Cross-cultural adaptation of mental health screening instruments for Samoan adolescents
Bibliographic record
Abstract
Mental health problems appear common among Pacific Islander adolescents. The lack of culturally adapted mental health screening instruments is a barrier to establishing prevalence estimates needed to inform resource allocation and health system budgeting. Following the Gjersing et al. (2010) guidelines, we adapted five clinical mental health screening instruments to measure symptoms of depression, anxiety, post-traumatic stress, and suicide-related indicators for Samoan adolescents. In collaboration with clinical experts and American Samoan adolescents, we employed a four-stage incremental approach: (1) establishing expert team consensus to modify items for conceptual equivalence; (2) an iterative process of group-based forward- and back-translations; (3) adolescent piloting testing using an online survey; and (4) an adolescent focus group to finalize instruments and to develop administrative guidelines. We adapted the Patient Health Questionnaire-9 Modified for Teens (PHQ-9M), the Generalized Anxiety Disorder 7 (GAD-7), Child PTSD Symptom Scale Self-Report for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (CPSS-5), and the CPSS-5 Trauma Screener. We also developed a deliberate self-harm questionnaire based on the Avon Longitudinal Study of Parents and Children (ALSPAC) questionnaire and the Self-Injurious Thoughts and Behaviors Interview (SITBI). The adult expert committee modified the English-language wordings in each tool to improve local relevance and comprehension; adolescent pretesting led to two minor changes to the CPSS-5. Participants reported concerns about honesty in responding to highly sensitive questions; to address this, the focus group provided additional administrative guidelines. We provide the first cross-culturally adapted mental health screening instruments for use among Samoan adolescents. These instruments provide an opportunity to measure prevalence and inform public health policy through future population-based surveys. Further research should evaluate cross-cultural validity, measurement equivalence, and concordance with clinical screening to aid in clinical diagnostics for screening programs in Samoan healthcare settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".