Family functioning but not social capital is associated with better mental health in adolescents affected by violence and displacement by armed conflict in Colombia.

BACKGROUND: The effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood. AIMS: Given social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement. METHODS: We examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12 to 17-year-old adolescents (N = 1,754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm and displacement by armed conflict. RESULTS: Neither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85-0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86-0.97]), non-specific violence and harm (OR 0.91 [0.86-0.97]) and social capital variables (OR 0.91 [0.85-0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months. CONCLUSIONS: Better family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.

Classic test and generalizability theories are both useful for cross-cultural adaptation of an allergic rhinitis health-related quality of life questionnaire.

BACKGROUND: An instrument to assess Allergic Rhinitis (AR) Health-Related Quality of Life (HRQL) in adult patients was developed in Spain. No validated instrument is currently cross-culturally adapted for use in daily practice to assess HRQL in AR patients in Colombia. PURPOSE: The aim of this study was to evaluate the measurement performance of an AR-HRQL specific questionnaire, ESPRINT-15 (Cuestionario ESPañol de Calidad de Vida en RINiTis), in Colombian adult patients with AR using the Classic Test Theory (CTT) and the Generalizability theory (G-theory) frameworks. METHODS: We conducted the cross-cultural adaptation in 2 stages. In stage 1, we evaluated comprehensibility, acceptability, and feasibility of ESPRINT-15 in healthy adults and adult patients with AR. In stage 2, we examined both reliability and validity of ESPRINT-15 scores using CTT and overall reliability applying the G-theory in adult patients with AR. RESULTS: For feasibility and acceptability, all items showed a higher than 95% level of understanding, and modifications in the original questionnaire were unnecessary. Reliability and validity using CTT showed a high internal consistency (Cronbach's alpha and Mc McDonald's omega = 0.95) and test-retest reliability (scores from 0.70 to 0.76). The overall reliability score using G-theory was 0.75, and G-coefficients scores associated with internal consistency and test-retest reliability measures were 0.96 and 0.61, respectively. Validity using exploratory factor analysis (EFA) identified 2 factors instead of the original ESPRINT-15 4 domains. However, confirmatory factor analysis (CFA) showed good fit regarding the original model. CONCLUSIONS: The proposed cross-cultural adaptation of ESPRINT-15 showed good reliability and validity measures. Additionally, it was easy to use and administer. ESPRINT-15 can be used clinically and for research in Colombian adults' patients with AR. CTT and the G-theory can be used in epidemiological studies to adapt AR-HRQL questionnaires cross-culturally in adult patients with AR.