Reliability and validity of PROMIS® pediatric family relationships short form in children 8-17 years of age with chronic disease

Qual Life Res. 2020 Jan;29(1):191-199. doi: 10.1007/s11136-019-02266-x. Epub 2019 Aug 10.


Purpose: Families play a key role in managing pediatric chronic illness. The PROMIS® pediatric family relationships measure was developed primarily within the general pediatric population. We evaluated the Family Relationships short form in the context of pediatric chronic diseases.

Methods: Children aged 8-17 years with asthma (n = 73), type 1 diabetes (n = 122), or sickle cell disease (n = 80) completed the Family Relationships 8a short form and the PROMIS Pediatric Profile-25's six domains representing physical, mental, and social health. Parents (N = 275) of these children completed the parent versions of the same measures. We evaluated reliability of the Family Relationships measure using Cronbach's alpha and IRT-based marginal reliability, and the standard error of measurement (SEM). Convergent/discriminant validity were assessed from correlations between the Family Relationships domain and the PROMIS-25 domains.

Results: SEM increased for scores above the normative mean of 50. Cronbach's alpha and IRT-estimated marginal reliabilities exceeded 0.80 for children and parents across diseases, except in asthma, where marginal reliability was 0.75 for parents. Scores displayed small to large correlations in the expected directions with social and mental health domains. The largest correlations occurred with parents' proxy reports of children's depressive symptoms in sickle cell disease and asthma, r = - 0.60 (95% CI - 0.74, - 0.48) and r = - 0.58 (95% CI - 0.68, - 0.48) respectively.

Conclusions: The Family Relationships 8-item short form demonstrated adequate reliability and convergent/discriminant validity for use in pediatric chronic conditions, though scores above the mean displayed greater uncertainty. Evidence of the measure's reliability and validity in multiple contexts furthers the case for its use.

Keywords: Children; Chronic disease; Family relationships; PROMIS®; Patient-reported outcomes; Social health; Survey validation.

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease / epidemiology*
  • Family Relations / psychology*
  • Female
  • Humans
  • Male
  • Patient Reported Outcome Measures*
  • Psychometrics / methods*
  • Quality of Life / psychology*
  • Reproducibility of Results