title: Developing a function impairment measure for children affected by political violence: a mixed methods approach in Indonesia.
abstract: OBJECTIVE
  Practitioners in political violence-affected settings would benefit from rating scales that assess child function impairment in a reliable and valid manner when designing and evaluating interventions. We developed a procedure to construct child function impairment rating scales using resources available in low- and middle-income countries.
  
  
  METHODS
  We applied a mixed methods approach. First, rapid ethnographic methods (brief participant observation, collection of diaries and a focus group with children) were used to select daily activities that best represented children's functioning. Second, rating scales based on these activities were examined for their psychometric properties. Construct validity was assessed through a confirmatory factor analysis procedure.
  
  
  METHODS
  Central Sulawesi, Indonesia.
  
  
  METHODS
  Qualitative data were collected for 53 children and psychometric testing was done with 403 children [average age: 9.9 (SD = 1.21), 49% girls] and 385 parents.
  
  
  RESULTS
  Using locally available resources, we developed separate child-rated and parent-rated scales, both containing 11 items. The child-rated scale evidenced good internal, test-retest and inter-rater reliability and acceptable convergent and discriminant validity. Construct validity was confirmed by fit of the theorized factor structure-a social-ecological clustering of daily activities.
  
  
  CONCLUSIONS
  The procedure resulted in a reliable and valid rating scale to assess child function impairment in the context of political violence. Practitioners can apply this procedure to develop new locally adequate rating scales to strengthen epidemiological surveys, baseline assessments, monitoring and evaluation and eventually, interventions. Further research should address the importance of gender differences and criterion-related validity.
authors.affiliation: Global Health Initiative, MacMillan Center, Yale University, New Haven, CT 06520-8206, USA. wietse.tol@yale.edu
authors.forename: Wietse A
authors.initials: WA
authors.lastname: Tol
authors.forename: Ivan H
authors.initials: IH
authors.lastname: Komproe
authors.forename: Mark J D
authors.initials: MJ
authors.lastname: Jordans
authors.forename: Dessy
authors.initials: D
authors.lastname: Susanty
authors.forename: Joop T V M
authors.initials: JT
authors.lastname: de Jong
mesh_terms: D002648:Child; D016000:Cluster Analysis; D005260:Female; D017144:Focus Groups; D006801:Humans; D007214:Indonesia; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D019370:Observation; D010290:Parents; D011057:Politics; D011594:Psychometrics; D014754:Violence / Q000523:psychology*