Does the family APGAR effectively measure family functioning?

BACKGROUND The Family APGAR has been widely used to study the relationship of family function and health problems in family practice offices. METHODS Data were collected from 401 pediatricians and family physicians fr om the Pediatric Research in Office Settings network and the Ambulatory Sen tinel Practice Network. The physicians enrolled 22,053 consecutive office v isits by children aged 4 to 15 years. Parents completed a survey that inclu ded the Family APGAR and the Pediatric Symptom Checklist. Clinicians comple ted a survey that described child psychosocial problems, treatments initiat ed or continued, and specialty care referrals. RESULTS Family dysfunction on the index. visit often differed from dysfunct ion at follow-up (K=0.24). Only 31% of the families with positive Family AP GAR scores at baseline were positive at follow-up, and only 43% of those wi th positive scores at follow-up had a positive score at the initial visit. There were many disagreements between the Family APGAR and the clinician. T he Family APGAR was negative for 73% of clinician-identified dysfunctional families, and clinicians did not identify dysfunction for 83% of Family APG AR-identified dysfunctions (K=0.06). CONCLUSIONS Our data do not support the use of the Family APGAR as a measur e of family dysfunction in the primary care setting. Future research should clarify what it does measure.