Validating a Trauma-Focused Family Functioning Assessment for Caregivers of Children with Behavioral Challenges: A Mixed-Methods Research

Background:
African American mothers raising sons with behavioral challenges often navigate intersecting stressors, including racialized stress, community adversity, and personal trauma. These cumulative burdens can heighten caregiver distress, disrupt family functioning, and exacerbate children’s behavioral difficulties. Although existing family assessment tools offer useful frameworks, they rarely incorporate caregiver trauma, cultural context, or the unique socio structural stressors affecting African American families. A culturally grounded, trauma‑informed family assessment tool is needed to more accurately capture caregiver experiences and guide effective intervention. This three‑phase study aims to develop, refine, and psychometrically validate the Trauma‑Focused Family Assessment Tool for African American mothers raising sons with behavioral challenges. The project includes (1) qualitative exploration of caregiver experiences, (2) instrument development and content/face validity evaluation, and (3) psychometric testing to establish reliability and construct validity.

Methods:
An exploratory sequential mixed‑methods design guided instrument development.
Phase 1 (Qualitative): A focus group with African American mothers (n=20) was conducted using purposive sampling at a community behavioral health organization. Eligible participants identified as African American, were primary caregivers of a boy aged 5–18 receiving behavioral health services, and were age 18 or older. Data were collected on March 25, 2025, using a semi‑structured guide and analyzed through reflexive thematic analysis supported by independent coding, consensus meetings, analytic memos, and an audit trail.

Phase 2 (Development & Validation): A thematic synthesis of literature (2005–2025) across PsycINFO, PubMed, and ERIC informed item generation, supplemented by foundational tools (Family APGAR, McMaster FAD). Clinicians and psychometric experts (n=15) evaluated item clarity and relevance using a 4‑point scale to calculate item‑level content validity indices (I‑CVI). Items scoring below 0.80 were revised or removed. Five experts participated in structured interviews to assess face validity, usability, and cultural responsiveness. The refined tool demonstrated strong validity (mean CVI = 0.85) and improved clarity, enhancing its practical application in community behavioral health settings.

Phase 3 (Psychometric Testing): The final phase, currently in progress, will evaluate the tool’s reliability and construct validity. Approximately 30 families will complete the instrument, allowing assessment of internal consistency, test–retest reliability, and preliminary factor structure. Analyses will include Cronbach’s alpha, intraclass correlation coefficients, and exploratory factor analysis to determine domain coherence and dimensionality.

Results:
The study is supported internally by GRO Community (2025–2026). Qualitative data collection was completed in March 2025, with analysis finalized in August 2025. Quantitative content‑validity data were collected from September 11 to October 21, 2025, and analyzed in December 2025. Expert review yielded 87 initial items, with 73 retained following content and face validity evaluation. Domain‑level CVIs ranged from 0.78 to 0.90, indicating strong relevance and clarity. Psychometric testing is scheduled to begin in March 2026, with final results expected later in 2026.

Conclusion:
The Trauma‑Focused Family Assessment Tool demonstrates strong content and face validity and reflects the lived experiences, cultural context, and trauma‑related needs of African American mothers raising sons with behavioral challenges. Ongoing psychometric testing will establish reliability and construct validity, supporting the tool’s potential as a culturally responsive framework for assessing caregiver well‑being and family functioning in clinical and community settings.