Developmentally and culturally appropriate screening in primary care: development of the behavioral health checklist.

Objective: To evaluate the construct validity of the Behavioral Health Checklist (BHCL) for children aged from 4 to 12 years from diverse backgrounds.

Method: The parents of 4-12-year-old children completed the BHCL in urban and suburban primary care practices affiliated with a tertiary-care children's hospital. Across practices, 1,702 were eligible and 1,406 (82.6%) provided consent. Children of participating parents were primarily non-Hispanic black/African American and white/Caucasian from low- to middle-income groups. Confirmatory factor analyses examined model fit for the total sample and subsamples defined by demographic characteristics.

Results: The findings supported the hypothesized 3-factor structure: Internalizing Problems, Externalizing Problems, and Inattention/Hyperactivity. The model demonstrated adequate to good fit across age-groups, gender, races, income groups, and suburban versus urban practices.

Conclusion: The findings provide strong evidence of the construct validity, developmental appropriateness, and cultural sensitivity of the BHCL when used for screening in primary care.