Validation of a culturally-specific measure to identify depression in Aboriginal and Torres Strait Islander people

Project status: 
Active
Start date: 
01/2014
Completion date: 
12/2016

The primary aim of this study is to validate an extensively adapted and culturally appropriate, free to use, tool for use with Indigenous people attending primary care services, the adapted nine-item Patient Health Questionnaire (aPHQ-9), against a gold standard (criterion standard) the MINI International Neuropsychiatric Interview (MINI) 6.0.0., as a screening instrument for depression. The secondary aim is to evaluate the level of contribution of seven additional questions to the aPHQ-9 to the diagnosis of depression, as compared to the aPHQ-9.

This cross sectional project will involve 500 Indigenous primary care attendees from Australia’s states and territories. We will validate (criterion validity) the aPHQ-9 as a screening tool, alone, and in combination with the additional seven questions, against a gold standard structured criterion interview for depression MINI International Neuropsychiatric Interview (MINI) 6.0.0., in Indigenous men and women attending primary health care services across Australia.

Issue

There is no culturally meaningful, appropriately valid, simple, free-to-use tool to screen for depression in Aboriginal and Torres Strait Islander peoples attending primary health care in Australia.

In previous work by Professor Alex Brown and others, five Aboriginal language groups of Central Australian Aboriginal men independently selected the 9-item Patient Health Questionnaire (PHQ-9) depression screening tool from a selection of screening tools, as the most appropriate to adapt for use with Indigenous people. The PHQ-9 was adapted to the local needs of all five language groups over 12-months and consensus regarding wording was reached.

The PHQ-9 wording was modified, using simplified English, to make the ‘adapted PHQ-9’ (aPHQ-9) culturally meaningful and give it face validity.

This study aims to validate this tool.

Methods

This will provide the evidence on whether to recommend use of the aPHQ-9 as a screening tool for depression in health services research, clinical care delivery and policy evaluation in Federal and State chronic diseases programmes.