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.