Evaluation of Family-Centered Participation-Based Assessments: Content Validity and Clinical Utility

PURPOSE: Understanding family and caregiver needs is an essential component for providing effective family-centered care (Nickel, Weinberger, & Guze, 2018). Evidence on the effectiveness of different standard measures in capturing the needs of families is emerging. The purpose of this study was to determine the content validity and clinical utility of seven measures, based on the judgment of practitioners.

DESIGN: 63 occupational therapists and eight speech and language pathologists in supervisory positions were recruited for this quasi-experimental study. Of these, 49 participants practiced in educational settings, and 22 in outpatient or clinic settings. Overall, participants were practicing in pediatrics between 2-33 years (Mean= 16 years, SD= 9.25).

METHOD: Seven standardized family-centered measures were selected for evaluation: Measure of Processes of Care; Canadian Occupational Therapy Measure; Looking into Family Experiences (Family L.I.F.E); Parent Empowerment and Efficacy Measure; Parent Daily Hassel Questionnaire; and Life Participation for Parents. Participants rated the measures using a scale developed for this study. The scale included a rating from 0 (not at all) to 5 (very high) of four items describing each measure’s content validity related to family-centered constructs and four items focused on the clinical utility of the measure to the respondent’s practice settings. Data were analyzed using the Content Validity Index (CVI; Polit & Beck, 2006). ANCOVA was used to determine differences in clinical utility ratings according to the practice setting, with years of practice as a covariate. Pearson’s r was used to test correlations between content validity and clinical utility ratings for each measure.

FINDINGS: A wide range of CVI scores between raters suggests high diversity in the way that participants interpreted the content validity of the measures. ANCOVA test revealed non-significant differences in clinical utility ratings between the different practice setting. Significant relationships between content validity and clinical utility were found for all assessments suggesting that when an assessment was considered as conceptually relevant it was also rated as more clinically useful. Measures developed by occupational therapy researchers were perceived as more useful than those developed in other professions.

CONCLUSIONS: All the measures evaluated in this study were found beneficial for gaining a better understanding of family needs to support meaningful pediatric interventions. However, findings show wide variability in the way that practitioner perceive measures in terms of their family-centeredness and their clinical utility. Practitioners should be encouraged to use clinical reasoning when selecting formal measures. The questions which guided the knowledge translation and clinical reasoning of the providers regarding the relevance and usefulness of measures will be presented.

IMPACT STATEMENT: This proposal promotes the use of standardized measures to assess the needs of families and caregivers by presenting seven valid and clinically useful measures and providing guidelines for clinical reasoning in family-centered evaluations.

References

Nickel, W. K., Weinberger, S. E., & Guze, P. A. (2018). Principles for patient and family partnership in care: an American College of Physicians position paper. Annals of internal medicine, 169(11), 796-799. DOI: 10.7326/M18-0018

Polit, D. F., & Beck, C. T. (2006). The content validity index: are you sure you know what’s being reported? Critique and recommendations. Research in nursing & health, 29(5), 489-497. DOI: 10.1002/nur.20147