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How to distinguish promotion, prevention, and treatment trials in public mental health

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Resumo:Background. Promoting mental health, preventing mental disorders and providing effective treatments are public health priorities. Randomized controlled trials (RCTs) frequently evaluate mental health and psychosocial support interventions to achieve one or more of these objectives. Distinguishing between RCTs focused on mental health promotion, prevention or treatment remains conceptually and methodologically challenging. No standardized tool exists to position RCTs along a promotion-to-treatment continuum in mental health. We aimed to develop and validate the VErona-LUgano Tool (VELUT) for distinguishing RCTs along the promotion-to-treatment continuum. Methods. An interdisciplinary tool development group (TDG) was established. The Population, Intervention, Comparison and Outcome framework was used to define key constructs. Items in the tool were devised, categorized and reduced through qualitative and quantitative methods. Finally, we performed a preliminary validation of the VELUT applying item response theory (IRT) using data from 180 RCTs. Results. The TDG generated 33 items for the initial version of the VELUT, reduced to 16 through review, cognitive interviews and psychometric analysis. Analyses of 180 RCTs using the 16-item tool showed high internal consistency (α = 0.94) and unidimensionality. Following item reduction and IRT, a final 8-item version was retained, and IRT models confirmed strong item discrimination for the 8 items and high scale reliability (marginal reliability >0.90 across most of the range of the scale), good response distribution, item performance and alignment with the Institute of Medicine (IOM) promotion-to-treatment continuum. Conclusions. The VELUT addresses methodological gaps in global mental health research by helping to position RCTs of MHPSS interventions along the IOM promotion-to-treatment continuum.
Autores principais:Purgato, Marianna
Outros Autores:Albanese, Emiliano; Gross, Alden L.; Annoni, Anna Maria; Acarturk, Ceren; Cadorin, Camilla; Jordans, Mark J.D.; Lund, Crick; Papola, Davide; Prina, Eleonora; Sijbrandij, Marit; Silva, Manuela; Silva, Manuela; Tedeschi, Federico; Tol, Wietse A.; Barbui, Corrado
Assunto:evidence synthesis item response theory mental health prevention promotion Epidemiology Public Health, Environmental and Occupational Health Psychiatry and Mental health SDG 3 - Good Health and Well-being
Ano:2025
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade Nova de Lisboa
Idioma:inglês
Origem:Repositório Institucional da UNL

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