The development and validation of a family functioning measure for Aboriginal and Torres Strait Islander adults

Abstract

Background Family and kinship networks are a key aspect of culture for Aboriginal and Torres Strait Islander peoples from Australia. They are intrinsically connected to good health and wellbeing, and cultural knowledge exchange. However, despite the known importance of family and kinship networks in Aboriginal and Torres Strait Islander cultures, and the move towards family-centred approaches in healthcare service provision, there is no validated, national measure of family functioning for Aboriginal and Torres Strait Islander peoples. A valid tool to measure family functioning is necessary in order to better understand what fosters good family functioning, and to inform and develop programs and healthcare interventions. Methods Mayi Kuwayu: the National Study of Aboriginal and Torres Strait Islander Wellbeing is a longitudinal cohort study of Aboriginal and Torres Strait Islander adults aged 16 years and over. An existing family functioning scale was modified for use in the Mayi Kuwayu Study to measure family functioning at the national Aboriginal and Torres Strait Islander population level. This study used a national sample of Aboriginal and Torres Strait Islander adults (N = 8705, ≥16 years) for the psychometric assessment of the modified Mayi Kuwayu Study Family Functioning Measure. This involved face validity, acceptability, internal consistency/reliability, construct validity, and convergent and divergent validity testing. Results Participants in this study were 8705 Aboriginal and Torres Strait Islander peoples, with a mean age of 48 years, who primarily live in regional Australia (47.3%). The Mayi Kuwayu Family Functioning Measure demonstrated face validity for family functioning and had good internal consistency/reliability (Cronbach’s alpha > 0.90). Construct validity results were mixed, with an indication of uni-dimensionality (with one component explaining 59.5% of variance), but some item redundancy and inconsistency in responding patterns among groups of respondents. Balancing psychometric properties with Aboriginal and Torres Strait Islander expert and end-user feedback of the measure indicate that the full scale should be retained. Finally, the measure demonstrated strong convergent and divergent validity, with prevalence ratios exhibiting dose-response relationships between family functioning and conceptually related outcomes (convergent validity) and conceptually unrelated outcomes (divergent validity). Conclusion The Mayi Kuwayu Family Functioning Measure is a valid measure of family functioning in the Aboriginal and Torres Strait Islander adult population.

Relationship of Aboriginal family wellbeing to social and cultural determinants, Central Australia: ‘Waltja tjutangku nyakunytjaku’

“… 30 31 The measure has recently been validated by Mayi Kuwayu research team, including the development of quartile cut-points applied in this paper. 30 Participants responded to nine items regarding their family, “In my family: We get on together and cope in hard times; We celebrate special days and events; We talk with each other about the things that matter; We are always there for each other; We manage money well; We have common interests; People are accepted for who they are; We have good support from mob); We have family knowledge and traditions that we pass on our children”. The response options are as follows: ‘not at all’ (coded as 1), ‘a little bit’ (2), ‘a fair bit’ (3), ‘a lot’ (4), ‘unsure’ (recoded as missing).…”

“…These categories were determined based on findings from the validation study of the family functioning measure. 30 …”

“…The Mayi Kuwayu Study family functioning measure is a validated, modified scale of family functioning from the Western Australian Aboriginal Children Health Survey 30 31. The measure has recently been validated by Mayi Kuwayu research team, including the development of quartile cut-points applied in this paper 30.…”

“…The Mayi Kuwayu Study family functioning measure is a validated, modified scale of family functioning from the Western Australian Aboriginal Children Health Survey 30 31. The measure has recently been validated by Mayi Kuwayu research team, including the development of quartile cut-points applied in this paper 30. Participants responded to nine items regarding their family, “In my family: We get on together and cope in hard times; We celebrate special days and events; We talk with each other about the things that matter; We are always there for each other; We manage money well; We have common interests; People are accepted for who they are; We have good support from mob); We have family knowledge and traditions that we pass on our children”.…”

“…For participants who responded unsure or missing to one item, an imputed value (the mean of their other eight family functioning items) replaced the missing or unsure. Total family functioning score was derived by summing responses for the nine items, and categories are based on quartile cut-points established in the work by the Mayi Kuwayu research team to validate the measure 30 and in line with the original family functioning scale. 31 The categories are low (9 to ≤24), medium (>24 to ≤29), high (>29 to ≤33) and very high (>33 to 36).…”