Dissemination & Implementation Science
Advancing our Understanding of Empowerment Across Diverse Consumers: A Psychometric Investigation of the Family Empowerment Scale with A Novel Multiethnic Sample
Amanda M. Vincent, M.A.
Doctoral Candidate
University of Hawai’i at Manoa
Honolulu, Hawaii
Marina M. Matsui, M.A.
Graduate Student
University of Hawai’i at Manoa
Honolulu, Hawaii
Tommie M. Laba, M.A.
Graduate Student
University of Hawai’i at Manoa
Kaneohe, Hawaii
Brad Nakamura, Ph.D.
Professor
University of Hawaii at Manoa
Honolulu, Hawaii
Increasing caregivers’ access to and use of effective treatment services for their children is perhaps the most pressing mission in modern youth mental health, particularly with ongoing public crises both increasing youths’ stress and reducing their opportunities for service referrals through school and community avenues. Strategies to better engage caregivers in their children’s services have ranged from large scale system-of-care reform to consumer-directed marketing, and professionals across helping disciplines have lauded family empowerment as a critical component for these efforts’ successes. At the same time, measurement of empowerment as both a behavioral determinant and an outcome of service participation is scarce. The Family Empowerment Scale (FES; Koren et al., 1992) is the first and only measure of caregivers’ empowerment in the context of seeking mental health services for their children; however, questions about its structure, scoring, and performance with diverse caregivers remain unresolved decades after its development. Researchers have disagreed about whether to conceptualize empowerment as occurring along settings (i.e., Community/Political, Family, Service System; Koren et al., 1992), along expressions (i.e., Knowledge, Systems Advocacy, Self-Efficacy, and Competence; Singh et al., 1995), or even as a predominantly unidimensional construct (c.f., Lambert et al., 2020), and these disparate labels have made it challenging to compare and digest results from already limited research.
The current study provides a renewed examination of the FES’ factor structure, reliability, and convergent validity with an ethnically diverse, community sample of 351 caregivers (75.8% female; 43.6% Asian, 23.6% multiethnic, 17.4% Pacific Islander). First, we will present confirmatory factor analyses comparing the extent to which a three-factor (i.e., based upon Koren et al.’s [1992] scoring schema), four-factor (Singh et al., 1995), or three-factor bifactor model (Lambert et al., 2020) best fits with the current sample’s FES responses. Second, we will present the internal consistencies of the total and forthcoming FES subscale factors using Cronbach’s alpha, coefficient omega, and if the bifactor model prevails, omega hierarchical, which differentiates item response variance that is unique to each subscale score as opposed to an overall latent factor. Finally, we will present the FES’ convergent validity correlations with the Parental Attitudes Toward Psychological Services Inventory (Turner, 2012), a measure of caregivers’ broad attitudes toward outpatient mental health services, and the Parent Engagement in Evidence-Based Services questionnaire (Chang et al., 2019), a measure of various behavioral determinants for caregivers’ use of evidence-based mental health interventions for their children. Discussion will center on clinical implications and future directions, including practical utility of the best-fitting FES factor model, expanding FES administration to more ethnically and clinically diverse caregivers, and leveraging empowerment’s relationship with other treatment-associated constructs (e.g., stigma, knowledge) to increase service uptake.