Examining validity evidence of HEARTSMAP-U for psychosocial screening in the post-secondary educational context

Background: The prevalence of reported mental health concerns is rising among post-secondary students. Screening instruments can help identify these concerns and connect students to appropriate care. However, most existing instruments are limited to certain diagnoses, have varying levels of psychometric evidence, do not measure a wide range of psychological and social stressors, or have not been developed in partnership with students. The goal of this dissertation was to adapt the clinician- and self- administered pediatric psychosocial screening tools, MyHEARTSMAP and HEARTSMAP respectively, to be suitable for use by post-secondary students. Methods: The HEARTSMAP-U tool was adapted and evaluated over three years in partnership with post-secondary students, administration, and clinical experts. A scoping review was conducted to identify validation practices and gaps with existing instruments. In a multi-phase, multi-method process, HEARTSMAP-U was adapted from existing HEARTSMAP instruments through consensus-driven meetings, student focus groups, and a survey with post-secondary mental health professionals. A preliminary evaluation study was conducted to assess HEARTSMAP-U’s validity evidence with University of British Columbia (Vancouver) students. Results: The scoping review revealed a need for screening tools developed with, by, and for diverse post-secondary students. The student-centred HEARTSMAP-U instrument consists of ten psychosocial sections and generates urgency and severity-specific resource recommendations based on students' scoring patterns. Students and post-secondary mental health professionals found the tool content to be acceptable and relevant to end-users. HEARTSMAP-U demonstrated evidence of predictive validity in identifying students with psychiatric concerns and evidence of convergent validity as scores were highly correlated with other instruments measuring similar concerns and general quality of life (PedsQL-YA) and strength-based psychosocial assessments (MHC-SF). A small proportion of piloted students followed up with tool-recommended resources, but a large number reported their intent to access them in the future. Conclusion: HEARTSMAP-U was adapted and evaluated through a multi-method, student-centered approach, resulting in a tool that is deemed acceptable and suitable for use in the post-secondary education setting. Currently, HEARTSMAP-U is undergoing larger-scale validation to further assess its predictive validity and utility. Future studies may explore its implementation potential in post-secondary institutions and how it can be integrated within existing mental health strategies.