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.
Highlights
The health of individuals and communities begins with the developmental foundations laid in the family [1, 2]
Confirmatory Factor Analysis confirmatory factor analysis (CFA) confirmed the results found in the Exploratory factor analysis (EFA)
The findings suggest that the long-form and short-form versions of the Family Health Scale (FHS) were reliable and valid in a sample that represented a variety of family types and socioeconomic statuses that were generally representative of the U.S population
Summary
The health of individuals and communities begins with the developmental foundations laid in the family [1, 2]. The individuals comprising families as well as external environments (e.g., neighborhood, community, society, policy, and law) influence family health routines, norms, and family health [3]. 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]. Health routines and norms are developed as family members share their understandings, opinions, and behaviors about health and healthcare, which. Families are an unparalleled influence and resource for maintaining health and preventing disease because members may support and nurture one another through the various life stages in ways that no other system can [5, 6]. The economic value of the care that families provide across the life course is far greater than that provided by the medical system [7, 8]
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