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