4 - (SYM 114) a Delphi Approach to Co-develop a Measure with Community Stakeholders to Assess the Impact of Community-based Mental Health Outreach Programming

Existing psychological measures are often developed with predominantly White, college- educated, and/or middle-class samples (Corrigan et al., 2003; Evans-Lacko et al., 2010; Ritsher et al., 2003; Sanchez et al., 2022, Wei et al., 2015). This may result in low response rates in underserved communities due to limited fit, relevance, and unfamiliarity of psychological language. For example, a meta-analysis with mental health literacy measures found that most were assessed with college-educated, young adult populations (Wei et al., 2015), limiting the external validity of the measure in minoritized communities.
 
Our study aimed to co-develop a measure intended for minoritized communities utilizing a mixed-method approach, guided by a Delphi expert consensus methodological framework. Two rounds of focus groups with an expert panel of providers (N=9) qualitatively assessed their perspectives on strengths, challenges, and areas of need with existing measures used in community-based mental health centers in California. From these focus groups, a pilot measure of 26 items assessing mental health literacy, stigma, and help-seeking was developed. Round three included an anonymous quantitative survey completed by the provider panel (N=12), with items designed to collect feedback on the terminology, scaling, and visual formatting of the measure. A 3-point Likert scale of improvement was used to assess aspects of the measure along with the ability to provide feedback. A benchmark of 80% consensus of adequacy was required for items to be finalized. Of the initial 26-item pilot measure, 15 items met this benchmark.
 
Following three rounds of survey development with providers, the new 15-item survey was assessed with community members. Two focus groups were held with community members in English (N=10) and Spanish (N=6). Responses revealed similar concerns with existing measures being too burdensome to complete and confusing due to clinical terminology that was unfamiliar to underserved communities. Community members shared that the language in the newly developed measure included terminology familiar to and was written at a level that was easy to understand. A round three quantitative survey will be completed with community members to further refine the survey, which will parallel the provider procedure. The psychometric properties of the measure will be assessed. Developing a mental health literacy, stigma, and help-seeking measure that is informed by and for underserved communities allows for a better snapshot of their true mental health needs.