Testing the psychometric quality of screening tools for the well-being of children and caregivers in alternative care-settings: a multi-informant study with families in Tanzania

ABSTRACT

Given the lack of validated screening tools for the well-being of children and caregivers in family-based care in low-income settings, the present study aimed to test the psychometric quality of two newly developed tools: Scorecard A as a screener for children’s emotional and behavioral problems and Scorecard B as a screener for caregivers’ well-being and resources. The study was conducted within the framework of an ongoing caregiver training program in Dar es Salaam, Tanzania, and included a sample of 124 caregivers and 99 children (57 girls, M_age = 9.30, SD = 4.65, range 3–17) divided in three equally sized age groups of preschool (3 to 5 years), primary school (6 to 12 years) and secondary school age (13 to 17 years). Caregivers reported on children’s emotional and behavioral problems using Scorecard A and the Strengths and Difficulties Questionnaire (SDQ) administered as a structured interview. A sub-sample (n = 78) of caregivers participated in another structured interview on various aspects of their well-being and caregiving resources, based on which interviewers rated Scorecard B. Additionally, caregivers completed Scorecard B and measures of their well-being and resources administered as self-report questionnaires. All assessments were conducted twice with an interval of 1 week. Scorecard A showed good internal consistency and test-retest-reliability across age groups and significant associations with the SDQ total score and subscales indicate convergent validity, particularly among preschool-aged children. The internal consistency of Scorecard B was acceptable in the questionnaire and good in the interviewer rating, while re-test-reliability in both modes and inter-rater reliability between interviewer and caregiver rating were moderate. Associations with established measures of well-being and resources provided evidence for convergent validity of Scorecard B. The Scorecards hold promise as brief screening tools to identify children and caregivers with difficulties and evaluate intervention programs in low-resource contexts.

KEYWORDS:

• Orphans
• caregivers
• Africa
• well-being
• screening
• reliability
• validity

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Danida [The Civil Society Fund].

Notes on contributors

Tobias Hecker

Tobias Hecker is an Assistant Professor of Clinical Psychology and Developmental Psychopathology at the Department of Psychology and at the Institute for Interdisciplinary Conflict and Violence Research at Bielefeld University, Germany. His research focuses on the consequences and prevention of violence and maltreatment of children. One focus of his research is on particularly on children in alternative care settings.

Getrude Mkinga

Getrude Mkinga is a PhD student at the Department of Psychology and the Institute for Interdisciplinary Conflict and Violence Research at Bielefeld University, Germany. Her research focuses on prevention of maltreatment by parents and caregivers to children and early childhood adversities to promote good mental health, academic and economic success in later life.

Katharina Hach

Katharina Hach has recently completed her master’s degree in psychology at Bielefeld University, Germany, with a focus on clinical psychology. She has now started her psychotherapy training in cognitive behavioral therapy.

Ronald Ssentuuwa

Ronald Ssentuuwa is a Regional Programme Development Advisor Alternative Care with SOS Children Villages International in East and Southern Africa Office in Addis Ababa, Ethiopia. He focuses on designing and implementing interventions to ensure children in need of care and protection receive quality care to realize their fullest potential.

Maregesi Machumu

Maregesi Machumu is a child development specialist at the Department of Educational Psychology and Curriculum Studies at Dar es Salaam University College of Education, Tanzania. His research focuses on linking children’s play and learning and the consequences and prevention of violence and maltreatment of children.

Niels Peter Rygaard

Niels Peter Rygaard is a Danish clinical psychologist. He is co-founder and CEO of www.fairstartfoundation.com, recipient of the 2020 American Psychologist Association Award for International Humanitarian Work for Underserved Populations. His focus is on transforming child-at-risk research into online educations and trainings with global partners.

Lene Godiksen

Lene Godiksen has extensive work experience from East Africa with social protection, alternative care, and children’s rights. She holds an MA in Children’s Rights from the University of Geneva and is Senior Program Manager in SOS Children’s Villages Denmark.

Florian Scharpf

Florian Scharpf is a post-doctoral researcher at the Department of Psychology and at the Institute for Interdisciplinary Conflict and Violence Research at Bielefeld University, Germany. His research focuses on understanding risk and protective factors for the mental health and well-being of children and adolescents exposed to adversity including community and family violence.