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Qualitative methodologies are recommended in the development and evaluation of psychological instruments. However, reporting on qualitative methods in instrument development studies remains variable and often insufficient to support claims surrounding content validity. In the current article, we present a commentary discussing the critical role qualitative inquiry plays in the development of patient-reported outcome measures. We outline the current state of reporting in qualitative instrument development and evaluation studies with a focus on mental health literature and highlight the clinical relevance of this topic for health care professionals. Despite challenges, we express confidence in the potential value of substantively engaging with qualitative methods and comprehensive reporting and summarize recommendations to this effect based on the current literature. [ Journal of Psychosocial Nursing and Mental Health Services, 61 (3), 40–44.]

BACKGROUND Existing screening tools for mental health issues among post-secondary students have several challenges, including a lack of standardization and co-development by students. HEARTSMAP-U was adapted to address these issues. OBJECTIVE The purpose of this study is to evaluate the suitability of HEARTSMAP-U as a self-screening tool for psychosocial issues among post-secondary students, by evaluating its validity evidence and clinical utility. METHODS A prospective cohort study was conducted with UBC-Vancouver students to evaluate HEARTSMAP-U’s predictive validity and convergent validity. Participating students completed baseline and 3-month follow-up assessments with HEARTSMAP-U and a clinician-administered interview. RESULTS In a diverse student sample (N=100), HEARTSMAP-U demonstrated high sensitivity (95-100%) in identifying any psychiatric concerns that were flagged by a research clinician, with lower specificity (21-25%). Strong convergent validity (r=0.54 to 0.68) was demonstrated when relevant domains and sections of HEARTSMAP-U were compared with other conceptually similar instruments. CONCLUSIONS This preliminary evaluation suggests that HEARTSMAP-U may be suitable for screening usage in the post-secondary educational setting. However, larger scale evaluation is necessary to confirm and expand on these findings.

BackgroundMental health challenges are highly prevalent in the post-secondary educational setting. Screening instruments have been shown to improve early detection and intervention. However, these tools often focus on specific diagnosable conditions, are not always designed with students in mind, and lack resource navigational support.ObjectiveThe aim of this study was to describe the adaptation of existing psychosocial assessment (HEARTSMAP) tools into a version that is fit-for-purpose for post-secondary students, called HEARTSMAP-U.MethodsWe underwent a three-phase, multi-method tool adaptation process. First, a diverse study team proposed a preliminary version of HEARTSMAP-U and its conceptual framework. Second, we conducted a cross-sectional expert review study with Canadian mental health professionals (N = 28), to evaluate the clinical validity of tool content. Third, we conducted an iterative series of six focus groups with diverse post-secondary students (N = 54), to refine tool content and language, and ensure comprehensibility and relevance to end-users.ResultsThe adaptation process resulted in the HEARTSMAP-U self-assessment and resource navigational support tool, which evaluates psychosocial challenges across 10 sections. In Phase two, clinician experts expressed that HEARTSMAP-U's content aligned with their own professional experiences working with students. In Phase three, students identified multiple opportunities to improve the tool's end-user relevance by calling for more “common language,” such as including examples, definitions, and avoiding technical jargon.ConclusionsThe HEARTSMAP-U tool is well-positioned for further studies of its quantitative psychometric properties and clinical utility in the post-secondary educational setting.