| ObjectiveThe aim of this study was to develop the Adolescent Mental Health Literacy Assessment Questionnaire(AMHLAQ)and evaluate its reliability and validity in medical college students,so as to provide an effective assessment tool for the study of Chinese adolescents’mental health literacy(MHL).Besides,applying the AMHLAQ to explore the difference of medical college students’MHL level in different characteristics and the relationship between MHL and depressive and anxiety symptoms,in order to provide basis for improving their MHL and mental health status.MethodsAccording to the literature review,group discussion and expert interview and basing on the definition of MHL and the KAP theory,a total of 36 items in 4 dimensions were constructed,and the Liket 5-level scoring standard was used for scoring.A questionnaire survey was conducted among freshmen and sophomore students in two medical schools in Anhui Province by convenient cluster sampling in May 2020.AMHLAQ,Center for Epidemiologic Studies Depression Scale(CES-D)and Self-rating Anxiety Scale(SAS)were used to evaluate the MHL,depressive symptoms and anxiety symptoms,respectively.Among 3 826 students after matching with gender,the items were screened by independent-samples t-test,factor analysis and other methods,and the reliability and validity of the questionnaire was evaluated by homogeneity reliability,split-half reliability coefficient and construct validity and so on.In all participants(7 771),independent-samples t test and variance analysis were used to analyze the difference of MHL in demographic variables.Correlation analysis,chi-square analysis,restrictive cubic spline model,etc.were used to analyze the association between MHL and depressive and anxiety symptoms.P<0.05 was considered statistically significant.ResultsA total of 7 771 students participated in the survey,including 1 903 boys(24.5%)and 5 868 girls(75.5%).The gender of the participants was matched,and a total of 3826 participants were included for analysis during the reliability and validity process.Factor analysis revealed that AMHLAQ consists of 22 questions grouped into 4domains(knowledge,recognition,attitude and practice).Variance cumulative contribution rate of four dimensions was 62.213%.The Cronbach’sαcoefficient of the total questionnaire was 0.897,the split-half reliability was 0.800,test-retest reliability was 0.871.The Cronbach’sαcoefficient of each dimension was 0.796 to 0.885,the split-half reliability of each dimension was 0.725 to 0.846,and the test-retest reliability was 0.871 of each dimension is 0.729 to 0.865,so the indicators have great reliability.Confirmatory factor analysis showed the model fitted well(χ~2/df=19.319,P<0.01;RMSEA=0.069;GFI=0.907,AGFI=0.881,NFI=0.914,RFI=0.900,CFI=0.918).In the application analysis of 7 771 students,the average score of MHL was 84.84±11.30.Detection rate of depressive and anxiety symptoms were 16.7%and 8.2%.The results of independent-samples t-test and variance analysis indicated that MHL scores in girls and those living in urban,mothers with higher education level,better family economic status,more partners were higher(P<0.05 for each).Spearman correlation analysis showed that MHL were negatively correlated with depressive and anxiety symptoms(r depressive symptoms=-0.431,r anxiety symptoms=-0.373,P<0.005 for each),similar correlation were be found in four dimensions.Restricted cubic spline model showed that the total and four dimensions were non-linearly correlated with depressive and anxiety symptoms(P<0.05 for each).ConclusionAMHLAQ meets the psychological standard and has good reliability and validity.In consequence,AMHLAQ can be used to estimate the MHL of adolescents.In the application of large samples,the level of MHL is related to a variety of demographic variables(e.g.gender,registered residence).Depressive and anxiety symptoms are negatively correlated with the total MHL and four dimensions.The higher of MHL,the lower risk of depressive and anxiety symptoms. |
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