Measurement of Mental Health Among Adolescents at the Population Level: A Multicountry Protocol for Adaptation and Validation of Mental Health Measures

Liliana Carvajal-Velez, Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. Electronic address: lcarvajal@unicef.org.
Jill W. Ahs, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University College, Stockholm, Sweden.
Jennifer Harris Requejo, Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York.
Christian Kieling, Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Andreas Lundin, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Manasi Kumar, Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
Nagendra P. Luitel, Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepal.
Marguerite Marlow, Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Belfast, United Kingdom.
Sarah Skeen, Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Belfast, United Kingdom.
Mark Tomlinson, Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Belfast, United Kingdom; School of Nursing and Midwifery, Queens University, Belfast, United Kingdom.
Brandon A. Kohrt, Department of Psychiatry, George Washington University, Washington, District of Columbia.

Document Type

Journal Article

Publication Date

1-1-2023

Journal

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Volume

72

Issue

1S

DOI

10.1016/j.jadohealth.2021.11.035

Keywords

Adolescent; Anxiety; Assessments; Depression; Developing countries; Gold standard validation; Mental health; Protocol; Questionnaires; Transcultural adaptation; Translation; Validation

Abstract

PURPOSE: Mental disorders are among the leading causes of disability among adolescents aged 10-19 years. However, data on prevalence of mental health conditions are extremely sparse across low- and middle-income countries, even though most adolescents live in these settings. This data gap is further exacerbated because few brief instruments for adolescent mental health are validated in these settings, making population-level measurement of adolescent mental health especially cumbersome to carry out. In response, the UNICEF has undertaken the Measurement of Mental Health Among Adolescents at the Population Level (MMAP) initiative, validating open-access brief measures and encouraging data collection in this area. METHODS: This protocol presents the MMAP mixed-methods approach for cultural adaptation and clinical validation of adolescent mental health data collection tools across settings. Qualitative activities include an initial translation and adaptation, review by mental health experts, focus-group discussions with adolescents, cognitive interviews, synthesis of findings, and back-translation. An enriched sample of adolescents with mental health problems is then interviewed with the adapted tool, followed by gold-standard semistructured diagnostic interviews. RESULTS: The study protocol is being implemented in Belize, Kenya, Nepal, and South Africa and includes measures for anxiety, depression, functional limitations, suicidality, care-seeking, and connectedness. Analyses, including psychometrics, will be conducted individually by country and combined across settings to assess the MMAP methodological process. DISCUSSION: This protocol contributes to closing the data gap on adolescent mental health conditions by providing a rigorous process of cross-cultural adaptation and validation of data collection approaches.

Department

Psychiatry and Behavioral Sciences

Link to Full Text

Share

COinS