Abstract
Depression is a global concern as with an estimated 300 million individuals worldwide experiencing depression. In South Africa, the prevalence rate of depression is estimated at 9.7% of the population. With the increase in mobile internet usage in South Africa, an online depression screening tool could provide opportunities for the screening of depression symptoms aiding access to mental health interventions. This project identified an open access tool for screening depression, the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R), and adapted it for online use by the adult South African population. This study followed on from the adaptation phase on the CESD-R and aimed to determine the content validity of the adapted CESD-R for online use in South Africa using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. The study followed a two-phased design. Study one utilised a qualitative approach, where 50 experts commented on the content validity of the tool. The results were used to further adapt the tool which resulted in a 20-item depression screening tool. Study two followed a quantitative design in order to establish the content validity in terms of determining the Content Validity Ratios, Item-Content Validity Index as well as the Kappa Statistic of the 20 items. Based on these statistics, 19 of the 20 items were retained. Overall, the adapted online depression screening tool displays good content validity and holds potential as a screening tool where access to mental health may be limited.
Highlights
Introduction and literature reviewAccording to the World Health Organization’s (WHO, 2017) Global Health estimates for 2017, an estimated 300 million individuals have depression globally, accounting for 4.4% of the world’s population (WHO, 2017)
Depression is one of the mental health illnesses that have been found to be comorbid with NCD, such as cancer and diabetes, and respiratory and cardiovascular diseases, interventions for depression are vital in controlling non-communicable diseases (Caruso et al, 2017; Leentjens, 2010; Stein et al, 2019)
This study demonstrated that a 19-item adapted online depression screening tool displays relevance in terms of the construct being measured and the appropriateness of the target population, and context for which it is intended
Summary
Introduction and literature reviewAccording to the World Health Organization’s (WHO, 2017) Global Health estimates for 2017, an estimated 300 million individuals have depression globally, accounting for 4.4% of the world’s population (WHO, 2017). The association between mental health and non-communicable diseases (NCD) has been highlighted by the WHO world mental health surveys (Leentjens, 2010). Depression is one of the mental health illnesses that have been found to be comorbid with NCD, such as cancer and diabetes, and respiratory and cardiovascular diseases, interventions for depression are vital in controlling non-communicable diseases (Caruso et al, 2017; Leentjens, 2010; Stein et al, 2019). In 2017, mental health facilities in South Africa were limited with 4.33 beds per 100 000 population in general hospitals, and 16.56 beds per 100 000 in mental health hospitals (WHO, 2017). As a result of the lack of or limited mental health resources in South Africa, mental illnesses, such as depression, are often under-diagnosed and under-treated (Nglazi et al, 2016)
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