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Development and Validation of the Pediatric Well-Being Picture Scale© Using a Mixed-Methods Research Design
Judith Quaranta1, Rosa Darling1, Mei-Hsiu Chen2
1Decker College of Nursing and Health Sciences, Binghamton University, Binghamton, NY 13902, USA.
Insights
This study developed the Pediatric Well-Being Picture Scale© (PWBPS©), a new tool for assessing child well-being. The PWBPS© is a valid and reliable picture-based scale for early identification and intervention in children aged 8-11.
Area of Science:
- Pediatric Psychology
- Mental Health Screening
- Child Development
Background:
- Decreased well-being in children can precede mental health issues.
- Child mental health visits rose significantly during the COVID-19 pandemic.
- Early identification and intervention are crucial for preventing mental health decline in children.
Purpose of the Study:
- To develop the Pediatric Well-Being Picture Scale© (PWBPS©), the first picture-based screening tool for children aged 8-11.
- To create an accessible tool for children regardless of literacy, language, or developmental levels.
- To enable quick screening for early referral and intervention in pediatric well-being.
Main Methods:
- Mixed-methods research design incorporating focus groups and interviews.
- Content and face validity, test/retest reliability, and convergent validity were assessed.
- Exploratory factor analysis was conducted on data from public elementary school students.
Main Results:
- A 10-item, 3-point picture-based Likert scale (PWBPS©) was developed.
- Strong test/retest reliability (ICC = 0.823) and Cronbach's alpha (up to 0.89) were found.
- Convergent validity was confirmed with a significant correlation (Spearman's = 0.64) to the KIDSCREEN-10 scale.
Conclusions:
- The Pediatric Well-Being Picture Scale© (PWBPS©) is a valid and reliable screening tool.
- The PWBPS© facilitates quick and accurate assessments of children's well-being.
- Early intervention, supported by tools like the PWBPS©, is vital for mitigating negative mental well-being effects.
Abstract:
Background/Objectives: Decreased well-being may be a precursor to mental health challenges. Mental health visits for 5-11-year-old children increased by 24% from 2019 to 2020. COVID-19 led to record high levels of anxiety and depression in young children. This highlights the need for early identification and intervention of decreased well-being to prevent progression to potential mental health issues. The purpose of our research was to develop the Pediatric Well-Being Picture Scale© (PWBPS©), the first picture-based screening tool for ages 8-11 years, accessible to children regardless of their literacy, language skill, and developmental levels, allowing for quick screening for early referral and intervention. Methods: The mixed-methods research design included focus groups and one-on-one interviews for content and face validity, test/retest reliability, convergent validity, and exploratory factor analysis. Subjects were recruited from public elementary schools. Results: The numbers of participating subjects were as follows: N = 17 for focus groups; N = 12 for one-on-one interviews; N = 50 for test/retest reliability; and N = 237 for convergent validity. Thematic analysis resulted in a 10-item, 3-point picture-based Likert scale. The test/retest reliability demonstrated strong correlations, with an ICC of 0.823 (95% CI [0.690, 0.905]). The Cronbach's alpha for all the administrations was 0.74, 0.74, 0.84, and 0.89. The convergent validity demonstrated correlation with the validated KIDSCREEN-10. The Spearman's correlation was 0.64 (95% CI as [0.55, 0.71]). The cutoff for the PWBPS© was 18.5, which correlated to a score of 22 on the KIDSCREEN-10. All the items loaded on one component. Conclusions: These findings demonstrate that the PWBPS© is valid and reliable, allowing for quick and accurate assessments of children's well-being and allowing for early intervention, which is key to reducing the negative effects of poor mental well-being.
