Objective To evaluate the reliability and validity of the multicomponent mental health literacy measure-Chinese version in male military personnel and to provide evidences for the application of the measure in China.
Methods Using random cluster sampling, we recruited 1 175 military personnel in two cities (Beijing and Tianjin) and two provinces (Hebei and Shandong) province for a mobile phone-based self-administered survey and a resurvey in 237 persons selected from 1 106 valid respondents six weeks after the initial survey during November – December 2018. The modified multicomponent mental health literacy measure-Chinese version was adopted in the study and the reliability and validity of the instrument were assessed with item analysis, internal consistency coefficient, test-retest reliability, construct validity, convergent validity and discriminant validity.
Results Two items in the original measure were revised and 4 items were deleted (2 due to poor homogeneity and 2 due to small absolute value of load) and the final measure included totally 22 items. Project analysis resulted in the correlation coefficients between the scores of each items and the total score of the measure ranging from 0.20 to 0.48 (all P < 0.01), indicating a good item homogeneity of the measure. The overall Cronbach′s α and test-retest reliability of the measure was 0.80 and 0.64; and the Cronbach′s α of the measure′s three domains of knowledge, belief and resources was 0.76, 0.71 and 0.77, respectively, indicating a good reliability. Exploratory factor analysis revealed that the cumulative variance contribution rate was 38.59% for the three domains of the measure and the item factor structure was consistent with that of the original measure. Confirmatory factor analysis showed a good fitness of the constructed model, with the goodness-of-fit index (GFI) of 0.91, root mean square residual (RMR) of 0.01, root mean square error approximation (RMSEA) of 0.06, and adjusted goodness-of-fit index (AGFI) of 0.90. For the respondents of the test-retest survey, the average scores of mental health literacy, knowledge, belief, and resources domain, and mental health knowledge questionnaire were 13.00 ± 4.05, 5.45 ± 2.49, 4.76 ± 2.07, 2.78 ± 1.29, and 14.82 ± 2.50, respectively; the overall score and scores of each domain of the mental health literacy were significantly correlated positively with mental health knowledge questionnaire score (P < 0.01 for all). For the respondents of the initial survey, the average scores of mental health literacy, knowledge, belief, and resources domain, the Center for Epidemiological Studies Depression Scale, and Generalized Anxiety Disorder Scale was 11.47 ± 4.35, 5.09 ± 2.52, 3.95 ± 2.08, 2.43 ± 1.43, 3.21 ± 3.82, and 2.65 ± 2.99, respectively; the overall score of mental health literacy and the scores of belief and resources domains were significantly correlated inversely with depression and anxiety scores (all P < 0.01), but the knowledge domain score was not correlated with depression and anxiety scores (all P > 0.05). The results indicated good convergent validity and discriminant validity of the measure.
Conclusion The modified multicomponent mental health literacy measure-Chinese version is of good reliability and validity when administered in male military personnel and could be used as an evaluation instrument of mental health literacy for Chinese military personnel.
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