title: Effective Screening for Emotional Distress in Refugees: The Refugee Health Screener.
abstract: Screening for emotional distress is important, but not widely available. This study assesses the utility of the Refugee Health Screener 15 (RHS-15) in a public health setting. Refugee Health Screener 15 and diagnostic proxy (DP) instruments assessing anxiety, depression, and posttraumatic stress disorder were administered to refugees from 3 countries at their public health examination. Properties of the RHS-15 and its components were evaluated utilizing appropriate methods. Scale Cronbach α was 0.95, and a factor analysis identified 1 factor accounting for 66% of scale variance. Refugee Health Screener 15 scores and cases discriminated between refugee groups similar to DPs. Refugee Health Screener 15 case sensitivity and specificity to DPs were acceptable (≥0.87/0.77). A shorter, 13-item component had acceptable metric properties. The RHS-15 appears to be a valid screener for emotional distress of refugees. The 13-item scale may be more efficient and as efficacious for case identification. The critical public health need and recommendations for implementation are discussed.
authors.affiliation: *Pacific Institute for Research and Evaluation, Albuquerque, NM; †The VA Long Beach Healthcare System, Long Beach, CA; ‡Department of Biology, University of New Mexico, Albuquerque, NM; §Lutheran Community Services Northwest, SeaTac; ‖Asian Counseling, Referral Service; and ¶Public Health Seattle & King County, Seattle, WA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hollifield
authors.forename: Eric C
authors.initials: EC
authors.lastname: Toolson
authors.forename: Sasha
authors.initials: S
authors.lastname: Verbillis-Kolp
authors.forename: Beth
authors.initials: B
authors.lastname: Farmer
authors.forename: Junko
authors.initials: J
authors.lastname: Yamazaki
authors.forename: Tsegaba
authors.initials: T
authors.lastname: Woldehaimanot
authors.forename: Annette
authors.initials: A
authors.lastname: Holland
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis* / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D012036:Refugees / Q000523:psychology*; D015203:Reproducibility of Results; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014492:United States Public Health Service; D055815:Young Adult