The Family Health Scale: Reliability and Validity of a Short- and Long-Form

Alice Ann Crandall, Nomi S. Weiss-Laxer, Eliza Broadbent, Erin Kramer Holmes, Brianna Michele Magnusson, Lauren Okano, Jerica M. Berge, Michael D. Barnes, Carl Lee Hanson, Blake L. Jones, Len B. Novilla

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.

Original languageEnglish (US)
Article number587125
JournalFrontiers in Public Health
StatePublished - Nov 20 2020

Bibliographical note

Funding Information:
NW-L was supported by the Health Resources and Administration award number T32HP30035.

Publisher Copyright:
© Copyright © 2020 Crandall, Weiss-Laxer, Broadbent, Holmes, Magnusson, Okano, Berge, Barnes, Hanson, Jones and Novilla.


  • depression
  • factor analysis
  • family health
  • psychometrics
  • structural equation modeling


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