Study title

Validation of a child and family assessment and instrument (FRAIT) for use by health visitors to identify and measure Family Resilience (Phase 2) 

Principal / Lead Investigator
  • Fran Dale (Independent health visitor) 
  • Georgina Jones (Abertawe Bro Morgannwg UHB
  • Jane O'Kane (Abertawe Bro Morgannwg UHB
  • Michelle Thomas (University of South Wales) 
  • Liz Wilson (Hywel Dda UHB) 
  • David Pontin (University of South Wales)   
Type of study

Applied research: Mixed methods study design

Health care / Social care / Mixed?

Health care

Who is the study sponsor?

University of South Wales


Background: Health visitors [HVs] work with a wide range of families. Some families experience difficulties in life which affects their health, and they can address them and overcome them. Some families cannot and need help. We have developed an instrument and assessment tool for HVs called the Family Resilience Assessment Instrument and Tool (FRAIT) to identify situations when families may not be able to address/overcome life difficulties which may interfere with child health/child development outcomes.

Project Aim:

Phase 1: To explore the concept of family resilience as used in HV practice. To develop a Family Assessment Instrument and Tool (FRAIT) for use by HVs to identify and support aspects of family resilience to improve child health and development outcomes

Phase 2: To validate a Family Assessment Instrument and Tool (FRAIT) for use by HVs. Phase 2 aims to identify whether the new instrument and assessment tool supports HVs in their decision making.

In Phase 1 we worked with HVs, HV educators-in-practice and HV managers to identify a working definition of family resilience.

HVs may use the short version to quickly measure the resilience of families within their case-load to support annual acuity review. In Phase 2 we wish to test the Family Resilience Instrument and Tool (FRAIT) reliability and validity in usual HV work circumstances.

Please describe how the public / patients were involved in the development of the study design, and how they will be involved in the funded study?

Lay (retired) health visitor included as a team member. 

How could this research potentially benefit patients?

Support decision making by health visitors to increase family resilience. 

Does the study involve commercial partnership activity?


Does the study involve a methodological innovation? 

We used group concept mapping software (Concept Systems Global Max™) to develop an in-depth understanding of the underpinning constructs. An instrument and assessment tool were developed: 1) A 39-item assessment tool for use when HVs first meet families, and on subsequent scheduled reviews. 2) A short instrument developed from the same data to measure family resilience.

Is accrual / recruitment data reported on UKCRN Portfolio?



Welsh Government / Cwm Taf UHB & ABUHB     

Total grant value

£ 27,828 

Grant income to Wales

£ 27,828 

Start date


End date


Further info (e.g. related web link)

FRAIT website:

Outputs generated (Reports / Publications)

Wallace C, Dale F, Jones G, O'Kane J, Thomas M, Wilson L, Pontin D. Developing the health visitor concept of family resilience in Wales using Group Concept Mapping. Rural Remote Health. 2018 Nov;18(4):4604. doi: 10.22605/RRH4604. Epub 2018 Nov 16.


All health visitors in Wales have been trained to use FRAIT by October 2017. Welsh Government are collecting the FRAIT data from January 2018 as part of their Healthy Child Wales Programme policy (WG, 2016).