Building a Foundation for Family Health Measurement in National Surveys: A Modified Delphi Expert Process

Weiss‐Laxer, Nomi S.; Crandall, AliceAnn; Okano, Lauren; Riley, Anne W.

doi:10.1007/s10995-019-02870-w

Cited by 50 publications

(45 citation statements)

References 17 publications

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“…The individuals comprising families as well as external environments (e.g., neighborhood, community, society, policy, and law) influence family health routines, norms, and ultimately family health ( 3 ). Family health is “a resource at the level of the family unit that develops from the intersection of the health of each family member, their interactions and capacities, as well as the family's physical, social, emotional, economic, and medical resources” ( 4 ). Healthy families promote a sense of belonging and build family members' ability to develop, care for each other, and meet life's responsibilities.…”

Section: Introductionmentioning

confidence: 99%

“…Public health frameworks, such as Healthy People 2020 ( 9 ) and Public Health 3.0 ( 10 ), place the individual at the center of community health and neglect the critically important role of families as producers and central contexts for health. In fact, from a review of family health content assessed in six routinely administered U.S. national health surveys, there is a nearly exclusive focus on individual health status of family members, behaviors, and medical care utilization ( 4 ). When family measures are included, they typically focus on a narrow range of family sociodemographic factors such as family structure, household composition, income, race, and occasionally individual members' health ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…Foundational work to define and measure family health and its core concepts and domains began with an interdisciplinary group of family health experts who formed the Family Health Maternal and Child Health Measurement Resource Network (Family Health MRN), supported by the Maternal and Child Health Bureau of the U.S. Health and Human Services Administration ( 4 ). Using a three-round Delphi expert process, the team identified key domains and concepts of family health.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Family Health Scale: Reliability and Validity of a Short- and Long-Form

Crandall

Weiss‐Laxer

Broadbent

et al. 2020

Front. Public Health

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Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Family Health Scale: Reliability and Validity of a Short- and Long-Form

Crandall

Weiss‐Laxer

Broadbent

et al. 2020

Front. Public Health

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“…This number of measures was compatible with the literature about on-line Delphi techniques. 23,24 Stage B: Agreement on the criteria for equity indicator rating Based on the literature and on the experience gained in the extant Israeli National Program for Quality Indicators in Community Healthcare, 21,25 the researchers identi ed and evaluated diverse criteria that could guide the Delphi participants on the rating of the disparity measures. The steering committee helped de ne the nal four criteria by anonymously voting on the weight of each criterion.…”

Section: A3mentioning

confidence: 99%

Developing a national set of health equity indicators using a consensus building process

Wilf‐Miron

Avni²,

Valinsky³

et al. 2020

Preprint

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BackgroundConsiderable health disparities documented in Israel between communities, populations and regions, undermine the rights of all citizens to attain the best possible health. The first step towards health equity is to agree on a set of national indicators, reflecting equity in health services provision and health outcomes, and allowing monitoring of the impact of interventions on the reduction of disparities. We sought to describe the process of reaching a consensus on a defined set of national equity indicators. MethodsThe study was conducted between January 2019 and June 2020, in a multistage design: A) Identifying appropriate disparity measures. B) Agreement on the screening criteria and relative weighting. C) Constructing the consultation framework as an on-line, 3-round Delphi technique.ResultsThirty measures of disparity, presented to participants, represented the following domains: Health promotion (11 indicators); acute and chronic morbidity (11), life expectancy and mortality (2), health infrastructures and affordability of care (4); education and employment (2). Three scoring rounds took place between February-May 2020. Of the 77 individuals contacted, 75 (97%) expressed willingness to participate, and 55 (73%) completed all three rounds. The leading ten indicators selected were: Diabetes care, childhood obesity, adult obesity, distribution of healthcare personnel, fatal childhood injuries, smoking, infant mortality, inability to afford care, access to mental health services, and distribution of hospital beds. Agreement among raters, measured as intra-class correlation coefficient was 0.75.ConclusionThe Delphi technique provided a cost–effective, feasible and acceptable method for reaching a consensus with a variety of experts and public representatives. Equity indicators chosen by a broad range of people from different sectors are more likely to be accepted and ultimately implemented. The diverse set of clinical and system indicators should be used to guide governmental decision-making and inter-sectoral strategies, furthering the pursuit of a more equitable healthcare system.

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“…Although in public and professional discourse the definition of "family" can be a contested concept, in everyday life people understand its meaning and importance. We define family as "two or more persons related by blood, adoption, marriage or choice and whose relationship is characterized by at least one of the following: social and/or legal rights and obligations; affective and emotional ties; and endurance or intended endurance of relationship" (8). This definition can embrace various types of families and the role of extended family, as well as individuals who live alone but continue to be influenced by family.…”

Section: Introductionmentioning

confidence: 99%

Families as a Cornerstone in 21st Century Public Health: Recommendations for Research, Education, Policy, and Practice

Weiss‐Laxer

Crandall

Hughes

et al. 2020

Front. Public Health

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Families are vastly overlooked in US initiatives to promote population health and health equity despite being the most proximal context for health across the life course. We urge the public health sector to take the lead in recognizing families as essential for promoting 21st century population health. We highlight ways families influence health by providing context, care, continuity, and connections. The dual private and public aspect of families has contributed to how they have been overlooked in the public health sector. We provide recommendations for better integrating families into population health initiatives through national health goals, research, education, policy, and practice.

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Building a Foundation for Family Health Measurement in National Surveys: A Modified Delphi Expert Process

Cited by 50 publications

References 17 publications

The Family Health Scale: Reliability and Validity of a Short- and Long-Form

The Family Health Scale: Reliability and Validity of a Short- and Long-Form

Developing a national set of health equity indicators using a consensus building process

Families as a Cornerstone in 21st Century Public Health: Recommendations for Research, Education, Policy, and Practice

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