ABSTRACT
OBJECTIVE: Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. METHODS: The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. RESULTS: The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18-30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869-0.877; ω = 0.874-0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). CONCLUSIONS: The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.
Subject(s)
Patient Health Questionnaire , Humans , Female , Adolescent , Young Adult , Adult , Male , Bolivia , Peru , Psychometrics , Reproducibility of ResultsABSTRACT
Objetivo: evaluar la estructura interna, invarianza de medida, validez de criterio y confiabilidad del CASM-85 en estudiantes de secundaria peruanos. Materiales y Métodos: se evaluaron 2075 estudiantes de ambos sexos, entre 11 y 18 años, provenientes de colegios nacionales y particulares de Arequipa, Chimbote, Lima y Pucallpa. Se realizó un análisis de la correlación ítem-ítem e ítemresto para cada dimensión del CASM-85, un análisis factorial confirmatorio y modelos MIMIC (Multiple Indicator, Multiple Cause) para evaluar la invarianza de medida a través de grupos según sexo, edad, colegio y ciudad. La confiabilidad fue estimada mediante los coeficientes Alpha y Omega. La validez de criterio entre el CASM-85 y el rendimiento académico se revisó a través de la r de Pearson y modelos de regresión. Resultados: se eliminaron ítems heterogéneos y se obtuvo una forma reducida de 45 ítems a compararse con su original de 53 ítems. Para la forma original el CFI y TLI fue < .9 en todas las ciudades, mientras que para la forma reducida fue < . 9 solo en Chimbote. Los SRMR y RMSEA fueron ≤ .10 y ≤ .09 para las formas original y reducida respectivamente. Los modelos MIMIC confirmaron invarianza para todas las variables excepto para la variable ciudad con la forma original (│ΔCFI│ = .09, │ΔTLI│ = .08). La confiabilidad fue moderada tanto para la forma original (Ω ≥ .68; α ≥ .81) como para la reducida (Ω ≥ .77; α ≥ .84). La r de Pearson mostró una relación positiva y de fuerza débil para la forma original (r = .17) y reducida (r = .18). Conclusión: la forma reducida del CASM-85 (45 ítems) ha mostrado mejores propiedades psicométricas que su forma original.
Objective: To assess the internal structure, measurement invariance, criterion validity and reliability of the CASM-85 in Peruvian high school students. Materials and methods: Two thousand seventy-five (2075) students of both sexes, aged 11 to 18 years, from public and private high schools of Arequipa, Chimbote, Lima and Pucallpa were evaluated. An item-item and item-rest correlation analysis for each dimension of the CASM- 85, a confirmatory factorial analysis and MIMIC (Multiple Indicator, Multiple Cause) models were used to evaluate the measurement invariance across the groups according to their sex, age, school and city. Reliability was estimated using alpha and omega coefficients. The criterion validity between the CASM-85 and academic performance was determined using Pearsons r and regression models. Results: The heterogeneous items were removed, obtaining a 45-item short form compared to the original 53-item form. In the original form, CFI and TLI were < .9 in all the cities, whereas in the short form, CFI and TLI were < .9 only in Chimbote. SRMR and RMSEA were ≤ .10 and ≤ .09 in the original and short forms, respectively. The MIMIC models confirmed the measurement invariance in all variables, with the exception of the original form between cities (│ΔCFI│ = .09, │ΔTLI│= .08). Reliability was moderate for both the original (Ω ≥ .68; α ≥ .81) and short forms (Ω ≥ .77; α ≥ .84). Pearsons r showed a positive and weak correlation in the original (r = .17, p < .001) and short (r = .18, p < .001) forms. Conclusion: The CASM-85 short form (45 items) has shown better psychometric properties than its original full form.