The Development of a Family
Wellbeing Index in Hong Kong
Family and Group Practice Research Centre
Department of Social Work
The Chinese University of Hong Kong
Prof. Joyce L. C. Ma
Prof. Mooly M. C. Wong
Ms. Po-san Wan
Dr. Lily Xia
Mr. Michael Fok
Agency-University Collaboration
Sponsored by the Hong Kong Family Welfare Society
A multidisciplinary research team from the Chinese
University of Hong Kong
➢ Prof. Joyce Ma, Prof. Mooly Wong, and Dr. Lily Xia
(Department of Social Work)
➢ Ms. Po-san Wan (Hong Kong Institute of Asia-Pacific Studies)
2
Gap of Knowledge
Currently, there is no self-developed family wellbeing
index in Hong Kong
The current relevant studies on family wellbeing are
➢ Studies with single dimension: e.g., family functioning and
family relationships (e.g., Ma & Lai, 2013); psychological
wellbeing (e.g., Shek, 2002)
➢General survey: e.g., Family Survey (Family Council, 2011, 2013,
2015)
➢ Adapted scale: e.g., the Beach Center Family Quality of Life
(FQOL) (HKFWS, 2017, 2018)
➢Checklist tool: e.g., Family Impact Assessment Checklist
developed by University of Hong Kong (2018)
3
Objectives
To develop a socially relevant and culturally
appropriate measuring tool
To assess the wellbeing of families in Hong Kong
4
Definition of Family
There is no single and one-size-fits-all definition of
“family”
Context-specific definition
• Legal, household, custom
General understanding
• Social relationships of a group of two or more people
Structure• Two generation-family, with a married couple living with
their children or their parents under the same roof
Functions • Core functions of the family: economic support,
emotional support, care responsibility, socialization, etc.
5
Definition of Family in This Study
Family is defined as a socially recognized group
(of at least two people in a relationship, usually joined by blood, marriage, or adoption) that
extends mutual economic support, emotional
connection, and care to its members. Such a
relationship arises from commitment and
obligation, without a pre-determined timeframe.
(adapted from University of Hong Kong, 2017)
6
Definition of Family Wellbeing
Wellbeing is a general and multidimensional concept that has been defined in several ways
Webster’s dictionary defines wellbeing as “the state of being healthy and free from want”
Family wellbeing has been explicitly defined in studies such as the following:
➢“The emotional, social and economic wellbeing of children, parents and families” (Sing et al., 2001, p. 1)
➢“The ability to perform functions and practices for the benefit of the group and individuals” (Proyor, 2007, p. 23)
7
Definition of Family Wellbeing
There are three ways of thinking about family wellbeing (Wollny et al., 2010)
➢ (1) as a multidimensional concept encompassing
different domains, and as an amalgamation of different
types of wellbeing (i.e., physical, social, economic, and
psychological)
➢ (2) there are implied criteria for families being “well” or
“unwell” that are subjective and related to culture
➢ (3) family wellbeing can be conceptualized in terms of
functions, and needs and their fulfillment
8
In this study, family wellbeing is
conceptualized as
a state of family that can perform
various functions to satisfy the diverse
needs of individual members in the
family through interaction with the
environment
9
Considerations when developing a
family wellbeing index
Family inclusiveness
Objective versus subjective indicators
Data collection method and the
response rate of the participants
10
Family Inclusiveness
Families keep changing and are becoming diversified in structure, shape, and function
Different types of familial relationships are found in Hong Kong, such as cohabitation, childless couples, homosexual relationships, and nuclear families using assisted reproductive technology (CUHK, 2018)
This index is designed for measuring family wellbeing, regardless of family type
In this study, family is operationalized as
➢consisting of at least two people (usually joined by blood, marriage, or adoption) living in the same household
11
Objective versus Subjective Indicators
Objective indicators: e.g., study on living conditions in
Macao (HKIAPS, CUHK, 2014)
Subjective indicators: e.g., studies on family wellbeing in
Malaysia (2017), the United Kingdom (2011), and Hong
Kong (Family Council, 2011, 2013, 2015; HKFWS, 2017, 2018; HKU, 2018)
Contribution of subjective indicators
➢ To provide as complementary information to objective
data, so as to paint a comprehensive picture of family
wellbeing
This index uses subjective indicators to understand the
perceptions of family members
12
Data Collection Method and
Response Rate
Rationale for adopting the method of telephone survey in this study:
➢ high degree of representativeness (when compared with online surveys)
➢ low cost (when compared with household surveys)
➢ feasibility and high response rate (when compared with online surveys and household surveys)
13
Operationalization of Domains –Example 1: Care and Support (扶持共濟)
This refers to the degree of sharing and exchange of resources of family members in time of need (Ma & Wan, 2015)
Sharing and exchange of resources is one of the important functions of families, particularly for families with adult children (Ma & Wan, 2015)
The degree of reciprocal care and support among family members reflects the level of family solidarity (Bengtson & Roberts, 1991; United Nations, 2012)
In this study, care and support is operationalized in a behavioral sense, including financial support, manual labor support, information sharing, and emotional support
15
Operationalization of Domains –Example 1: Care and Support (扶持共濟) 16
Indicator Item Source of / Support for Question
Direction
Financial support Family members are willing to offer financial support to each other when required (Q20)
家人樂意幫忙解決財政困難
Bengtson & Roberts, 1991; Ma & Wan, 2015; National Population and Family Development Board, 2017 +
Manual labor support
Family members are willing to offer help in managing household
chores when required (Q21)
家人樂意幫忙處理家庭事務
Bengtson & Roberts, 1991; Ma & Wan, 2015
+Information sharing Family members are willing to
share information when required (Q22)
家人樂意就重要事情提供意見
Ma & Wan, 2015
+Emotional support Family members are willing to
listen to each other when required (Q23)
家人樂意聆聽心事
Ma & Wan, 2015
+
Operationalization of Domains –Example 2: Family Responsibilities (成長共進)
This refers to the strength of commitment of family members to raise
the next generation, particularly the young children, and to the
performance of familial roles and to meeting familial obligation (Bengtson & Roberts, 1991; Noor et al., 2014)
Core family responsibilities:
➢ for minors and the next generation: socialization and guidance (Superu, 2016; University of HK, 2017; The Vanier Institute of the Family, 2019)
➢ for adults: facilitation of familial role performance (Bengtson & Roberts,
1991)
In this study, we operationalized family responsibilities as warmth, discipline (guan), and role fulfillment
17
Operationalization of Domains –Example 2: Family Responsibilities (成長共進)
18
Indicator Item Source of / Support for Question
Direction
Warmth Family members show love and
care to children (Q18)
對子女有足夠嘅關懷同照顧
Ma, Wong, Lau & Lai,
2012
+
Discipline
(Guan)
Family members explain what is
right and wrong to the children
(Q19)
對細路有獎罰分明嘅管教
Ma,Wong, Lau & Lai,
2012
+Role fulfillment Family members can bring their
own strengths and abilities into full
play (Q17)
可以發揮各自嘅長處同能力
Bengtson & Roberts,
1991
+
Study Design
• Pilot study • Literature review
• Focus group and expert consultations
• Cross-sectional telephone survey (N = 205)
• Reliability & validity test
Developing the index
• Main survey
• Cross-sectional telephone survey (N = 2000: landline N = 1200 & mobile N = 800)
Telephone survey
• Promoting the tool
• Training to practitioners
Application & promotion
Pilot survey: Mar 28–Apr 3, 2019 Main survey: July–Aug, 2019 Sep 2019–March 2021
20
Focus Group for
Service Users
(N = 9)
7 Domains, 26 Indicators, and
32 Questions
(dropped 1 indicator, added 1 new
indicator, and revised 5 questions)
Expert Review
(N = 13)
7 Domains, 26 Indicators, and
33 Questions
(revised 8 questions and added 1
question)
Pilot Survey
(N = 205)
8 Domains, 26 Indicators, and
29 Questions
(added 1 new domain, dropped 3
questions, and revised 2 questions)
Main Survey
(N = 2000)
Co
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Val
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Alp
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Exp
lora
tory
Fac
tor
An
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Literature Review
(Research Team)7 Domains, 26 Indicators, and
32 Questions
Steps in Developing the Index21
5-point Likert Scale
(1 = strongly disagree,
5 = strongly agree)
Developing the Index
Comprehensive literature review
➢ the conceptual framework and the questionnaire draft of the index
Focus group interviews/individual interviews with different stakeholders
➢ Service user: diverse family structures (e.g., intergenerational, intact,
single parent, etc.); age groups (adolescents, adults, elderly); family
role (e.g., breadwinner, homemaker, caregiver); and family
situations (e.g., family members with mental health or physical
health issues, children with special education needs)
➢ Professional: social worker (managerial and frontline level, NGO and
Government); family lawyer; clinical psychologist; and psychiatrist
➢Government official specialized in policy making
➢ Scholar on family studies
22
Developing the Index
Pilot Test: (Cross-sectional Telephone Survey)
➢ Purposes: (1) to test the reliability and validity of the questionnaire;
(2) to revise the questionnaire for the main survey
➢ Conducted independently by the Telephone Survey Research
Laboratory of the Hong Kong Institute of Asia-Pacific Studies, CUHK
➢ Criteria for the selection of respondents:
❖ 18 years old or above; living with at least one family member
❖ Hong Kong resident
❖ Speaks Cantonese or Mandarin
➢ Respondents: N = 205 (landline N = 155; mobile N = 50)
➢ The results were weighted based on up-to-date figures on the age-sex
distribution of the population, provided by the Census and Statistics
Department
23
24
40
23
38
46
39
19
0
5
10
15
20
25
30
35
40
45
50
18-29 30-39 40-49 50-59 60-69 70 or above
Age
18-29
30-39
40-49
50-59
60-69
70 or above
25
23
130
35
2
13
2
0
20
40
60
80
100
120
140
Living with
spouse only
Parents with
unmarried child
Household of
three
generations
Single parent
family
Others Refused to
answer
Family Structure
Living with spouse only
Parents with unmarried child
Household of three generations
Single parent family
Others
Refused to answer
26
12
3
1
6
12
15
33
36
24
6
15
30
21
0
5
10
15
20
25
30
35
40
Family Income
No income
4,000 or below
4,000–9,999
10,000–14,999
15,000–19,999
20,000–24,999
25,000–29,999
30,000–39,999
40,000–59,999
60,000–79,999
80,000–99,999
100,000 or above
Don’t know
Refused to answer
27
1921
69
25
71
0
10
20
30
40
50
60
70
80
Primary or below Form 1-3 Form 4-7 or
equivalent
College (non-
degree)
College (degree or
above)
Education Level
Primary or below
Form 1-3
Form 4-7 or equivalent
College (non-degree)
College (degree or above)
28
116
22 21
39
6
1
0
20
40
60
80
100
120
140
On job Student Household Retired Unoccupied Refused to answer
Occupation Status
On job
Student
Household
Retired
Unoccupied
Refused to answer
Cronbach’s Alpha of the Pilot Test
The whole index: .890 (Valid N = 205, 100%)
Family health and safety:
.440
(Valid N = 205, 100%)
3 questions
Family resources:
.759
(Valid N = 205, 100%)
7 questions
Care and support:
.737
(Valid N = 205, 100%)
4 questions
Family atmosphere:
.797
(Valid N = 205, 100%)
4 questions
Family responsibilities:
.635
(Valid N = 205, 100%)
3 questions
Work-life balance:
.567
(Valid N = 205, 100%)
2 questions
Family and community
relationships:
.518
(Valid N = 205, 100%)
3 questions
30
No. of questions in this test = 26
No. of questions originally = 33
No. of questions for main survey = 29
Question excluded in this test: Q10, Q26, Q27, Q28, Q32, Q37, Q38
Exploratory Factor Analysis
Total variance
explained:
61.131%
32 Communalities
Question Initial Extraction
q6 1.000 0.567
q7 1.000 0.686
q8 1.000 0.615
q9 1.000 0.703
q11 1.000 0.671
q12 1.000 0.686
q13 1.000 0.652
q14 1.000 0.690
q15 1.000 0.623
q16 1.000 0.633
q17 1.000 0.565
q18 1.000 0.691
q19 1.000 0.626
q20 1.000 0.609
q21 1.000 0.606
q22 1.000 0.553
q23 1.000 0.708
q24 1.000 0.692
q25 1.000 0.609
q29 1.000 0.807
q30 1.000 0.754
q31 1.000 0.618
q33 1.000 0.599
q34 1.000 0.605
q35 1.000 0.676
q36 1.000 0.674
Extraction Method: Principal
Component Analysis.
Rotated Component Matrixa
Domain QuestionComponent
1 2 3 4 5 6 7
Family health
and safety
q6 0.662
q33 0.453 0.464
q36 0.458 0.653
Family
resources
q7 0.788
q8 0.694
q9 0.760
q11 0.657
q12 0.761
q34 0.612
q35 0.796
Care and
support
q20 0.710
q21 0.536
q22 0.644
q23 0.723
Family
atmosphere
q13 0.452 0.561
q14 0.657
q15 0.648
q16 0.507
Family
responsibilities
q17 0.554
q18 0.761
q19 0.718
Work-life
balance
q24 0.815
q25 0.727
Family and
community
relationships
q29 0.859
q30 0.757
q31 0.498
Extraction Method: Principal Component Analysis.
Rotation Method: Varimax with Kaiser Normalization.
a. Rotation converged in 10 iterations.
No. of questions in this test = 26 No. of questions originally = 33No. of questions for main survey = 29Question excluded in this test: Q10, Q26, Q27, Q28, Q32, Q37, Q38
Revised Family Wellbeing Index
8 Domains,
26 Indicators, &
29 Questions
33
Family health and safety
身心康泰
Family resources
資源共享
Care and support
扶持共濟
Family atmosphere
和睦共處
Family responsibilities
成長共進
Work-life balance
生活平衡
Family and com-munity relationships
社會共融
Family and ICTs
資訊科技
Major Revisions to the Index Change the Likert scale from 1-5 (1 = strongly disagree, 5 = strongly
agree) to 0-10 (0 = Strongly disagree, 10 = strongly agree) to increase
the sensitivity of the scale
One new domain added:
➢ Family and ICTs (Q10 and Q28)
Questions removed from the index and changed as demographic
variables
34
Q32 Overall speaking, I have a happy family life 整體嚟講,你嘅家庭係幸福嘅
Q37 How many family members are in need of intensive care due to old age, chronic illness or
disability ?你屋企有幾多位家人因年紀大、疾病或者殘障,而需要人特別照顧佢嘅生活起居呢?
Q38 In the past year, have there been any crisis in your family, such as the death of a family
member, a severe illness in the family, un-employment, financial difficulties, or relationship
conflicts?喺過去一年,你屋企有無發生重大嘅事故,例如家人去世、重病、意外住院、失業、嚴重嘅經濟困難或者感情衝突?
Major Revisions of the Index Questions revised:
35
Question Original Revised Direction
28 The family has rules for
using social media
喺屋企有相關嘅規矩去使用社交媒體
The family has rules for using social media
for entertainment such as playing computer
games, watching movies
喺屋企有相關嘅規矩去使用社交媒體用嚟娛樂,例如玩遊戲、睇電影
+
36 Overall, family members
have good health
condition in the past
one year
整體而言, 在過去一年,你同你屋企人有良好嘅健康狀況
Overall, family members have good
physical health condition in the past one
year (Revised)
整體而言, 在過去一年,你同你屋企人有良好嘅身體健康狀況
+
Overall, family members have good mental
health condition in the past one year (New)
整體而言, 在過去一年,你同你屋企人有良好嘅精神健康狀況
+
Contributions of Our Study36
To construct a comprehensive tool with cultural
competence
To provide useful references to related parties,
such as government officials, scholars, service
operators, and human resources professionals, to
formulate policies, and to develop, evaluate,
and monitor services
Potential Social Impact
To construct a positive and a healthy social
discourse on families in Hong Kong
To counter-act society’s prejudiced views of
marginalized types of families
37
Limitations of Our Pilot Study
Focus group:
➢Biased views of service users
Household-based survey:
➢Missed some important family members such as non-
residential parent in a divorce family, grandparents
who lived apart from their adult children, and other
family members (e.g., children, elderly people, disabled
family members living in residential care homes)
Telephone survey:
➢Some people were not reached by either landline or
mobile phone
38
Future Plan
Refining the index by reviewing updated
references, exchanging views with different
stakeholders, and receiving comments from
experts
39
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Bengtson, V. L., & Roberts, R. E. (1991). Intergenerational solidarity in aging families: An example offormal theory construction. Journal of Marriage and the Family, 53(4), 856-870.
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References
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References
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42
Family Health and Safety (身心康泰)
Health means a state of complete physical, mental and social wellbeing
and not merely the absence of disease or infirmity (World Health
Organization, 2019). Safety refers to family members’ sense of physical
security in home environment (Noor et al., 2014)
4 Indicators and 4 Questions
44
Indicator Item Source of / Support for Question Direction
Family safety Family members feel safe while at home (Q6)喺家庭感到安全
Hong Kong Family Welfare Society & POP, HKU, 2018; National Population and Family Development Broad, 2017; Superu, 2016 +
Physical health condition
Overall, family members have good
physical health condition in the past one year (RevisedQ36)整體而言, 在過去一年,你同你屋企人有良好嘅身體健康狀況
National Population and Family
Development Broad, 2017; Superu, 2016
+
Mental health condition
Overall, family members have good mental health condition in the past one year (New)整體而言, 在過去一年,你同你屋企人有良好嘅精神健康狀況
National Population and Family Development Broad, 2017; Superu, 2016 +
Family prospect Family life will be better than now after 3 years Q33)三年後嘅生活狀況會比現在好
Ma & Wong, 2010
+
Family Resources (資源共享) Family resources refers to the optimal utilization of time, income, human capital,
psychological capital, and social capital of family members (Zubrick et al., 2000)
5 Indicators and 7 Questions
45
Indicator Item Source of / Support for Question DirectionEconomic situation
Family has sufficient money to manage household expenses in the past one year (Q7)過去一年,家庭收入足夠應付日常嘅開支
National Population and Family Development Broad, 2017; Superu, 2016 +
Living environment
Family has a comfortable living place (Q8)有舒適嘅居住環境
National Population and Family Development Broad, 2017; Superu, 2016 +
Family time Family members has sufficient time together (Q11)有足夠嘅相處時間
Hong Kong Family Welfare Society & POP, HKU, 2018; National Population and Family Development Broad, 2017
+
Family members enjoy the time together (Q12)享受一起相處嘅時間
Hong Kong Family Welfare Society & POP, HKU, 2018 +
Life skill Family members have ability to cope with daily life issues Q9)有能力解決生活難題
Hong Kong Family Welfare Society & POP, HKU, 2018 +
Accessibility of resources
Family members can seek help from friends, relatives or neighbors when encountered unmanageable difficulties (Q34)容易找到親戚、朋友或鄰居幫忙
Hong Kong Family Welfare Society & POP, HKU, 2018 +
Family members can access services from government departments or community units when encountered unmanageable difficulties (Q35)容易找到政府部門或社會機構幫忙
Hong Kong Family Welfare Society & POP, HKU, 2018 +
Family Atmosphere (和睦共處)
Family atmosphere means the positive climate and constructiveinteractions among the family members in the home environment
(Ma & Wan, 2015)
4 Indicators and 4 Questions
46
Indicator Item Source of / Support for Question
Direction
Trust Family members can trust each other (Q13)可以互相信賴
Ma, Wong, Lau & Pun, 2009; Ma & Wong, 2010 +
Give and take Family members can give and take (Q14)可以彼此遷就
adapted by informants+
Appreciation Family members can appreciate each other’s contribution to the family (Q15)感激各人為家庭嘅付出
adapted by informants+
Harmony Family members usually get along well (Q16)經常相處融洽
Hong Kong Family Welfare Society & POP, HKU, 2018 +
Work-life Balance (生活平衡)
Work-life balance refers to the time that family members make
available for themselves and for one another (Zubrick et al., 2000)
1 Indicator & 2 Questions
47
Indicator Item Source of / Support for Question
Direction
Work-life conflict Family members have come home from work too tired to do the chores which need to be done (Q24)工作令你哋攰到做唔到應做嘅家庭事務R
Scholz et al., 2014, Lau et al., 2012
-
Because family members often stressed from responsibilities at home, we have a hard time concentrating on their work (Q25)家庭煩惱或問題,令你哋難以專心工作R
Van Gsteenbergenet al., 2007
-
Family and Community Relationships (社會共融)
Family and community relationships mean the positive connection
of family with the wider environment (Superu, 2016)
3 Indicators and 3 Questions
48
Indicator Item Source of / Support
for Question
Direction
Participation in social activities or religion associations
Family members participate social activities or religion associations frequently (Q29)經常參加社會或宗教團體嘅聚會或者活動
Committee on the promotion of civic education, 2010 +
Contribution to society
Family members participate volunteer work or give donation frequently (Q30)經常參與義工服務或慈善捐款
Wan, Cheng & Law, 2014
+
Social justice Current family standard of living is comparable to family’s efforts 目前嘅生活水平同家人嘅努力比較,係相當公平 (Q31)
adapted by informants
+
Family and ICTs (資訊科技)
Family and ICTs refers to the positive influence of new
information and communication technologies on family
life
2 Indicators and 2 Questions
49
Indicator Item Source of / Support for Question
Direction
Control The family has rules for using social media for entertainment such as playing computer games, watching movies (revised Q28)喺屋企有相關嘅規矩去使用社交媒體用嚟娛樂,例如玩遊戲、睇電影
National Population and Family Development Broad, 2017 +
Communication Family members use social media to communicate with each other frequently (Q10)經常用社交媒體與家人聯絡同溝通
Wang et al., 2018
+