Adapting the CYRM-R for use among adolescent girls and young mothers affected by HIV in South Africa

Working paper number: 466
Author: Wylene Saal, Angelique Thomas, Hlokoma Mangqalaza, Christina Laurenzi, Jane Kelly, Elona Toska
Unit: CSSR

Abstract

While adolescent girls and young women affected by HIV have faced barriers to engaging in HIV care and protection against unwanted pregnancies and sexually transmitted infections, adolescent mothers’ abilities to overcome and withstand challenges have been largely overlooked. Little is known about appropriate methodologies to measure maternal resilience in South Africa, especially among young mothers. We aim to improve the relevance, comprehensibility and internal validity of an age-appropriate resilience measurement for use among adolescent and young mothers living with HIV in South Africa. 

Cognitive interviews were conducted to inform the adaptation of the Child and Youth Resilience Measure Revised (CYRM-R), a 17-item instrument designed for use with youth aged 10-23 years old from different cultural backgrounds within the South African context. Cognitive interviewing is an approach used to identify inconsistencies and response errors that may occur between questions asked by a researcher and how the participant understands or interprets the questions being asked. A total of n=9 interviews were conducted by a researcher trained in working with adolescents that included training on approaches to cognitive interviews and probing techniques.

Overall, the process of cognitive interviewing not only offered us unique perspectives on how to modify items within the CYRM-R scale, but also provided us with extensive, additional qualitative data on the experiences of young women and the personal and relational support received from their parents/caregivers. The cognitive interviews elicited information on items that need to be modified which informed adaptations to the scale.  The participants’ responses uncovered items that had similar understandings and responses. New probes or key words were added to elicit the appropriate responses. Furthermore, the participants’ understanding of specific words within items revealed areas for adapting the wording. These words were changed or substituted to ensure that the participants understood the meaning of the items. The utilization of vignettes proved to be a useful technique to promote discussion and engage participants to reflect on their experiences.

Cognitive interviewing is a useful approach in improving the relevance and comprehensibility of the CYRM-R. 

Publication file: SaalThomasMangqalazaLaurenziKellyToska