Balancing Cultural Specificity and Generalizability: Brief Qualitative Methods for Selecting, Adapting, and Developing Measures for Research With American Indian Communities

Culturally appropriate, valid and reliable measures are critical to assessing how interventions impact health. There is a tension between measures for specific cultural settings versus more general measures that permit comparisons across samples. We illustrate a feasible approach to measurement selection, adaptation and testing for a study of brief interventions to prevent suicide among American Indian youth ages 10-24. We used a modified Nominal Group Technique (NGT) with N = 7 Apache Community Mental Health Specialists (CMHS') to elicit priority impacts of interventions under study. We then tested the reliability and validity in N = 93 youth at baseline. The NGT results included selection of alternative measures, item removal and addition, and creation of a local well-being index. Measurement testing indicated excellent to good internal consistency (alpha: 0.82-0.96) and strong construct validity. Study results demonstrate a feasible approach to balancing cultural specificity and generalizability while producing valid and reliable measures to use in an intervention trial. Public Significance Statement Studies addressing the psychometric evaluation of mental health assessment instruments for use in American Indian populations are relatively rare. This study demonstrates how brief qualitative methods can aid in the adaptation and development of psychometrically valid assessment instruments that reflect local understandings of mental health and well-being.