervention.