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Published on: April 23, 2014
Translation, Cultural Adaptation, and Psychometric Validation of the McMaster Family Assessment Device's General
Halimatou Alaofè1, Raymond Yurika1, Abidemi Okechukwu1
1The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA.
Background:
Family functioning plays a critical role in diabetes self-management and glycemic control, yet validated tools for assessing family dynamics in Francophone African contexts remain limited. This study aimed to translate, culturally adapt, and psychometrically validate the French version of the Family Assessment Device-General Functioning Subscale (FAD-GF12) among adults with type 2 diabetes (T2D) in Benin.
Methods:
A cross-sectional psychometric validation study was conducted among 512 adults with T2D recruited from six healthcare centers. Translation and cultural adaptation followed established guidelines, incorporating expert review and participant feedback. The sample was randomly split for exploratory factor analysis (EFA; n = 256) and confirmatory factor analysis (CFA; n = 256). Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICCs). Construct validity was examined using linear regression (continuous hemoglobin A1C-HbA1C) and logistic regression (HbA1c ≤7%) models.
Results:
The French FAD-GF12 demonstrated good internal consistency (α = 0.85) and satisfactory test-retest reliability (ICC > 0.75). EFA and CFA supported a two-factor structure distinguishing positive and negative family functioning, with good model fit (comparative fit index [CFI] = 0.94, Tucker-Lewis index [TLI] = 0.92, root mean square error of approximation [RMSEA] = 0.06, standardized root mean square residual [SRMR] = 0.04). The two factors were moderately correlated (r = 0.58), indicating related but distinct constructs. Better family functioning was significantly associated with lower HbA1c levels (β = -0.35, p = 0.003) and higher odds of good glycemic control (AOR = 2.04; 95% CI: 1.27-3.27; p = 0.004).
Conclusions:
The French FAD-GF12 is a reliable, valid, and culturally appropriate tool for assessing family functioning among adults with T2D in Benin. Its demonstrated association with glycemic control highlights the importance of integrating family-centered approaches into diabetes care in Francophone African settings.
