Routine outcome measurement in adolescents seeking mental health services: standardization of HoNOSCA in Kenyan sample

Grace Nduku Wambua,Fredrik Falkenström,Manasi Kumar,Pim Cuijpers

doi:10.1186/s12888-021-03438-1

Abstract

BackgroundThe evaluation of treatment outcomes is important for service providers to assess if there is improvement or not. The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) was developed for this use in child and adolescent mental health services. Outcome measurement in routine mental health services is limited. This paper evaluates the psychometric properties of the self and clinician rated versions of the HoNOSCA for routine use in child and adolescent mental health services in Kenya.MethodsUsing a prospective design, the clinician- and self-rated versions of the HoNOSCA and the Paediatric Symptom Checklist (PSC) were administered at the Youth Centre at the Kenyatta National Hospital in Nairobi. Initial ratings were obtained from adolescents 12-17 years (n = 201). A sample of 98 paired ratings with 2 follow-ups were examined for measurement of change over time.ResultsOur findings showed good reliability with the self-rated version of the HoNOSCA score, correlating well with the self-reported version of the PSC (r = .74, p < .001). Both versions correlated well at follow-up and were sensitive to change. Using factor analysis, the maximum likelihood factoring and Promax rotation resulted in a four-factor structure, which with a Kaiser–Meyer–Olkin measure of sampling adequacy of 0.8 explained 54.74% of total variance.ConclusionThe HoNOSCA appears to be of value, and easy to use in routine settings. Our findings suggest further investigation with a larger sample.

Highlights

The evaluation of treatment outcomes is important for service providers to assess if there is improvement or not
The self-rated version of the HoNOSCA and the Paediatric Symptom Checklist (PSC) were completed by all adolescents at intake, and each time they came for follow-up at the clinic
Scores of the PSC suggest that there was significant psychological impairment among all the participants. Clinicians attending to these adolescents filled in the corresponding HoNOSCA; the mean of these ratings was 7.02 (SD = 5.07)

Summary

Introduction

The evaluation of treatment outcomes is important for service providers to assess if there is improvement or not. The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) was developed for this use in child and adolescent mental health services. This paper evaluates the psychometric properties of the self and clinician rated versions of the HoNOSCA for routine use in child and adolescent mental health services in Kenya. The HoNOSCA is part of a larger body of work - the Health of the Nation Outcome Scales (HoNOS) developed by Wing et al, [11, 12] in the United Kingdom as a brief mental health measure with the aim of tracking progress towards improving the health and social functioning of mentally ill people. The HoNOSCA was first developed as a clinician rated measure to track child and adolescent outcomes in routine care. Several studies have examined the psychometric properties of the HoNOSCA [13, 14, 16] and because of its good psychometric properties and ease of use in routine clinical services, it has been translated into different languages [18]

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