Paudel Shishir, Chalise Anisha, Shakya Prashabdhi, Bhandari Tulsi Ram
Department of Public Health, CiST College, Pokhara University, Kathmandu, Nepal.
Kathmandu Institute of Child Health, Hepali Height, Nepal.
SAGE Open Med. 2025 Jun 14;13:20503121251341423. doi: 10.1177/20503121251341423. eCollection 2025.
To develop and validate the Mental Health Literacy Assessment Scale for assessing mental health literacy among community health workers.
A total of 24 items were initially generated and refined through cognitive interviews and expert evaluation. The final scale consisted of 20 items. Face validity was ensured through cognitive interviews conducted in two phases with community health workers and volunteers. Content validity was assured based on the ratings of six experts. Cross-sectional survey was performed among 233 community health workers. Exploratory factor analysis using Varimax rotation was performed to identify latent variables with factor loadings > 0.4. Confirmatory factor analysis was employed to validate the model, using root mean square error of approximation < 0.05, standardized root mean square residual < 0.08, comparative fit index ⩾ 0.90, and Tucker-Lewis index ⩾ 0.90. Reliability was assessed through Cronbach's alpha where alpha coefficient > 0.70 indicated internal consistency.
Exploratory factor analysis identified four factors explaining 50.75% of variance explained by positive mental health behaviors (21.44%), misconceptions about mental health (14.24%), symptoms of mental distress (8.70%), and mental health stigma (6.37%). The confirmatory factor analysis demonstrated excellent model fit, with indices such as the normed Chi-square (1.31), comparative fit index (0.95), Tucker-Lewis index (0.94), and root mean square error of approximation (0.03). The scale displayed strong convergent and discriminant validity, with an average variance extracted > 0.43 and composite reliability > 0.70 for all factors. Internal consistency was confirmed, with a Cronbach's alpha value of 0.78 for the overall scale.
The Mental Health Literacy Assessment Scale has demonstrated robust psychometric properties and comprehensive coverage of mental health literacy components, making it a valuable tool for both research and practical applications among Community health workers in Nepal. While these findings support its utility in this context, further validation is needed to establish its applicability across other low- and middle-income countries to assess its effectiveness in diverse cultural and geographic settings.
开发并验证心理健康素养评估量表，以评估社区卫生工作者的心理健康素养。
最初生成了24个条目，并通过认知访谈和专家评估进行完善。最终量表由20个条目组成。通过分两个阶段对社区卫生工作者和志愿者进行认知访谈确保了表面效度。基于六位专家的评分保证了内容效度。对233名社区卫生工作者进行了横断面调查。使用方差最大化旋转进行探索性因素分析，以识别因子载荷>0.4的潜在变量。采用验证性因素分析来验证模型，使用近似均方根误差<0.05、标准化均方根残差<0.08、比较拟合指数⩾0.90和塔克-刘易斯指数⩾0.90。通过克朗巴哈系数评估信度，其中α系数>0.70表示内部一致性。
探索性因素分析确定了四个因素，解释了由积极心理健康行为（21.44%）、对心理健康的误解（14.24%）、精神痛苦症状（8.70%）和心理健康污名（6.37%）所解释的方差的50.75%。验证性因素分析显示模型拟合良好，标准化卡方（1.31）、比较拟合指数（0.95）、塔克-刘易斯指数（0.94）和近似均方根误差（0.03）等指标均良好。该量表显示出较强的收敛效度和区分效度，所有因素的平均提取方差>0.43，组合信度>0.70。确认了内部一致性，总量表的克朗巴哈α值为0.78。
心理健康素养评估量表已证明具有强大的心理测量特性，且对心理健康素养成分具有全面覆盖，使其成为尼泊尔社区卫生工作者研究和实际应用中的宝贵工具。虽然这些发现支持了其在这一背景下的效用，但需要进一步验证以确定其在其他低收入和中等收入国家的适用性，以评估其在不同文化和地理环境中的有效性。
