Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria

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2019

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Abstract

<jats:sec id="S2054425119000086_sec_a1"><jats:title>Background</jats:title><jats:p>The Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies.</jats:p></jats:sec><jats:sec id="S2054425119000086_sec_a2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>We used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (<jats:italic>N</jats:italic> = 24), and piloting with cognitive interviewing (<jats:italic>N</jats:italic> = 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items.</jats:p></jats:sec><jats:sec id="S2054425119000086_sec_a3" sec-type="results"><jats:title>Results</jats:title><jats:p>We identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation.</jats:p></jats:sec><jats:sec id="S2054425119000086_sec_a4" sec-type="conclusion"><jats:title>Conclusions</jats:title><jats:p>Culturally adapting screening tools represents a vital first step toward improving community case detection.</jats:p></jats:sec>

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10.1017/gmh.2019.8

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Kaiser, BN, C Ticao, C Anoje, J Minto, J Boglosa and BA Kohrt (2019). Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. Global Mental Health, 6. 10.1017/gmh.2019.8 Retrieved from https://hdl.handle.net/10161/19066.

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Kohrt

Brandon A. Kohrt

Adjunct Associate Professor in the Department of Psychiatry and Behavioral Sciences

Brandon Kohrt is a medical anthropologist and psychiatrist who completed his MD-PhD at Emory University in 2009. He is currently Assistant Professor of Psychiatry, Global Health, and Cultural Anthropology at Duke University. Dr. Kohrt has worked in Nepal since 1996 researching and aiding victims of war including child soldiers. Since 2006 has worked with Transcultural Psychosocial Organization (TPO) Nepal. Dr. Kohrt has been a consultant to The Carter Center Mental Health Program Liberia Initiative since 2010. Dr. Kohrt is the component lead for the Grand Challenges Canada funded Mental Health Beyond Facilities (mhBeF) program in Nepal, Liberia, and Uganda. Dr. Kohrt has published scientific articles and book chapters about mental health among conflict- and disaster-affected populations in Nepal, Liberia, and Haiti. Dr. Kohrt has collaborated on numerous documentary films about human rights and global health including Returned: Child Soldiers of Nepal’s Maoist Army.  


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