Measuring violence against children:A COSMIN systematic review of the psychometric properties of child and adolescent self-report measures

Research on violence against children (VAC) requires meaningful, valid, and reliable self-report by children. Many instruments have been used globally and decisions to select suitable measures are complex. This review identifies child and adolescent self-report measures that are most likely to yield valid, reliable, and comparable data in this field. A systematic review (PROSPERO: CRD4201706) was conducted using the 2018 Consensus-based Standards for the selection of health Measurement Instrument (COSMIN) criteria. Six electronic databases and gray literature were searched. Manuscripts published in English and describing the development and psychometric qualities of child/adolescent self-report instruments were included. Thirty-nine original instruments and 13 adaptations were identified in 124 studies. The quality of evidence ranged from “very low” to “high” depending on the measure and the psychometric properties assessed. Most measures were not widely used, and some have been applied in many settings despite limited evidence of their psychometric rigor. Few studies assessed content validity, particularly with children. The ACE, CTQ, CTS-PC, CECA, ICAST, and JVQ have the best psychometric properties. An overview of items measuring frequency, onset, duration, perpetrators, and locations is provided as well as an assessment of the practicalities for administration to help researchers select the instrument best suited for their research questions. This comprehensive review shows the strengths and weaknesses of VAC research instruments. Six measures that have sufficient psychometric properties are recommended for use in research, with the caveat that extensive piloting is carried out to ensure sufficient content validity for the local context and population.</p

Measuring violence against children:A COSMIN systematic review of the psychometric and administrative properties of adult retrospective self-report instruments on child abuse and neglect

Valid, meaningful, and reliable adult retrospective measures of violence against children (VAC) are essential for establishing the prevalence, risk factors, and long-term effects of VAC. We aim to summarize the available evidence on the psychometric properties of adult retrospective VAC measures and to provide evidence-based recommendations for appropriate measure selection. We searched six electronic databases and gray literature for studies that report on the development, content validity, or psychometric properties of adult retrospective child abuse and neglect measures for this review (PROSPERO: CRD4201706). We used the 2018 Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria to evaluate each included study and measure. We assessed if measures included questions on frequency or severity, the perpetrator, or the location of the violence, and noted the administrative practicalities for each instrument such as length, readability, available translations, and cost to access. We identified 288 studies and 77 measures. The quality of evidence ranged from “low” to “high,” depending on the measure and the psychometric properties assessed. The measures with the most robust evidence available across multiple contexts are the: ACE and ACE-IQ; FBQ and FBQ-U; CTQ and CTQ-SF; and ICAST-R. This review shows the strengths and weaknesses of retrospective VAC measures. The substantial evidence presented in this review can be used by researchers to make psychometrically sound decisions for measurement selection which should be supported by extensive piloting and adaptation to the respective local context

Preferences on Governance Models for Mental Health Data: Qualitative Study With Young People

BACKGROUND: Improving access to mental health data to accelerate research and improve mental health outcomes is a potentially achievable goal given the substantial data that can now be collected from mobile devices. Smartphones can provide a useful mechanism for collecting mental health data from young people, especially as their use is relatively ubiquitous in high-resource settings such as the United Kingdom and they have a high capacity to collect active and passive data. This raises the interesting opportunity to establish a large bank of mental health data from young people that could be accessed by researchers worldwide, but it is important to clarify how to ensure that this is done in an appropriate manner aligned with the values of young people. OBJECTIVE: In this study, we discussed the preferences of young people in the United Kingdom regarding the governance, sharing, and use of their mental health data with the establishment of a global data bank in mind. We aimed to determine whether young people want and feel safe to share their mental health data; if so, with whom; and their preferences in doing so. METHODS: Young people (N=46) were provided with 2 modules of educational material about data governance models and background in scientific research. We then conducted 2-hour web-based group sessions using a deliberative democracy methodology to reach a consensus where possible. Findings were analyzed using the framework method. RESULTS: Young people were generally enthusiastic about contributing data to mental health research. They believed that broader availability of mental health data could be used to discover what improves or worsens mental health and develop new services to support young people. However, this enthusiasm came with many concerns and caveats, including distributed control of access to ensure appropriate use, distributed power, and data management that included diverse representation and sufficient ethical training for applicants and data managers. CONCLUSIONS: Although it is feasible to use smartphones to collect mental health data from young people in the United Kingdom, it is essential to carefully consider the parameters of such a data bank. Addressing and embedding young people's preferences, including the need for robust procedures regarding how their data are managed, stored, and accessed, will set a solid foundation for establishing any global data bank

“What does that mean?":The content validity of the ISPCAN Child Abuse Screening Tool - Child version (ICAST-C) in Romania, South Africa, and the Philippines

Background: The International Society for Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool (Children\u27s Version), known as the ICAST-C Version 3, is used widely to assess violence against children, but there is limited psychometric evidence, especially on content validity. Objective: This study aimed to assess the content validity of the ICAST-C with adolescents in Romania, South Africa, and the Philippines. Methods: A purposive sample of adolescents (N = 53, 51 % female) were recruited from urban areas in Romania, the Eastern Cape Province of South Africa, and Metro Manila, Philippines. Semi-structured one-on-one in-depth cognitive interviews sought adolescent perspectives on the relevance, comprehensibility, and comprehensiveness of the ICAST-C. Data were analysed using template analysis. Results: The ICAST-C was broadly perceived to be relevant and comprehensive in measuring violence against children in all study locations. However, there were issues with the comprehensibility of the measure, described at three levels: interpreting items, undertaking coherent elaborations of relevant behaviors and places, and generating a coherent response to the questions. Conclusions: Suggestions to revise the ICAST-C include, among others, adding a practice or how-to section on answering the survey, clarifying the intent of questions, especially on neglect and sexual abuse, emphasizing that questions cover all locations, and asking more positive questions. Pilot studies testing the content validity and cultural appropriateness are needed as a matter of practice in large self-report surveys

What does that mean? : The content validity of the ISPCAN Child Abuse Screening Tool - Child version (ICAST-C) in Romania, South Africa, and the Philippines

Background: The International Society for Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool (Children\u27s Version), known as the ICAST-C Version 3, is used widely to assess violence against children, but there is limited psychometric evidence, especially on content validity. Objective: This study aimed to assess the content validity of the ICAST-C with adolescents in Romania, South Africa, and the Philippines. Methods: A purposive sample of adolescents (N = 53, 51 % female) were recruited from urban areas in Romania, the Eastern Cape Province of South Africa, and Metro Manila, Philippines. Semi-structured one-on-one in-depth cognitive interviews sought adolescent perspectives on the relevance, comprehensibility, and comprehensiveness of the ICAST-C. Data were analysed using template analysis. Results: The ICAST-C was broadly perceived to be relevant and comprehensive in measuring violence against children in all study locations. However, there were issues with the comprehensibility of the measure, described at three levels: interpreting items, undertaking coherent elaborations of relevant behaviors and places, and generating a coherent response to the questions. Conclusions: Suggestions to revise the ICAST-C include, among others, adding a practice or how-to section on answering the survey, clarifying the intent of questions, especially on neglect and sexual abuse, emphasizing that questions cover all locations, and asking more positive questions. Pilot studies testing the content validity and cultural appropriateness are needed as a matter of practice in large self-report surveys

Evidencing the Impact of Web-Based Coproduction With Youth on Mental Health Research: Qualitative Findings From the MindKind Study

BACKGROUND: Public involvement in research is a growing phenomenon as well as a condition of research funding, and it is often referred to as coproduction. Coproduction involves stakeholder contributions at every stage of research, but different processes exist. However, the impact of coproduction on research is not well understood. Web-based young people's advisory groups (YPAGs) were established as part of the MindKind study at 3 sites (India, South Africa, and the United Kingdom) to coproduce the wider research study. Each group site, led by a professional youth advisor, conducted all youth coproduction activities collaboratively with other research staff. OBJECTIVE: This study aimed to evaluate the impact of youth coproduction in the MindKind study. METHODS: To measure the impact of web-based youth coproduction on all stakeholders, the following methods were used: analysis of project documents, capturing the views of stakeholders using the Most Significant Change technique, and impact frameworks to assess the impact of youth coproduction on specific stakeholder outcomes. Data were analyzed in collaboration with researchers, advisors, and YPAG members to explore the impact of youth coproduction on research. RESULTS: The impact was recorded on 5 levels. First, at the paradigmatic level, a novel method of conducting research allowed for a widely diverse group of YPAG representations, influencing study priorities, conceptualization, and design. Second, at the infrastructural level, the YPAG and youth advisors meaningfully contributed to the dissemination of materials; infrastructural constraints of undertaking coproduction were also identified. Third, at the organizational level, coproduction necessitated implementing new communication practices, such as a web-based shared platform. This meant that materials were easily accessible to the whole team and communication streams remained consistent. Fourth, at the group level, authentic relationships developed between the YPAG members, advisors, and the rest of the team, facilitated by regular web-based contact. Finally, at the individual level, participants reported enhanced insights into mental well-being and appreciation for the opportunity to engage in research. CONCLUSIONS: This study revealed several factors that shape the creation of web-based coproduction, with clear positive outcomes for advisors, YPAG members, researchers, and other project staff. However, several challenges of coproduced research were also encountered in multiple contexts and amid pressing timelines. For systematic reporting of the impact of youth coproduction, we propose that monitoring, evaluation, and learning systems be designed and implemented early

Exploring adolescents’ perceptions of a self-report measure on violence against children: a multi-country study in Romania, South Africa, and the Philippines

This thesis explores how adolescents perceive, interpret, and experience answering self-report measures on violence against children. In doing so, this study tests the International Society for Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool (Children’s Version), known as the ICAST-C, with adolescents aged 10-17 years in Romania, South Africa and the Philippines. This study contributes to a nascent body of research that recognises the complexity of measuring violence against children, particularly in relation to testing self-report measures with the target population. It contributes to the literature on psychometric properties of self-report measures and is broadly situated within a public health approach to the prevention of violence against children. This study aims to enhance the evidence base on self-report violence measures by testing the ICAST-C. It uses the construct of content validity and cognitive processing theories to understand the particular ways in which adolescents interpret items, recall experiences, and generate an accurate answer that reflects their experiences. Consequently, it contributes to the development of robust measures that are capable of monitoring violence against children. In-depth cognitive interviews and arts-based methods were used with adolescents in Iasi and Cluj-Napoca, Romania; Buffalo City, South Africa; and Metro Manila, Philippines, between 2018-19. Data were generated from transcripts of interviews, observation notes, completed forms, and drawings completed by participants. Ethical approval was received from the University of Edinburgh, Babes-Bolyai University, University of Cape Town, and Ateneo de Manila University. The findings of the study show that while the ICAST-C is generally perceived to be acceptable, relevant and comprehensible, cognitive interviewing revealed deeper issues with clarity of items and response options. Factors pertaining to adolescents’ past experiences, perceived benefits and burdens, efforts exerted, and features of the ICAST-C impacted how they perceived and comprehended the measure. Adolescents’ observations highlighted issues with interpreting the intent and wording of items, and contexts and behaviours that are considered, or not considered. In addition, adolescents’ processes of recall reveal potential challenges in generating an internal response that is also linked with the options presented on the ICAST-C. While viewed as broadly appropriate, certain items were perceived as inappropriate in specific contexts e.g. sexual abuse items in the Philippines. These evaluations are formed not only due to contextual differences but also item interpretations that diverged from the intended measurement objective. Adolescents shared insightful and valuable feedback on the ICAST-C and offered suggestions for its use. Adolescents’ emotions while answering the ICAST-C reflect complex processes. They experienced several emotions rapidly and simultaneously, and thus this process needs to be understood as dynamic rather than static. Emotions are produced due to several reasons, such as comprehension, past experiences, beliefs, and expectations about their performance. The study highlights the value of adolescents being able to discuss their experiences in a safe setting with trained interviewers afterward. It also highlights the wide-ranging meanings adolescents assign to the ICAST-C such as a protective tool, an instrument that enables disclosure, and a measure that creates awareness. Adolescents bring their everyday selves and experiences with them into the study, which highlights the value of asking about topics other than violence. This study discusses key meanings adolescents create in the research interaction. The findings of this study emphasise the value of using qualitative methods to understand the psychometric property of content validity, as well as testing self-report measures with the target population. This study presents several recommendations for using the ICAST-C in future studies as well as for conducting research on violence with children and adolescents, such as conducting pilot studies in contexts using cognitive interviewing methods to ascertain content validity, planning for and creating opportunities for disclosure, including a post-completion interview while conducting surveys on violence, and expanding the scope of the ICAST-C to include other topics and more positive questions. The findings also highlight adolescents’ experiences of answering questions on violence, and in so doing, acknowledge the value of accommodating all emotions and experiences that may come up during research

Users’ experiences of trauma-focused cognitive behavioural therapy for children and adolescents: a systematic review and metasynthesis of qualitative research

Trauma-focused cognitive behavioural therapy (TF-CBT) is an effective intervention for post-traumatic stress disorder, yet implementation may be hindered by practitioners’ concerns about how treatment is experienced by users. This metasynthesis systematically reviews qualitative evidence on youth and caregivers’ experiences of TF-CBT to better understand user perspectives on process and outcomes of treatment. A systematic review and metasynthesis were undertaken for qualitative studies of treatment experience related to TF-CBT. Data were extracted according to Evidence for Policy and Practice Information and Coordinating Centre guidelines, and studies were critically appraised using Critical Appraisal Skills Programme checklists. Findings from included studies were coded and synthesized using thematic synthesis methodology. Eight studies were selected after a full-text review of 39 papers. Findings were organised around nine sub-themes, under three broad thematic categories: ‘engagement in TF-CBT’; ‘experience of treatment components’; and ‘therapeutic outcomes’. Youth were often unclear about what to expect from treatment and concerned about (in)compatibility with their therapist. Youth reports indicated how such misgivings can be addressed through early psychoeducation and efforts to strengthen the therapeutic alliance. Once underway, treatment was viewed as a place of refuge and validation, aided by therapist competence and confidentiality. Youth and caregivers felt that constructing a trauma narrative was instrumental for recovery. Cognitive-behavioural coping techniques were useful during treatment and in the long-term. While participants in TF-CBT may begin treatment with unclear expectancies, careful attention to early engagement and other process issues can optimise process and outcomes. Implications for clinical practice and further research are discussed