Mapping Aboriginal children’s social and emotional wellbeing: Development and validation of a new tool in an Aboriginal cohort study

<h2>Abstract</h2><h3>Purpose</h3> This study aimed to develop the first Aboriginal-led co-designed tool to map Australian Aboriginal children's social and emotional wellbeing (SEWB) based on holistic definitions of wellbeing that have been discussed, supported and refined by Aboriginal and Torres Strait Islander peoples over the last 30 years. <h3>Methods</h3> Development of the Aboriginal Children's SEWB Tool was embedded in wave 2 follow-up of an existing cohort of families: the Aboriginal Families Study (AFS). Items from a questionnaire completed by mothers/caregivers of the study children (aged 5–8 years) were selected to map the seven domains of the SEWB framework. The process was Aboriginal-led by the first author, the AFS research team and Aboriginal Governance Group. Psychometric testing and revision included assessment of the structure, testing of the internal consistency of domains, and criterion validity against the Strengths and Difficulties Questionnaire (SDQ). <h3>Main findings</h3> The Aboriginal Children's SEWB Tool (parent/caregiver report) comprises 80 items grouped into 29 indicators across six domains: Body; Mind and emotion; Family and kinship; Community; Culture; and Country, spirit and spirituality. Criterion validity was supported: children with high scores on the SEWB Tool had seven times higher odds of positive emotional wellbeing and four times the odds of high mental health competence, as measured with the SDQ, compared with children with low scores (Adj. OR 7.7, 95% CI 2.5 – 23.9 and Adj. OR 3.9, 95% CI 1.4 – 10.2, respectively). Fewer items were available on connection to Country, spirit, spirituality and ancestors; further refinement in these areas will be of benefit. <h3>Principal conclusion</h3> The Aboriginal Children's SEWB Tool was developed in response to a lack of measures recognising Aboriginal and Torres Strait Islander peoples' conceptualisations of child social and emotional wellbeing. The new tool provides a holistic picture of SEWB experienced by Aboriginal children, with the capacity to map strengths, gaps and areas for healing across body, mind and emotion, family and kinship, community, culture and Country, spirit and spirituality. Use of the tool would support health and social practitioners working with individual children and families, within schools as well as in research settings. Work is needed to further enhance the tool.