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Development and Validation of Age-Specific Resilience Instruments for Early Childhood Assessment: A Taiwan Birth Cohort Study

  • Julianna C. Hsing
    Affiliations
    Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA

    Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
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  • Bea-Jane Lin
    Affiliations
    Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA

    Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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  • Uma Pulendran
    Affiliations
    Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA

    Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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  • Shilpa G. Jani
    Affiliations
    Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA

    Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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  • Wan-Lin Chiang
    Affiliations
    Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA

    Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    College of Public Health, National Taiwan University, Taipei, Taiwan
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  • Tung-liang Chiang
    Correspondence
    Corresponding author: Tung-liang Chiang, ScD. National Taiwan University, College of Public Health, Room 620, No.17, Xu-Zhou Rd., Taipei, Taiwan 10055.
    Affiliations
    College of Public Health, National Taiwan University, Taipei, Taiwan
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  • C. Jason Wang
    Correspondence
    Corresponding author: C. Jason Wang, MD, PhD. Stanford University School of Medicine, 615 Crothers Way, Encina Commons, MC6019, Stanford, CA 94305.
    Affiliations
    Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA

    Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
    Search for articles by this author

      Abstract

      Background

      We sought to develop and validate age-specific instruments for measuring early childhood resilience at ages 3, 5 and 8 in the Taiwan Birth Cohort Study, a national longitudinal study.

      Methods

      Using data from 18,553 mother-infant pairs, we conducted exploratory factor analysis (EFA) on a simple random half of our sample. We then used the remaining half of these data for confirmatory factor analysis (CFA) to further assess the fit of three CFA models (i.e., first-order, second-order, and bifactor). Psychometric properties, distributions, and inter-item and inter-factor correlations of each instrument were also evaluated.

      Results

      EFA and CFA showed that the bifactor model of resilience (which included a general resilience factor and five specific factors) had the best fit for all three resilience scales, with 19 items at year 3, 18 items at year 5, and 19 items at year 8. All three resilience scales showed good psychometric properties, including construct validity, internal consistency, and normal distributions. For predictive validity, we found that in the face of adversity (measured by the High Risk Family Score), individuals with high resilience scores at age 3 had better general health scores at ages 3, 5, and 8 compared to those with low resilience scores.

      Conclusions

      We describe the development and validation of age-appropriate survey instruments to assess resilience in young children at the population level. These instruments can be used to better understand how resilience can impact child health over time, and to identify key factors that can foster resilience.

      Keywords

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