Abstract
Resilience as a strength-based notion, measured across cultures, age groups, and sub-populations, contributes to understanding health and well-being. Yet, there is limited evidence of how the construct performs in resource-limited countries. We explored the psychometric properties of the CYRM-28 and validated the scale with adolescents living with HIV (ALHIV), a key sub-population. The participants included members of an advisory panel and 406 ALHIV, aged 15–19 years, attending an antiretroviral therapy and teen-club clinic in Blantyre, Malawi. This study employed a mixed-method study using an exploratory sequential design. The advisory panel discussed the CYRM-28, and select ALHIV then translated it into Chichewa, pilot-tested it using cognitive interviews, and back-translated it for clarity and appropriateness. The resultant CYRM-28 was tested using a survey with purposefully selected ALHIV. The overall median score was 123, with an interquartile range of 110–130. Minimum and maximum scores were 53 and 140. Cronbach’s alpha of 0.863 and Kaiser–Meyer–Olkin measure (0.866) confirmed internal consistency and the sample size adequacy, respectively. Bartlett’s tests of sphericity (p < 0.001) informed factor analysis. Exploratory factor analysis determined possible dimensions of resilience and the sub-scales. The confirmatory factor analysis (CFA) confirmed the construct validity and supported a three-factor model consistent with the conceptualization of resilience as a multi-dimensional construct. Structural equation modeling was applied to perform CFA to measure model of resilience. Multiple fit indices showed a good fit for the model. The CYRM-28 has good internal consistency, test and re-test reliability, and moderate convergent validity which render it useful as a self-report resilience measure to inform and evaluate interventions for the health and well-being of adolescents in Malawi.
Highlights
The study conformed to recommendations for using Child Youth Resilience Measure (CYRM)-28, which included employing a six-member advisory panel to inform research study processes, site-specific questions, and the adaptation of the scale for adolescents living with HIV (ALHIV) in Malawi (Ungar, 2016)
The original version of the CYRM was translated into Chichewa, the dominant language in the study setting, and this version was validated for survey use among ALHIV
The KMO measure of sampling adequacy was 0.866, confirming that our sample was good enough to continue with exploratory factor analysis (EFA) (Acock, 2013)
Summary
Ungar defines resilience as “the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided in culturally meaningful ways” (2008, 225). This definition encompasses multiple socio-ecological factors that influence positive outcomes over time. These are individual (cognitive skills, self-management), relational (peer, family, community support), and contextual (education, health, social services) (Obrist et al, 2010). The inclusion of socioecological factors in this study is critical for a nuanced understanding of resilience
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