Factorial validity of the Twi versions of five measures of mental health and well-being in Ghana

Abstract

Background Mental health is considered an integral part of human health. Reliable and valid measurement instruments are needed to assess various facets of mental health in the native language of the people involved. This paper reports on five studies examining evidence for the factorial validity of the Twi versions of five mental health and well-being measurement instruments: Affectometer-2 (AFM-2); Automatic Thought Questionnaire–Positive (ATQ-P); Generalized Self-Efficacy Scale (GSEs); Patient Health Questionnaire-9 (PHQ-9); and Satisfaction with Life Scale (SWLS) in a rural Ghanaian adult sample. Method Measures were translated and evaluated using a research-committee approach, pilot-tested, and administered to adults ( N = 444) randomly selected from four rural poor communities in Ghana. We applied confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM to the AFM-2, ATQ-P, and the PHQ-9, and CFA to the GSEs and the SWLS. The omega coefficient of composite reliability was computed for each measure. Results A two-factor bifactor ESEM model displayed superior model fit for the AFM-2. The total scale and the Negative Affect subscale, but not the Positive Affect subscale, attained sufficient reliability. Two models (a four-factor 22-item bifactor ESEM model and a 5-factor 22-item ESEM model) fitted the data best for the ATQ-P. The bifactor ESEM model displayed a high reliability value for the total scale and satisfactory reliability values for three of its four subscales. For the GSEs, a one-factor CFA model (residuals of items 4 and 5 correlated) demonstrated superior model fit with a high reliability score for the total scale. A two-factor ESEM model outperformed all other models fitted for the PHQ-9, with moderate and satisfactory reliability scores for the subscales. A one-factor CFA model (residuals of item 4 and 5 correlated) demonstrated superior model fit for the SWLS, with a satisfactory reliability value for the total scale. Conclusions Findings established evidence for the factorial validity of the Twi versions of all five measures, with the global scores, but not all subscale scores, demonstrating satisfactory reliability. These validated measurement instruments can be used to assess mental health and well-being in the research and practice contexts of the current sample.

Effects of a Community‐Based Multicomponent Positive Psychology Intervention on Mental Health of Rural Adults in Ghana

“…For the validation sample in the current study, a two‐factor bifactor ESEM model best fitted the data. An omega reliability coefficient of 0.88 for the global factor and 0.43 and 0.72 for the AFM‐PA and AFM‐NA subscales, respectively, were found for the current sample (Appiah et al, 2020).…”

“…Post‐intervention assessments were conducted with both groups immediately after the end of the program and at 3‐months follow‐up. Mental health measures were interviewer‐administered with previously Twi‐translated and validated versions of the scales, which are reported in other manuscripts (Appiah, Wilson‐Fadiji, Schutte, & Wissing, 2020). Data were collected using the SurveyCTO software.…”

“…This sample will be called the “validation sample” in the current paper, and will be referred to where the psychometric properties of the outcome measures are briefly mentioned in the Measures section. Detailed results for the validation studies of the outcome measures are reported in Appiah et al (2020). Within each community, a total of 21 consented individuals were randomly selected from the 110 participants in the validation sample coming from that community, recruited, and assigned to their respective conditions using a computer‐generated number sequence created with Excel.…”

“…Earlier, Khumalo, Temane, and Wissing (2011) found a Cronbach's alpha of .84 among a sample of Setswana‐speaking South Africans. For the validation sample of the current study, a three‐factor bifactor exploratory structural equation modeling (ESEM) model fitted the data well (comparative fit index [CFI] = 0.997; root mean square error of approximation [RMSEA] = 0.024), with omega reliability coefficients for the general mental health factor of 0.97, and 0.51, 0.57, 0.41 for the emotional, social, and psychological well‐being subscales, respectively (Appiah et al, 2020). Note that Appiah et al (2020) reported the omega coefficient rather than the Cronbach's alpha coefficient which is commonly reported in psychological studies, since it is widely recognized that omega is superior when scales are multidimensional (cf.…”

Integrated mental health screening for obstetric fistula patients in Mali: From evidence to policy

“…First, our measure for depression (PHQ-9) was not validated for local languages in Mali, and there is a possibility that it may not adequately capture the construct of depression in this population. However, our confidence in the measure is increased by the strong reliability coefficient (α = 0.79), and the fact that the PHQ-9 is one of the most widely used depression screeners across Africa and has been validated across a range of African languages [48][49][50]. Second, our study is limited by the fact that we did not have a measure of surgical success or of reintegration experiences.…”