Psychometric evaluation of the Major Depression Inventory among young people living in Coastal Kenya

Abstract

The lack of reliable, valid and adequately standardized Background measures of mental illnesses in sub-Saharan Africa is a key challenge for epidemiological studies on mental health. We evaluated the psychometric properties and feasibility of using a computerized version of the Major Depression Inventory (MDI) in an epidemiological study in rural Kenya.: We surveyed 1496 participants aged 13-24 years in Kilifi County, on Methods the Kenyan coast. The MDI was administered using a computer-assisted system, available in three languages. Internal consistency was evaluated using both Cronbach's alpha and the Omega Coefficient. Confirmatory factor analysis was performed to evaluate the factorial structure of the MDI.: Internal consistency using both Cronbach's Alpha (α= 0.83) and the Results Omega Coefficient (0.82; 95% confidence interval 0.81-0.83) was above acceptable thresholds. Confirmatory factor analysis indicated a good fit of the data to a unidimensional model of MDI (χ (33, = 1409) = 178.52 < 0.001, N p TLI = 0.947, CFI = 0.961, and Root Mean Square Error of Approximation, RMSEA = .056), and this was confirmed using Item Response Models (Loevinger's H coefficient 0.38) that proved the MDI was a unidimensional scale. Equivalence evaluation indicated invariance across sex and age groups. In our population, 3.6% of the youth presented with scores suggesting major depression using the ICD-10 scoring algorithm, and 8.7% presented with total scores indicating presence of depression (mild, moderate or severe). Females and older youth were at the highest risk of depression.: The MDI has good psychometric properties. Given its brevity, Conclusions relative ease of usage and ability to identify at-risk youth, it may be useful for epidemiological studies of depression in Africa. Studies to establish clinical thresholds for depression are recommended. The high prevalence of depressive symptoms suggests that depression may be an important public health problem in this population group.

A contextually relevant approach to assessing health risk behavior in a rural sub-Saharan Africa setting: the Kilifi health risk behavior questionnaire

“…This study’s findings from non-psychometric evaluation of the HRB questionnaire delivered via ACASI highlight the feasibility of using ACASI for collecting sensitive data such as information on HRB among adolescents in this rural low resource setting. In support of our findings, ACASI has previously been used among the adolescent population in Kilifi [ 52 ], as well as among an older age-group within the Kenyan setting [ 53 , 54 ]. Overall, these studies have found the ACASI to improve quality of response to sensitive questions, to decrease socially desirable responses, and has also suitably been used for collecting data among participants with low formal education [ 53 , 54 ].…”

Clustering of health risk behaviors among adolescents in Kilifi, Kenya, a rural Sub-Saharan African setting

“…Participants’ depressive symptoms over the past two weeks were assessed using the major depression inventory (MDI); which has been found reliable (Cronbach’s alpha = 0.83) and valid (Loevinger’s H coefficient for MDI’s 10 items was 0.38 confirming a unidimensional structure) to use among adolescents in this setting [ 51 ]. Both total raw scores from MDI and diagnostic classifications (i.e.…”

Neurocognitive and mental health outcomes and association with quality of life among adults living with HIV: a cross-sectional focus on a low-literacy population from coastal Kenya

“… 38 This measure, adapted to Swahili, yielded reliable psychometric properties among young adults in Kilifi. 39 …”