title: Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men.
abstract: OBJECTIVE
  The health inequalities experienced by Aboriginal and Torres Strait Islander Australians are well documented but there are few empirical data outlining the burden, consequences, experience and expression of depressive illness. This paper seeks to address the lack of accessible, culturally specific measures of psychosocial stress, depression or quality of life developed for, and validated within, this population.
  
  
  METHODS
  Building on an extensive qualitative phase of research, a psychosocial questionnaire comprising novel and adapted scales was developed and piloted with 189 Aboriginal men across urban and remote settings in central Australia. With a view to refining this tool for future use, its underlying structure was assessed using exploratory factor analysis, and the predictive ability of the emergent psychosocial constructs assessed with respect to depressive symptomatology.
  
  
  RESULTS
  The latent structure of the psychosocial questionnaire was conceptually aligned with the components of the a priori model on which the questionnaire was based. Regression modelling indicated that depressive symptoms were driven by a sense of injury and chronic stress and had a non-linear association with socioeconomic position.
  
  
  CONCLUSIONS
  This represents the first community-based survey of psychosocial stress and depression in Aboriginal men. It provides both knowledge of, and an appropriate process for, the further development of psychometric tools, including quality of life, in this population. Further research with larger and more diverse samples of Aboriginal people is required to refine the measurement of key constructs such as chronic stress, socioeconomic position, social support and connectedness. The further refinement, validation against criterion-based methods and incorporation within primary care services is essential.
authors.affiliation: Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Tce., Adelaide, SA, 5000, Australia. alex.brown@sahmri.com.|School of Population Health, South Australian Health and Medical Research Institute, University of South Australia, North Tce., Adelaide, SA, 5000, Australia. alex.brown@sahmri.com.
authors.forename: Alex
authors.initials: A
authors.lastname: Brown
authors.affiliation: Baker IDI Heart and Diabetes Institute, Alice Springs Hospital Campus, Gap Road, Alice Springs, NT, 0870, Australia. ricky.mentha@bakeridi.edu.au.
authors.forename: Ricky
authors.initials: R
authors.lastname: Mentha
authors.affiliation: Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Tce., Adelaide, SA, 5000, Australia. michaelh@nunku.org.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Howard
authors.affiliation: Onemda VicHealth Koori Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia. rowleyk@unimelb.edu.au.
authors.forename: Kevin
authors.initials: K
authors.lastname: Rowley
authors.affiliation: Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Tce., Adelaide, SA, 5000, Australia. rachel.reilly@sahmri.com.|School of Population Health, South Australian Health and Medical Research Institute, University of South Australia, North Tce., Adelaide, SA, 5000, Australia. rachel.reilly@sahmri.com.|Onemda VicHealth Koori Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia. rachel.reilly@sahmri.com.
authors.forename: Rachel
authors.initials: R
authors.lastname: Reilly
authors.affiliation: Spatial Epidemiology and Evaluation Research Group, School of Health Sciences, Sansom Institute for Health Research, City East Campus, University of South Australia, Internal Post Code CEA-09, GPO Box 2471, Adelaide, SA, 5001, Australia. catherine.paquet@unisa.edu.au.|Research Centre of the Douglas Mental Health University Institute, Verdun, QC, H4H 1R2, Canada. catherine.paquet@unisa.edu.au.
authors.forename: Catherine
authors.initials: C
authors.lastname: Paquet
authors.affiliation: School of Population Health, South Australian Health and Medical Research Institute, University of South Australia, North Tce., Adelaide, SA, 5000, Australia. kerin.odea@unisa.edu.au.
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D054521:Cultural Competency; D003863:Depression / Q000208:ethnology*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011594:Psychometrics; D036301:Qualitative Research; D011788:Quality of Life; D013315:Stress, Psychological / Q000208:ethnology*; D011795:Surveys and Questionnaires; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Aboriginal health; Clinical epidemiology; Depression; Psychometric instrument development; Psychosocial stress