Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (ASR-MHCOVID19) - Development and validation

ABSTRACT

Introduction: The COVID-19 crisis has generated an increasing stress throughout the population. Objective(s) To develop and validate the Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (GDH) (ASR-MH-COVID19). Method(s) The items content was based on the GDH guides for the prevention of mental health and psychosocial well-being of the general population during the COVID-19 outbreak. After content and facial validity analysis, the preliminary version of the ASR-MHCOVID19 (8 items to be answered on a Likert scale) was completed by 413 individuals (69.2% female;mean age=31.02+/-14,272), in September-December 2020 (Sample1) and then by 967 (70.9% female;mean age=34.02+/-14,272), in February-May 2021 (Sample2). Sample1 was randomly divided in two sub-samples. Sample1A was used for exploratory factor analysis/EFA and Sample1B for confirmatory factor analysis/CFA;CFA was then replicated with Sample2. The online surveys also included the Adherence Scale to the Recommendations of Portuguese GDH to minimize the impact of COVID-19 (ASR-COVID-19;Pereira et al. 2020). Result(s) CFAs were informed by EFA and showed that the unidimensional model presented acceptable-good fit indexes (Sample1B chi2 /df=2.747;RMSEA=.0980, p<.001;CFI=.973;TLI=.918, GFI=.972;Sample2 chi2 /df=3.327;RMSEA=.0490, p<.001;CFI=.993;TLI=.983, GFI=.990). Cronbach's alfas were alpha<.850. Pearson correlations between ASR-MH-COVID19 and ASR-COVID19 were significant (p<.01) and moderate-high for the total (r=.753) and dimensional scores (Distance and respiratory hygiene, r=.739;House and personal hygiene, r=.584;Use of remote services and isolation r=.425). Conclusion(s) The new ASR-MH-COVID19 has shown validity and reliability, allowing the investigation of this (mental) health behaviour.