Methodology respecting the recommendation of standardized measurement instruments

This appendix presents the steps that led to the recommendation of the most appropriate instruments to conduct surveys of mental health status, its determinants and possible consequences by means of population-based surveys (section 6).

Committee of experts

A committee of experts was established to pinpoint and recommend the standardized instruments. The committee, chaired by Dr. Pierre Gosselin and coordinated by Magalie Canuel, comprised three experts in the realm of mental health or population-based mental health surveillance: Dr. Alain Brunet (Douglas Mental Health University Institute), Dr. Arnaud Duhoux (Université de Montréal) and Dr. Alain Lesage (INSPQ). The experts were recruited by invitation based on their CVs. Each committee member filled out a conflict of interest disclosure form. No conflict of interest was reported.

Their mandate was to:

• comment on the list of indicators initially selected;
• verify that the list of instruments identified during the first stage of selection was complete;
• evaluate the standardized measurement instruments according to a list of criteria;
• revise and comment on the recommendations.

Indicators studied

Initially, only indicators that allow for the evaluation of mental health status were to be selected. Accordingly, emphasis was placed mainly on such indicators. However, it may be equally important to monitor the determinants of mental health status and certain other possible consequences in the wake of a disaster. Based on the experts’ recommendation, a number of instruments were proposed to measure certain of the indicators. Table 1 presents the list of indicators, which the committee of experts revised.

It should be noted that this toolkit mainly covers only one dimension of mental health, i.e. mental health problems. It covers to a limited extent positive mental health in the Well-being section.

Selection of the measurement instruments

The list of standardized measurement instruments was based on targeted research in two databases (PubMed and EBSCOhost), instrument databases such as PILOTS, the website of psychometric instruments in French, published books and the grey literature. Research in the two databases proved arduous given the difficulty of clearly defining the search criteria, which generated results not confined to standardized measurement instruments. Accordingly, it is mainly the other search engines that were used to establish the list of instruments.
 

First stage in the selection

For the tools to be selected in the first stage, they had to satisfy the following criteria:

• instruments in the public domain or protected by copyright but without charge;
• instruments written in or translated into French;
• instruments that use a self-report questionnaire.

Table 2 presents the list of instruments that satisfy these criteria.

*    The name of the instruments are identified in English when they have been developed in English.

Second stage in the selection

The experts were to assess the 166 preselected measurement instruments (Table 2) according to a list of criteria. They were to assign a score of 0 to 10 to each one. The scores were attributed subjectively and were based on the experts’ knowledge of the instruments. A score of 0 to 4 meant that the tool satisfied the criterion “not at all”, “very little” or “little.” A score of 5 to 10 meant that the tool satisfied the criterion “well” or “very well.” The experts were not to write anything if they were unfamiliar with the tool. An average score was then calculated of all the scores that the experts attributed.

The following selection and evaluation criteria applied to the instruments:

• a small number of items (or short administration period of the questionnaire);
• the sound metrological quality of the French and English versions;
• a validated French version;
• ease of use and interpretation by non-experts, e.g. the presence of threshold scores for interpretation;
• the availability of reference data for comparison purposes.

Third stage in the selection

Following the second stage of the selection, five to six instruments with the best scores were selected and prioritized. The committee then reached a consensus to recommend one instrument among those selected and to suggest one or two others with equally sound potential.