A Direct Observational Measure of Family Functioning for a Low-Resource Setting: Adaptation and Feasibility in a Kenyan Sample☆,☆☆
Section snippets
Setting
Study activities were conducted in peri-urban communities outside of Eldoret, Kenya. Eldoret is the third largest town in Kenya and is located on a main transportation route that runs from a costal port through Nairobi and into Uganda. The town lies within the Rift Valley and is home to multiple ethnic groups including Kalenjin, Luhya, Kikuyu, and Luo populations.
Participants
Participants included families with at least one caregiver over age 18 and at least one child between the ages of 10 and 17. We used
Context-Specific Qualitative Findings
Interview, FGD, and video-recorded role-play data resulted in context-specific indicators of family functioning. Core themes included the importance of structure and hierarchies; communication, emotional trust and respect; problem solving and planning, particularly regarding managing finances in the face of poverty; gendered family processes; and risks of discrimination and favoritism. Related to behaviors likely to emerge in direct observation, the strong emphasis on hierarchy and boundaries
Discussion
Through a multistep process, we adapted an observational measure of family functioning that proved feasible and acceptable to administer and rate in a low-resource context. Results yielded a direct observational tool for assessing family functioning that could be adapted across other low-resource settings. FAMPROS was chosen as the anchoring measure for adaptation and was initially modified based on context-specific family interaction data. Through iterative pilot testing, collaborative
Conflict of Interest Statement
The authors declare that there are no conflicts of interest.
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We wish to thank the team of enumerators and coders who administered and rated activities and family interactions, as well as all the families who participated. Dr. Kaiser was supported by an NRSA postdoctoral fellowship from the National Institute of Mental Health (MH113288). Drs. Puffer and Kaiser are fellows of the Implementation Research Institute.
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Funding: This work was supported by the Duke Global Health Institute.