Measuring Mental Health Literacy: Development of the Mental Health Awareness and Advocacy Assessment Tool
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Abstract
Background: Mental health literacy programs are a common community-based approach used to address the prevention of mental health issues on college campuses. Current assessment strategies used to evaluate the effectiveness of these programs often lack strong theoretical rational and psychometric rigor.
Purpose: The purpose of this study was twofold. First, based upon extant literature, theory, and standard clinical practice, we propose a process-based model of mental health literacy that includes three macro factors—identifying mental health issues, locating empirically based resources, and responding to mental health issues—and three micro processes of how they unfold—acquiring knowledge, building self-efficacy, and applying skills (behavior). The second aim was to test the psychometric properties of a new tool created to evaluate this process-based model—the Mental Health Awareness and Advocacy Assessment Tool (MHAA-AT).
Setting: Not applicable.
Intervention: Not applicable.
Research Design: A national sample of 296 college attending participants were recruited from Amazon’s Mechanical Turk. Participants responded to a demographic questionnaire and the newly developed MHAA-AT. Psychometric properties were examined through item response theory, exploratory factor analyses, and bivariate correlations.
Findings: Results suggest the MHAA-AT is a sound measure and demonstrates appropriate item, person, and trait characteristics on declarative knowledge items, and single factor structures on self-efficacy and behavior items with moderate to high reliability and validity. While additional testing is need among other samples, results suggest that the MHAA-AT is a quality assessment tool.
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References
Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., ... & Murray, E. (2018). WHO World Mental Health Surveys International College Student Project: prevalence and distribution of mental disorders. Journal of Abnormal Psychology, 127(7), 623-638. https://doi.org/10.1037/abn0000362 DOI: https://doi.org/10.1037/abn0000362
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorder (5th ed.). Washington, DC: Author. https://doi.org/10.1176/appi.books.9780890425596 DOI: https://doi.org/10.1176/appi.books.9780890425596
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37(2), 122-147. https://doi.org/10.1037/0003-066X.37.2.122 DOI: https://doi.org/10.1037//0003-066X.37.2.122
Bandura, A. (2005). The primacy of self-regulation in health promotion. Applied Psychology, 54(2), 245-254. https://doi.org/10.1111/j.1464-0597.2005.00208.x DOI: https://doi.org/10.1111/j.1464-0597.2005.00208.x
Bond, T., & Fox, C. M. (2015). Applying the Rasch model: Fundamental measurement in the human sciences (3rd ed.). New York, NY: Routledge. https://doi.org/10.4324/9781315814698 DOI: https://doi.org/10.4324/9781315814698
Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon's Mechanical Turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6(1), 3-5. https://doi.org/10.1177/1745691610393980. DOI: https://doi.org/10.1177/1745691610393980
Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1(2), 245-276. https://doi.org/10.1207/s15327906mbr0102_10 DOI: https://doi.org/10.1207/s15327906mbr0102_10
Cerny, B. A., & Kaiser, H. F. (1977). A study of a measure of sampling adequacy for factor-analytic correlation matrices. Multivariate Behavioral Research, 12(1), 43-47. https://doi.org/10.1207/s15327906mbr1201_3 DOI: https://doi.org/10.1207/s15327906mbr1201_3
Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10(7), 1-9.
Dahlberg, K. M., Waern, M., & Runeson, B. (2008). Mental health literacy and attitudes in a Swedish community sample–Investigating the role of personal experience of mental health care. BMC Public Health, 8(1), 8-18. https://doi.org/10.1186/1471-2458-8-8 DOI: https://doi.org/10.1186/1471-2458-8-8
Eisenberg, D., Golberstein, E., & Gollust, S. E. (2007a). Help-seeking and access to mental health care in a university student population. Medical Care, 45(7), 594-601. https://doi.org/10.1097/MLR.0b013e31803bb4c1 DOI: https://doi.org/10.1097/MLR.0b013e31803bb4c1
Eisenberg, D., Golberstein, E., & Hunt, J. B. (2009). Mental health and academic success in college. The BE Journal of Economic Analysis & Policy, 9(1). DOI:10.2202/1935-1682.2191 DOI: https://doi.org/10.2202/1935-1682.2191
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007b). Prevalence and correlates of depression, anxiety, and suicidality among university students. American Journal of Orthopsychiatry, 77(4), 534-542. https://doi.org/10.1037/0002-9432.77.4.534 DOI: https://doi.org/10.1037/0002-9432.77.4.534
Field, A. P. (2005). Discovering Statistics using SPSS. London: Sage. https://doi.org/10.53841/bpspag.2005.1.56.31 DOI: https://doi.org/10.53841/bpspag.2005.1.56.31
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231-243. https://doi.org/10.1037/a0025957 DOI: https://doi.org/10.1037/a0025957
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). "Mental health literacy": A survey of the public's ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166(4), 182-186. https://doi.org/10.5694/j.1326-5377.1997.tb140071.x DOI: https://doi.org/10.5694/j.1326-5377.1997.tb140071.x
Jorm, A. F., Nakane, Y., Christensen, H., Yoshioka, K., Griffiths, K. M., & Wata, Y. (2005). Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan. BMC Medicine, 3(1), 12-26. https://doi.org/10.1186/1741-7015-3-12. DOI: https://doi.org/10.1186/1741-7015-3-12
Jung, H., von Sternberg, K., & Davis, K. (2016). Expanding a measure of mental health literacy: Development and validation of a multicomponent mental health literacy measure. Psychiatry Research, 243, 278-286. https://doi.org/10.1016/j.psychres.2016.06.034. DOI: https://doi.org/10.1016/j.psychres.2016.06.034
Kitzrow, M. A. (2009). The mental health needs of today's college students: Challenges and recommendations. NASPA Journal, 46(4), 646-660. https://doi.org/10.2202/1949-6605.1310 DOI: https://doi.org/10.2202/1949-6605.5037
Lipson, S. K., Speer, N., Brunwasser, S., Hahn, E., & Eisenberg, D. (2014). Gatekeeper training and access to mental health care at universities and colleges. Journal of Adolescent Health, 55(5), 612-619. https://doi.org/10.1016/j.jadohealth.2014.05.009. DOI: https://doi.org/10.1016/j.jadohealth.2014.05.009
Löwe, B., Unützer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004). Monitoring depression treatment outcomes with the Patient Health questionnaire-9. Medical Care, 42(12), 1194-1201. https://doi.org/10.1097/00005650-200412000-00006 DOI: https://doi.org/10.1097/00005650-200412000-00006
Mason, W., & Suri, S. (2012). Conducting behavioral research on Amazon's Mechanical Turk. Behavior Research Methods, 44(1), 1-23. https://doi.org/10.3758/s13428-011-0124-6 DOI: https://doi.org/10.3758/s13428-011-0124-6
Mitchell, S. L., Kader, M., Darrow, S. A., Haggerty, M. Z., & Keating, N. L. (2013). Evaluating question, persuade, refer (QPR) suicide prevention training in a college setting. Journal of College Student Psychotherapy, 27(2), 138-148. https://doi.org/10.1080/87568225.2013.766109 DOI: https://doi.org/10.1080/87568225.2013.766109
O'Connor, M., & Casey, L. (2015). The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy. Psychiatry Research, 229(1-2), 511-516. https://doi.org/10.1016/j.psychres.2015.05.064. DOI: https://doi.org/10.1016/j.psychres.2015.05.064
Ostini, R., & Nering, M. L. (2005). Polytomous item response theory models. Newbury Park, CA: Sage. https://doi.org/10.4135/9781412985413 DOI: https://doi.org/10.4135/9781412985413
Paolacci, G., Chandler, J., & Ipeirotis, P. G. (2010). Running experiments on amazon mechanical turk. Judgment and Decision making, 5(5), 411-419. https://doi.org/10.1017/S1930297500002205 DOI: https://doi.org/10.1017/S1930297500002205
Reis, C., & Cornell, D. (2008). An evaluation of suicide gatekeeper training for school counselors and teachers. Professional School Counseling, 11(6), 386-394. https://doi.org/10.1177/2156759X0801100605 DOI: https://doi.org/10.5330/PSC.n.2010-11.386
Rizopoulos, D. (2006). ltm: An R package for latent variable modeling and item response theory analyses. Journal of Statistical Software, 17(5), 1-25. https://doi.org/10.18637/jss.v017.i05 DOI: https://doi.org/10.18637/jss.v017.i05
Sheeran, P., Maki, A., Montanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W. M., & Rothman, A. J. (2016). The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: a meta-analysis. Health Psychology, 35(11), 1178-1218. https://doi.org/10.1037/hea0000387 DOI: https://doi.org/10.1037/hea0000387
Quinnett, P. (2013). QPR gatekeeper training for suicide prevention: The model, rationale, and theory. Retrieved from: https://qprinstitute.com/research-theory
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092-1097. https://doi.org/10.1001/archinte.166.10.1092 DOI: https://doi.org/10.1001/archinte.166.10.1092
Wei, Y., McGrath, P. J., Hayden, J., & Kutcher, S. (2017). Measurement properties of mental health literacy tools measuring help-seeking: A systematic review. Journal of Mental Health, 26(6), 543-555. https://doi.org/10.1080/09638237.2016.1276532 DOI: https://doi.org/10.1080/09638237.2016.1276532
Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., & Pena, J. B. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104-115. https://doi.org/10.1037/0022-006X.76.1.104 DOI: https://doi.org/10.1037/0022-006X.76.1.104