Learning Objective #1: 1.Explain the process of calculating content validity for an instrument

Learning Objective #2: 2.Describe the importance of measuring functioning in adolescent mothers with postpartum depression.

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Postpartum depression is an international health concern, resulting in devastating effects on a woman's functioning: her relationships, her ability to work and function in other life roles, and her ability to care for her infant. Although 47% of adolescent mothers have symptoms of depression, no studies have reported data on their functional status, perhaps because a valid and reliable instrument is not available to measure functional status in this population. Such an instrument is needed to document baseline functioning and the effectiveness of depression treatment. Although the Inventory of Functional Status After Childbirth (IFSAC) is available and has strong psychometric properties in adult mothers, instruments developed for use in one population, e.g, adult, Caucasian, middle class women in the United States, cannot be assumed to validly and reliably measure functioning in another population without psychometric testing. The purpose of this psychometric study was to establish content validity of the Inventory of Functional Status After Childbirth, Revised for Adolescents (IFSAC-RA). Establishing content validity is an important first step in developing the psychometric properties of an instrument for a population. Initially, data were collected from adolescent mothers about their roles and activities (domains of functioning). Comprehension level and sociocultural relevance of the original IFSAC items were also evaluated. With input from the adolescent mothers and our Community Advisors, 27/53 IFSAC items were eliminated and 17 new items were added, creating the initial version of the IFSAC-RA. Then ten expert clinicians and scientists rated the clinical and scientific content of the IFSAC-RA, and a content validity index was calculated for each item and for the total instrument. The study provides a model for instrument development and revision before use in international research studies with populations different from the sample for which the instrument was developed.