Establishing the content validity of an online depression screening tool for South Africa

Abstract

Depression is a global concern as with an estimated 300 million individuals worldwide experiencing depression. In South Africa, the prevalence rate of depression is estimated at 9.7% of the population. With the increase in mobile internet usage in South Africa, an online depression screening tool could provide opportunities for the screening of depression symptoms aiding access to mental health interventions. This project identified an open access tool for screening depression, the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R), and adapted it for online use by the adult South African population. This study followed on from the adaptation phase on the CESD-R and aimed to determine the content validity of the adapted CESD-R for online use in South Africa using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. The study followed a two-phased design. Study one utilised a qualitative approach, where 50 experts commented on the content validity of the tool. The results were used to further adapt the tool which resulted in a 20-item depression screening tool. Study two followed a quantitative design in order to establish the content validity in terms of determining the Content Validity Ratios, Item-Content Validity Index as well as the Kappa Statistic of the 20 items. Based on these statistics, 19 of the 20 items were retained. Overall, the adapted online depression screening tool displays good content validity and holds potential as a screening tool where access to mental health may be limited.