Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan



Mohsin, Shamaila, Atif, Najia, Rabbani, Waqas, Tariq, Ahmaren, Khan, Shahzad Ali, Tariq, Mahjabeen and Sikander, Siham ORCID: 0000-0002-0223-7234
(2021) Cultural Adaptation of Community Informant Tool for Detection of Maternal Depression in Rural Pakistan. FRONTIERS IN PSYCHIATRY, 12. 598857-.

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Abstract

<b>Background:</b> Evidence indicates that mental health issues like depression, epilepsy, and substance misuse can be detected with reasonable accuracy in resource-poor settings. The Community Informant Detection Tool (CIDT) is one such approach used for detecting mental health problems, including depression. We adapted this community informant approach for detecting maternal depression in Pakistan. <b>Methods:</b> Adaptation of Community Informant Detection Tool for Maternal Depression (CIDT-MD) involved five steps. First, a scoping review of the literature was conducted to select an appropriate tool for adaptation. Second, in-depth interviews were conducted to explore the idioms of depression and distress, perceived causes, and the effects of maternal depression among currently depressed and recovered mothers (<i>n</i> = 11), mothers in law (<i>n</i> = 6), and Primary Care Providers (Primary Care Physicians and Lady Health Supervisors) (<i>n</i> = 6). Third, case vignettes and illustrations were created with input from a panel of mental health experts, incorporating the idioms of depression and distress used, causes, and effects for each symptom described. Fourth, to assess the comprehensibility of the illustrations and level of understanding, Focus Group Discussions (<i>n</i> = 4) were done with purposely selected community health workers (Lady Health Workers and Lay Peers, <i>n</i> = 28) trained in delivering maternal depression intervention. The final step was reflection and inputs by a panel of mental health experts on all steps to finalize the content of the tool. <b>Results:</b> Context-specific cultural adaptation in the presentation and format of CIDT-MD was conducted successfully. Lady Health Workers (LHW) and Lay Peers (LP) were found to be the most appropriate persons to use the tool and function as the informants. The adapted tool with all its vignettes and illustrations was found to be easily understandable, comprehensible, and culturally appropriate, meaningful, and contextually relevant by the community health workers and peers working in the relevant settings. They easily relate to and identify potentially depressed such women lining up with the tool. Lastly, the coding of the tool was found easy to follow as well. <b>Conclusion:</b> The Community Informant Detection Tool for Maternal Depression (CIDT-MD) is a culturally acceptable, easy to use, and comprehensible tool for detecting maternal depression in community settings of Pakistan. The community informants found the content and approach highly relevant to the local needs.

Item Type: Article
Uncontrolled Keywords: cultural adaptation, community informant, detection tool, maternal depression, Pakistan, Proactive Case Detection
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 22 Apr 2021 10:04
Last Modified: 18 Jan 2023 22:51
DOI: 10.3389/fpsyt.2021.598857
Open Access URL: https://doi.org/10.3389/fpsyt.2021.598857
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3120162