Contextually appropriate measurement as the basis for culturally appropriate interventions: a case study in Managua, Nicaragua

Overview of Ten Child Mental Health Clinical Outcome Measures: Testing of Psychometric Properties with Diverse Client Populations in the U.S

While many standardized assessment measures exist to track child mental health treatment outcomes, the degree to which such tools have been adequately tested for reliability and validity across race, ethnicity, and class is uneven. This paper examines the corpus of published tests of psychometric properties for the ten standardized measures used in U.S. child outpatient care, with focus on breadth of testing across these domains. Our goal is to assist care providers, researchers, and legislators in understanding how cultural mismatch impacts measurement accuracy and how to select tools appropriate to the characteristics of their client populations. We also highlight avenues of needed research for measures that are in common use. The list of measures was compiled from (1) U.S. state Department of Mental Health websites; (2) a survey of California county behavioral health agency directors; and (3) exploratory literature scans of published research. Ten measures met inclusion criteria; for each one a systematic review of psychometrics literature was conducted. Diversity of participant research samples was examined as well as differences in reliability and validity by gender, race or ethnicity, and socio-economic class. All measures showed adequate reliability and validity, however half lacked diverse testing across all three domains and all lacked testing with Asian American/Pacific Islander and Native American children. ASEBA, PSC, and SDQ had the broadest testing.

Tranquility is a child with a full belly: Pathways linking food insecurity and maternal mental distress in Nicaragua

A growing body of literature identifies food insecurity (FI) as a critical social determinant of mental health. Across settings, quantitative studies report positive correlations between FI and mental distress, especially among women. Less understood are the pathways by which FI undermines women's mental well-being. To address this gap, we conducted six focus group discussions with 45 Nicaraguan mothers. Thematic analysis identified three themes linking the management of FI and maternal mental well-being in this setting. The theme, la lucha, underscored how the chronicity of FI served as a constant mental strain by demanding mothers strategize on a daily basis to resolve it. The themes "tranquility is a child with a full belly" and "the despairing and frustrated mother" emphasized how FI challenged women's abilities to fulfill the responsibilities of motherhood and served as a reminder of social status. Our findings advance earlier quantitative work by identifying how the management of food insecurity undermines maternal mental well-being in a low-middle income setting and indicate that policies aimed at combating food insecurity can concomitantly improve maternal mental well-being if they bolster women's agency and work to reduce the stigma associated with being food insecure.