The family is a complicated emotional system that is considered the major pillar and the initial organization of any society, where human emotions and intimate relations emerge. It can be said that family functioning affects society functioning in a direct and major way. In other words, a healthy society is composed of healthy families. Members of a family are connected through biological, legal, emotional, geographical and historical bonds. As compared with other social groups, entering a family in the traditional sense is possible through giving birth to a child, adopting a child, caring for a child or getting married [1]. In Iran, the family is an indicator of the cultural value system. Recent decades have been exposed to structural changes that have affected all aspects of the family including communication among members, the emotional importance of members for one another, the meaning of family, economical functioning of family and the sexual roles [2]. Christensen believes the family is the cultural reflection of thousands of years of efforts to develop the members, improve their mental health, and reduce high-risk behaviors [3]. Therefore, given the continuous interactions that family members have within the family and with the society, it appears that family is the main focus of health in the society.
Based on a model developed in Iran, a healthy family is one with positive characteristics such as using healthy parenting styles, having skills for consulting with one another and decision making, and ensuring physical, mental and emotional needs of the members [4]. Healthy family functioning helps children to acquire a positive identity, increase independence, and reduce the incidence of behavioral and communication problems [5]. Currently, the comprehensive definition of family health is as follows: family health comprises a family’s quality of life, health of each member, family interactions, spiritual indicators, nutrition, overcoming problems, living environment, entertainment, daily activities, sleep, and sexual desires [6].
Studies show that healthy functions of the family directly affect needs, objectives, satisfaction with life and emotional relations [7], and affect factors such as structure, roles, communication, perception and dynamic personality of members [8]. Research on the family has mainly focused on the influence of family members on one another, especially between couples and parent-child relations [9, 10].
Assessing family health is one of the major objectives of family therapists, that is used to identify challenges and propose solutions to help families reach their specific goals. A variety of tools are used to assess function and health of families, but no consensus has been reached on a single tool for this purpose [11]. One of the most important and influential factors for family health is maintaining physical activity and healthful nutrition [12, 13], but studies overall show that these topics are not well addressed in families [14]. Studies show Iranian families also pay less attention to physical activity and nutrition [15].
One assessment tool, which fits within the operational context of the family is the family health climate scale (FHC-Scale), developed by Niermann et al. (2014) [16]. The FHC-Scale, developed in Germany, was based on Bandura’s social cognitive theory, which assumes that the environment and the individual determine their mutual relationship and affect one another’s healthy behavior. The FHC-Scale has two scales, physical activity (FHC-PA) (14 items) and nutrition (FHC-NU) (16 items) scored on a Likert scale from totally false (0) to totally true (3).
The FHC-PA scale has three dimensions: 1)“Value” reflects the importance of physical activity for all members of the family, 2) “Cohesion” covers common physical activities and leisure activities of family members, and 3) “Information” refers to the amount of searching for, sharing and using information related to sports and physical exercises. The FHC-NU scale has four dimensions: 1) “Value” focuses on family’s emphasis on improving nutrition in their daily diet, 2) “Cohesion” reflects regular eating sessions of the family and the importance of eating together, 3) “Communication” covers the support and encouragement of family members for having a balanced diet 4) “Consensus” comprises the acceptance of family members’ interests in nutrition-related behaviors [16].
As mentioned, family health is the foundation of individual health within a given society, and measuring family health is an important area of research. The FHC-Scale is an attractive tool to measure family health in that it is comprehensive but has fewer items, which makes it more feasible for use, and reliability and validity indices are also established. Therefore, the purpose of this study was to translate and validate the Persian version of FHC-Scale in Iranian families.