What is Child Well-being?: Does It Matter How We Measure It? Presented to the National Council on Family Relations Annual Conference, San Antonio, Texas November 7, 2013 1
Child well-being represents the whole child: Physical health, development, and safety Psychological and emotional development Social development and behavior Cognitive development and educational achievement 3
Physical health, development and safety 4 Safety and physical status Connections Commitment to learning Social competencies Character Personal life Cognitive development and educational achievement Positive Values Positive identity Social Healthy Diet Competence Educational/ intellectual Functioning in socially heterogenous groups Physical development Empathy Suicide Confidence Civic life Psychological/emotional development Contribution Intellectual development Behavior Problems Social development and behavior School Engagement Depression
Child well-being includes 5
Child well-being needs to be assessed across ages (An outcome at one stage of childhood is generally an input at the next stage of development.) 0-5 Yrs 6-11Yrs 12-17 Yrs 18-24 + Yrs 6
Child well-being is an outcome, not an input INPUTS OUTCOMES 7
Inputs Poverty Health Coverage Schools Food Security After-school programs Child Outcomes Education Health Behavior Socio-emotional 8
Child well-being is positive as well as negative 0 9 9
What does the public hear about kids? Morbidity Violence 10
Bad outcomes do matter Negative development is important (bad is stronger than good) 11
But, good outcomes matter too 12
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. 13
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence It s good science 14
Positive indicators, such as parent/adolescent relationships, are related to better child development 1.2 1.2 1 0.8 1 0.7 1 0.8 1 0.57 0.6 0.6 0.4 0.4 0.2 0.2 0 Becoming Sexually Active Becoming Sexually Active 0 Being Behind in in School Not a Positive Relationship w/mother Has a Positive Relationship w/mother 15
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence Good science Necessary to fully describe children and youth 16
Physical Health, Development, and Safety Positive Exercise Healthy eating habits Safety habits (seat belt, helmet) Negative Illness Obesity Injury 17
Psychological & Emotional Development Positive Life Satisfaction Hope Empathy Negative Depression Low Self-Esteem Suicidal Thoughts 18
Social Development & Behavior Positive Civic engagement Volunteering Environmental Stewardship Negative Drinking Drug use Gang Involvement 19
Cognitive Development & Educational Achievement Positive Educational engagement Curiosity Critical thinking Negative Dropout Truancy Expulsion 20
Relationships Positive Positive relationship with parents Positive sibling relationships Positive friendships Negative Conflict Violence Arguments 21
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence Good science Necessary to fully describe children and youth Can be measured well 22
Criticism that they are soft, squishy or gluey is not warranted Soft Squishy Gluey 23
Flourishing Families Project Funded by the John Templeton Foundation Developed and tested items Conducted a national survey Did psychometric analyses 24
Example of Constructs: Flourishing Children Constructs Relationship Skills Empathy Social Competence Flourishing in Relationships Positive relationships with parents Positive friendships with peers Flourishing in School and Work Diligence & Reliability Educational Engagement Initiative Taking Thrift Trustworthiness & Integrity Helping Others to Flourish Altruism Generosity Environmental Stewardship Environmental Stewardship Personal Flourishing Forgiveness Goal Orientation Gratitude Hope Life satisfaction Purpose Spirituality 25
Positive indicators can be measured well Strengths are more prevalent than deficits, so specificity in measurement is needed Positive bias in reporting of positive behaviors, which requires detailed response categories Use concrete items In scales, combine negative with positive items Develop items that work across subgroups 26
Overview of psychometric analyses Examined distributions of each item Assessed Cronbach s alpha (internal consistency) Conducted confirmatory factor analyses o Adolescents o Parents o Jointly o Criteria: CFI (>.95) TLI (>.95) RMSEA (<.085) Examined concurrent validity 27
Concurrent Validity Social behavior: Fighting o During the past 12 months, how many times were you in a physical fight? Health behavior: Smoking o During the past 30 days, on how many days did you smoke cigarettes? Emotional outcome: Depressive Symptoms o During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities? Cognitive outcome: Grades (parent report) o Now I would like to ask you about [his/her] grades during the LAST school year. Overall, across all subjects ([he/she] takes at school), did [he/she] get... Mostly A s; Mostly B s; Mostly C s; Mostly D s and lower; [His/her] school does not give these grades Examined in multivariate analyses 28
Constructs Relationship Skills Empathy Social Competence Flourishing in Relationships Positive relationships with parents Positive friendships with peers Flourishing in School and Work Diligence & Reliability Educational Engagement Initiative Taking Thrift Trustworthiness & Integrity Helping Others to Flourish Altruism Generosity Environmental Stewardship Environmental Stewardship Personal Flourishing Forgiveness Goal Orientation Gratitude Hope Life satisfaction Purpose Spirituality 29
Social Competence (Adolescent) Please indicate how much these statements describe you. (Not at all like me-exactly like me) I avoid making other kids look bad. If two of my friends are fighting, I find a way to work things out. When I work in school groups, I do my fair share. Please indicate how often this happens. How often (None of the time-all of the time) do you get along well with people of different races, cultures, and religions? do you listen to other students ideas? do you control your anger when you have a disagreement with a friend? can you discuss a problem with a friend without making things worse? do you follow the rules when you are at a park, theater, or sports event? do you respect other points of view, even if you disagree? Alpha=0.79 CFI= 0.986 TLI= 0.981 RMSEA= 0.042 30
Social Competence (Parent) Please indicate how much these statements describe your child. (Not at all like my child-exactly like my child) My child avoids making other kids look bad. How often (None of the time-all of the time) does your child get along well with people of different races, cultures, and religions? Alpha=0.62 CFI= 0.983 TLI=0.971 RMSEA=0.040 If two of my child's friends are fighting, my child finds a way to work things out. does your child follow the rules at a park, theater, or sports event? When my child works in groups, he/she does his/her fair share. does your child respect other people s point of view, even if he/she disagrees? 31
Quartile 1 Quartile 2 Quartile 3 Quartile 4 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Social Competence Fighting Smoking Depression (teen report) Grades Social Competence -0.14*** -0.28*** -0.10** 0.12*** Fighting Smoking Depression Grades 40 14 25 80 35 30 12 10 20 70 60 25 20 15 10 5 % who get in fights 8 6 4 2 % who smoke 15 10 5 % who exhibit signs of depressio n 50 40 30 20 10 % who earn As 0 0 0 0 32
Generosity (Adolescents) Please indicate how much these statements describe you. (Not at all like me-exactly like me) I enjoy sharing my things with others. Alpha=0.74 CFI=0.997 TLI=0.994 RMSEA=0.045 I do nice things for others without being asked. When I help out a friend, I expect something in return. If needed, I am willing to help my family by buying fewer things for myself. If needed, I am willing to help my family by giving up activities and trips that cost money. If needed, I am willing to help my family by giving up my free time to help around the house. 33
Generosity (Parents) Please indicate how much these statements describe your child. (Not at all like my child-exactly like my child) My child enjoys sharing his/her things with others. My child does nice things for others without being asked. (Strongly agree- Strongly disagree) Alpha=0.79 CFI=0.997 TLI=0.994 RMSEA=0.065 When my child helps out a friend, he/she expects something in return. If needed, my child is willing to help our family by buying fewer things for himself/herself. If needed, my child is willing to help our family by giving up activities and trips that cost money. If needed, my child is willing to help our family by giving up his/her free time to help around the house. 34
Quartile 1 Quartile 2 Quartile 3 Quartile 4 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Quartile 1 Quartile 2 Quartile 3 Quartile 4 Generosity Fighting Smoking Depression (teen report) Grades Generosity -0.07** -0.17*** -0.07* 0.05*** Fighting Smoking Depression Grades 30 14 25 60 25 12 20 50 20 10 8 15 40 15 10 % who get in fights 6 4 % who smoke 10 % who exhibit signs of depression 30 20 % who earn As 5 2 5 10 0 0 0 0 35
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence Good science Necessary to fully describe children and youth Can be measured well Public Perceptions 36
The public sees teenagers as American families are DUMB RUDE FALLING APART 37
In fact, most children are doing well 100% Children Ages 6-11 & 12-17 with 0-4 domains of Positive Well- Being: Health, Education, Behavior & Socio-emotional 90% 80% 31 23 70% 60% 50% 40% 30% 20% 10% 0% 25 25 21 19 19 15 9 13 Age 6-11 Age 12-17 Four Three Two One Zero 38
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence Good science Necessary to fully describe children and youth Can be measured well Public Perceptions Kids Perceptions 39
Program recruitment and retention represent an ongoing challenge 40
Positive youth development Programs that help youth build assets and work toward positive outcomes are an effective approach (more than negative didactic or shock approaches) 41
7 Reasons Why We Need to Focus on the Positive The Declaration of Independence Good science Necessary to fully describe children and youth Can be measured well Public Perceptions Kids Perceptions Community Perceptions 42
Community perceptions Members of a community don t want to be told they and their children are just problems Also, policies and programs need to know and build on community, family and youth strengths and assets 43
In sum, child well-being Represents the whole child Includes well-being and well-becoming Needs to be assessed across ages Is an outcome and needs to be distinguished from an input Is positive, as well as negative The Declaration of Independence Good science Necessary to fully describe children and youth Can be measured well Public Perceptions Kids Perceptions Community Perceptions 44
5 Reasons Why Rigorous, Accurate Measures of Child Well-being are Needed Complete and accurate measures are needed to inform policy makers and the public about trends 45
Rate per 100,000 Firearm Deaths 50 40 Rates (per 100,000) for Homicide, Suicide, and Firearm-Related Deaths of Youth Ages 15-19, Selected Years 1970-2010 Homicide Suicide Firearm Related Death 30 23.3 24.5 20 10 14.7 10.5 11.4 8.1 5.9 8.5 16.9 18.1 11.1 10.5 12.1 8.0 8.2 13.2 6.9 10.6 8.3 7.5 0 46
Child Abductions Report Missing Children Ages 0-17 in 1999: Family vs. Non- Family Abductions 12,100 (18%) 56,500 (82%) Non-family Family 47
Percent Volunteering 50 % of Students in Grades 8, 10, and 12 Who Volunteer 1 At Least Once a Month, 1991-2011 Eighth Grade Twelfth Grade 40 31.8 34.6 31.6 34.1 34.8 34.9 30 27.4 28.7 25.8 27.9 28.2 23.7 25.5 26.5 20 10 48 0 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011
5 Reasons Why Rigorous, Accurate Measures of Child Well-being are Needed Complete and accurate measures are needed to inform policy makers and the public about trends To identify negative trends and target populations at risk 49
Percent Obesity 25 % of Children Ages 2 19 Who Are Obese, By Age: Selected Years 1971-2010 20 16 20 18 17 18 18 15 10 5 6 5 7 5 11 10 12 10 12 Ages 2-5 Ages 6-11 Ages 12-19 0 50
Obesity % of Children Ages 2 19 Who Are Obese, By Age: Selected Years 1971-2010 males females 51
Rate per 1,000 females ages 15-19 Teen births 140.0 Birth Rates (per 1,000) for Females Ages 15 to 19, by Race and Hispanic Origin, Selected Years, 1960-2011 120.0 Total Non-Hispanic white 118.2 Non-Hispanic black 111.9 100.0 89.1 Hispanic 100.8 104.6 80.0 77.4 68.3 61.8 60.0 40.0 39.9 43.4 59.4 41.9 27.2 49.6 47.3 31.3 20.0 21.7 0.0 1957 1961 1965 1969 1973 1977 1981 1985 1989 1993 1997 2001 2005 2009 52
5 Reasons Why Rigorous, Accurate Measures of Child Well-being are Needed Complete and accurate measures are needed to inform policy makers and the public about trends To identify negative trends and target populations at risk To monitor progress 53
Percent Breast feeding 100 90 Percentage of Mothers Breastfeeding, by Birth Year of Infant, 2000-2010*, and Healthy People 2010 Goals Ever Breastfed (goal: 75%) Breastfed at 6 months (goal: 50%) 80 70 71 72 71 73 73 74 74 75 75 77 76.5 60 50 40 34 37 38 39 42 43 44 44 44 48 49 30 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010* 54
5 Reasons Why Rigorous, Accurate Measures of Child Well-being are Needed Complete and accurate measures are needed to inform policy makers and the public about trends To identify negative trends and target populations at risk To monitor progress To build the knowledge base 55
To build the knowledge base Valid, reliable, and comparable measures of child well-being are needed across disciplines and methods, for: Indicators Surveys used for research Evaluation studies, and Performance management 56
To build the knowledge base Targeting Collect Data on Performance & Outcome Measures Conduct Needs Assessment Identify Your Population Select Intervention, Develop Logic Model & Theory of Change, Indicators Implement Program/Approach & Conduct Ongoing Performance Management Conduct an Implementation Evaluation Conduct a Quasi-Experimental Outcomes Evaluation Conduct a Randomized-Controlled Impact Evaluation 57 57
5 Reasons Why Rigorous, Accurate Measures of Child Well-being are Needed Complete and accurate measures are needed to inform policy makers and the public about trends To identify negative trends and target populations at risk To monitor progress To build the knowledge base To inform the public, policymakers, and the press about the status of children Child well-being should be a leading indicator Clear, accurate, and simple measures of child wellbeing 58
Leading indicators Standard & Poor s (S&P) 500 Gross domestic product (GDP) Unemployment rate Inflation rate Housing starts What should be the leading child well-being indicators? An index of child well-being? 59
But indices are worrisome Indices often combine independent and dependent variables Indices often do not cover all domains, especially socio-emotional well-being Coverage of domains is often incomplete Indices often obscure countervailing trends 60
Obesity 25 % of Children Ages 6 11 Who Are Obese: 1971-2010 20 16 17 20 18 15 11 10 7 5 5 0 1971-1974 1976-1980 1988-1994 1999-2002 2003-2006 2007-2008 2009-2010 61
Teen Births 100 Birth Rates (per 1,000) for Females Ages 15 to 19, 1960-2011 90 89.1 80 70 60 50 40 68.3 53 50.2 59.9 61.8 47.7 45 42.6 41.1 40.5 39.7 41.1 41.5 40.2 37.9 34.2 31.3 30 20 10 0 1960 1970 1980 1986 1990 1991 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 62
What gets measured gets done Policy makers do track trends They don t read academic journal articles State and local data are of particular interest to policy makers 63
National Survey of Children s Health (NSCH) Developed to provide indicator data for U.S. children <18 for the nation and each state Telephone interviews with the most knowledgeable parent Primary focus on health, but includes information on a range of child well-being constructs and on the contexts in which children grow up Data on more than 90,000 children from 2007 (data for 2011-12 are now available) 64
Micro Data Indices Children s circumstances can be described for each individual child, across multiple developmental domains, and then aggregated Different than macro indices, which are built from data that have already been aggregated 65
NSCH Index Domains Physical health, development, and safety Psychological and emotional development Social development and behavior Cognitive development and educational achievement Overall Well-Being 66
Physical Health, Development, and Safety Health status Chronic health conditions Health risk behaviors Health promoting behaviors 67 6
Psychological and Emotional Development Internalizing problems Externalizing problems Self-esteem, self-concept Coping skills 68
Cognitive Development & Educational Achievement School problems Learning difficulties Cognitive development Achievement 69
Social Development & Behavior Parent-child relationship Activity engagement Positive social behaviors Negative social behaviors 70
An Example: Social Development & Behavior Parent-child relationship Communication Activity engagement Sports; clubs; organized events Volunteer, service work Positive social behaviors Respect for teacher, neighbors Gets along with other children Tries to understand feelings Tries to resolve conflicts Negative social behaviors Negative behavior problems 71
Whole Child Indices (4 Domains) Physical Health, Development & Safety 58% Psychological and Emotional Development 65% Social Development & Behavior 67% Cognitive Development & Educational Achievement 65% All Child Well-Being Domains 31% 72
Child Well-Being for 6-11 Year Olds, by State Physical Health, Development, and Safety 64.5%-71.7% 59.9%-64.4% 56.4%-59.8% 46.8%-56.3% 73
Child Well-Being for 6-11 Year Olds, by State Psychological and Emotional Development 69.4%-76.1% 66.3%-69.3% 62.7%-66.2% 50.0%-62.6% 74
Child Well-Being for 6-11 Year Olds, by State Social Development & Behavior 72.0%-76.1% 70.3%-71.9% 65.9%-70.2% 56.9%-65.8% 75
Child Well-Being for 6-11 Year Olds, by State Cognitive Development and Educational Achievement 73.2%-79.6% 67.5%-73.1% 62.6%-67.4% 47.3%-62.5% 76
In sum 7 Reasons We Need to Focus on the Positive: 1. The Declaration of Independence 2. Good science 3. Necessary to fully describe children and youth 4. Can be measured well 5. Public Perceptions 6. Kids Perceptions 7. Community Perceptions 5 Reasons Why Rigorous, Accurate Measures of Child Well-being are Needed: Complete and accurate measures are needed to inform policy makers and the public about trends To identify negative trends and target populations at risk To monitor progress To build the knowledge base To inform the public, policymakers, and the press about the status of children Child well-being should be a leading indicator Clear, accurate, and simple measures of child well-being 77