CCIH, 25 May 2009
Measuring Child Wellbeing:A self report measure from a child perspective
Adele ClarkCatholic Relief Services
CCIH, 25 May 2009
OVC Wellbeing Tool
• Why this matters
• Tool Development
• Current Status• How to Use• Feedback from
Children• Next Steps• Hands-on
CCIH, 25 May 2009
Why this matters
• Child participation• Ensuring children
have a voice in monitoring their wellbeing
• Empowering children
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Background• HIV Global Technical Team
Meeting November 2006
• Need for a comprehensive measure of OVC wellbeing
• Goal: create an instrument which can be used internationally to monitor holistic OVC programming from a child’s perspective that is valid, reliable and practical to administer.
Tool Development: Background
CCIH, 25 May 2009
Guiding Principles
• Capture wellbeing from the child’s perspective
• A valid and reliable measure of wellbeing
• Age-appropriate• Applicable to
multiple settings• Ease of use• Repeated measure
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• Literature Review
• Expert Statements
• Judging
• Draft tool created
• Piloting: five countries
• Analysis
Tool Development: Methodology
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The Tool
• Self-Report Measure• Originally 48 Questions• Likert Scale• Used for Children Aged 13-18
• 10 Domains of Wellbeing – Nutrition and food security – Shelter and environment – Protection – Family – Health
– Spirituality – Mental health – Education – Economic – Community cohesion
CCIH, 25 May 2009
Tool Development: Results
• 890 OVC • Compared OWT:
– Larger evaluation – Children’s Hope
Scale
1Snyder et al (1997). The Development and Validation of the Children’s Hope Scale. Journal of Pediatric Psychiatry 22(3), 399-421.
CCIH, 25 May 2009
Current Status
• OWT now finalized– Reduced number of
items in the tool from 48 to 36 items
• End Result: A valid, practical SELF REPORT tool to measure OVC wellbeing now exists.
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Current Status
• The OWT has been used in Ethiopia, Haiti, India, Kenya, Malawi, Rwanda, Tanzania, Vietnam, and Zambia.
• Translations are available on the OWT website.
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How the OWT information should be used
• To monitor OVC programs at an aggregate level to identify patterns of change in OVC wellbeing within projects. – Weaker domains should be explored – Strengths identified
• NOT an in-depth assessment tool at the individual level!– However, rapid scoring can highlight
need for follow-up and more in-depth assessment with children who report significant problems.
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Informed Consent
• REQUIRED!!!
• Must consult the child for consent.
• Need to train field staff on what this means: consultants, enumerators, etc.
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Translation
• Need accurate translation– Abstract concepts– Literal translation will
not work!
• Translate, then back translate
• Field test• Modify
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Administration
• Appropriate training for enumerators– Practice sessions for them– They must understand all the
items’ original intent!– Need to know how to respond– PLUS all the basics
(nonverbal responses, etc.)
• Takes 20-25 minutes oral • Self administration still
under study
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Scoring
• Enter into database (syntax available)• Option: field scoring
• Caution: Risk of over-interpretation.• General:
– Desirable scores: >25 (rare, especially at baseline)
– Average scores around 23 at baseline– Over time, expect this to increase– Special attention needed < 22, especially
as project progresses (look at individual domain scores and changes over time)
– <15 should be followed up immediately (error in response or an immediate problem?)
CCIH, 25 May 2009
Strengths and Challenges
• Strengths:– Child’s perspective– Holistic– Universal tool – Age appropriate– Rapid– Low cost
• Challenges:– Universal tool– Translation accuracy– Eliciting information from children on
sensitive subjects
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Feedback from the Children
• Initial feedback was critical in the adaptation of the tool (e.g. questions eliminated based on their feedback)
• Currently=Enthusiastic• Have said they are
pleased to be able to give their opinion on matters relating to them
• No reported problems understanding the questions on the OWT
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Next Steps
• Roll out in other countries
• Continue data analysis to determine predictive value of OWT
• Develop a similar tool for younger age groups
• Comparison study of self report data to other reports (work with Child Status Index)
• Mobile technology
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Take Home Points
• Important to consult OVC when Important to consult OVC when assessing their wellbeingassessing their wellbeing
• Participatory assessment and feedbackParticipatory assessment and feedback• Learning from what the children sayLearning from what the children say
CCIH, 25 May 2009
Thank you
Contact:
Adele Clark
Catholic Relief Services
Tool developed by a team of staff, led by Shannon Senefeld, Susan Strasser, and James Campbell.
Please note that the photographs in this publication are used for illustrative purposes only; they do not imply any particular health status (such as HIV or AIDS) on the part of the person who appears in the photograph.