Process evaluation of the Getting it Right study and acceptability and feasibility of screening for depression with the aPHQ-9

Abstract

Background The Getting it Right study determined the validity, sensitivity, specificity and acceptability of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) people. In this process evaluation we aimed to explore staff perceptions about whether Getting it Right was conducted per protocol, and if the aPHQ-9 was considered an acceptable and feasible screening tool for depression in primary healthcare. This process evaluation will provide information for clinicians and policy makers about the experiences of staff and patients with Getting it Right and what they thought about using the aPHQ-9. Methods Process evaluation using grounded theory approaches. Semi-structured interviews with primary healthcare staff from services participating in Getting it Right were triangulated with feedback (free-text and elicited) from participants collected during the validation study and field notes. Data were thematically analysed according to the Getting it Right study protocol to identify the acceptability and feasibility of the aPHQ-9. Results Primary healthcare staff (n = 36) and community members (n = 4) from nine of the ten participating Getting it Right services and Indigenous participants (n = 500) from the ten services that took part. Most staff reported that the research was conducted according to the study protocol. Staff from two services reported sometimes recruiting opportunistically (rather than recruiting consecutive patients attending the service as outlined in the main study protocol), when they spoke to patients who they knew from previous interactions, because they perceived their previous relationship may increase the likelihood of patients participating. All Getting it Right participants responded to at least six of the seven feedback questions and 20% provided free-text feedback. Most staff said they would use the aPHQ-9 and most participants said that the questions were easy to understand (87%), the response categories made sense (89%) and that they felt comfortable answering the questions (91%). Conclusion Getting it Right was predominantly conducted according to the study protocol. The aPHQ-9, the first culturally adapted, nationally validated, freely available depression screening tool for use by Indigenous people, appears to be acceptable and feasible to use. Trial registration Australian New Zealand Clinical Trial Registry ANZCTR12614000705684, 03/07/2014.

The Validity of the Self-Reporting Questionnaire-20 for Symptoms of Depression: A Sub- Analysis of the National Health Survey in Indonesia

“…The validity assessed is a diagnostic test or a screening tool which is also referred to as convergent and concurrent validity in other studies [28]. Meanwhile, some qualitative research has also been conducted to support the assessment of validity [29] with the focus on the appropriateness of tools, processes, and data [30].…”

Approaches to the development of new screening tools that assess distress in Indigenous peoples: A systematic mixed studies review

“…These methods include literature reviews, expert reviews, interviews, and focus groups. Phase Almeida [56] Marley [60] Getting it Right Collaborative [46] Brinckley [50] Assess scale Assess reliability Deploy questionnaire Schlesinger [57] Campbell [53] Esler [55] Haswell [51] Almeida [56] Janca [20] Brown [45] Marley [60] Snodgrass [62] Getting it Right Collaborative [46] Brinckley [50] Assess validity Deploy questionnaire Schlesinger [57] Campbell [53] Esler [55] Haswell [51] Almeida [56] Janca [20] Brown [45] Marley [60] Snodgrass [62] Getting it Right Collaborative [46] Brinckley [50] Evaluate clinical use Interview/ questionnaire Janca [61] Farnbach [47] Carlin [52] a These steps are not numbered because they may take place in any order and/or concurrently.…”

“…Most studies were undertaken in Australia (n = 10) with single studies in Canada and India. These numbers do not add up to19 because related studies published by the same authors, for example Brown et al, [44] Brown et al, [45] Getting it Right Collaborative [46] and Farnbach et al, [47] were grouped together.…”

“…The final phase-assess scale, primarily uses quantitative methods. However, more recently authors [47,52,61] have started to evaluate the clinical use of newly developed tools. Mixed methods have been employed to conduct these evaluations.…”