Assessment in Evidence-Based Practice Psychometric Properties, Clinical Utility and Professional Co-operation from Different Perspectives of the Home Observation for Measurement of the Environment in Sweden

Sammanfattning: The overall aim of the present thesis was to explore and compare professional co-operation in child welfare investigations, explore the psychometric properties, and describe the clinical utility from different perspectives of a translated Swedish version of the standardized assessment instrument the Home Observation for Measurement of the Environment (the HOME Inventory). Social workers in Sweden, Denmark, Britain, Germany, and Texas (USA) co-operated with different professionals around a fictitious child welfare case. Differences were found between and within country-based samples, indicating an unsystematic work procedure in the social work agencies studied. The psychometric properties of the translated Early Childhood version (EC-HOME) and Middle Childhood version (MC-HOME) of the HOME Inventory were explored in terms of inter-observer reliability and by Rasch analysis. The samples were authentic Swedish child welfare cases recruited from a field setting. Inter-observer reliability was satisfactory. Results were ambiguous regarding measurement construction of the two versions studied. Because of the differentiating ability of the EC-HOME and MC-HOME, total scores could provide an indication of inadequate home environments. Experiences of social work practitioners of the clinical utility of the HOME Inventory suggested that they considered the instrument to be comprehensive and have explicit potential benefits, i.e. to be clinically useful. Correspondingly, caregivers’ overall perceptions of the HOME Inventory were positive, determining the content relevant and the format acceptable. However, certain flaws have to be rectified before the HOME Inventory is to be implemented and used successfully. Further, education and the possibility to practice administering the instrument seemed to be essential conditions for future use according to social workers. When social workers and teachers’ apprehensions about support and stimulation provided by caregivers to children in their home environments were compared, preschool teachers’ apprehensions correlated poorly with the social workers’ assessment. These results suggest that the HOME Inventory is promising but cultural adaptation and further studies of psychometric properties are necessary. Different forms of support to practitioners and agencies for successful implementation are required. Awareness of the type of information provided by different sources is important when co-operating in child welfare.