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

Abstract

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.

Effects of positive and negative childhood experiences on adult family health

“…SEM is a valuable analytic tool because it allows one to control for measurement error and to examine multiple pathways simultaneously. Given that prior research has shown that the four family health outcomes are correlated [3], examining multiple pathways simultaneously was important for this analysis so that we could assess all of family health together rather than separately. Confirmatory factor analysis (CFA) was conducted to establish the measurement model.…”

“…family. This aspect of family health aligns most closely with traditional measures of family functioning [3]. Family healthy lifestyle comprises a family's collective healthy choices through regular physical activity, eating fruits and vegetables, following doctor's recommendations, and seeking health care services as needed.…”

“…Family health was measured using the 32-item Family Health Scale (FHS) [3]. The FHS is a holistic measure of family health that was developed based on two theoretical frameworks: the Denham Family Health Framework [4] and the Family Health Measurement Resource Network Model [1].…”

“…These include internal and external resources such as help-seeking efficacy, the ability to effectively cope with family challenges, financial resources and other basic needs, and access to health care. Finally, family external social supports refers to the presence of a social network or social capital outside of the family that the family can count on for advice, care, or assistance, whether financial or otherwise [3]. These domains offer protection against many physical and mental issues within families by creating stronger relationships and family functioning [4][5][6][7][8].…”

“…The measurement of family health is relatively new [1][2][3], and understanding how one's family experiences in childhood affects family health in adulthood is not currently well understood. Therefore, in an effort to better understand the intergenerational transmissibility of family health, in this study we examine the effects of retrospectively reported adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) that occurred before age 18 years on family health in adulthood.…”