Trial reportBMC psychiatry2020
Cognitive testing of the PHQ-9 for depression screening among pregnant and postpartum women in Kenya.
Trial report in BMC psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Women's Experiences of Screening and Assessment of Mental Health Problems in the Perinatal Period: A Systematic Review and Meta-synthesis.Clinical child and family psychology review · 2026Pooled it
- Effects of a Home-Based Intervention on HIV Prevention Health Behaviors in Pregnant/Postpartum Kenyan Women: Estimating Moderating Effects of Depressive Symptoms.AIDS and behavior · 2021Trial
- "Helpful in Thinking Through the Question": Redesigning the Patient Health Questionnaire-8 for Depression Assessment to Enhance Patient Engagement and Understanding.JMIR human factors · 2026Article
- Disclosing depressive symptoms: perceived sensitivity of PHQ-9 items in a general population sample.BMC psychology · 2026Article
- Development and Validation of a Novel Risk Calculator to Predict Sub-optimal HIV Outcomes Among Pregnant and Postpartum Women with HIV in Kenya.AIDS and behavior · 2025Article
- Cognitive interviewing of the PHQ-A for depression screening among adolescents living with and without HIV in Malawi.Journal of affective disorders · 2025Article
- Why are we still using the PHQ-9? A Historical Review and Psychometric Evaluation of Measurement Invariance.The Psychiatric quarterly · 2025Article
- Understanding depression and the PHQ-9 items among people living with HIV: A multiple methods qualitative study in Yaoundé, Cameroon.SSM. Mental health · 2024Article
- The psychometric properties of the Swahili version of the Primary Care Post Traumatic Stress Disorder screen for DSM-5 among adults in Kenya.Frontiers in psychiatry · 2024Article
- Acceptability and content validity of suicidality screening items: a qualitative study with perinatal women.Frontiers in psychiatry · 2024Article
- A Fast and Minimal System to Identify Depression Using Smartphones: Explainable Machine Learning-Based Approach.JMIR formative research · 2023Article
- Convergent Validity of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire (PHQ-9) in Pregnant and Postpartum Women: Their Construct Correlations with Functional Disability.Healthcare (Basel, Switzerland) · 2023Article
- Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers.Frontiers in psychiatry · 2023Article
- Higher rates of mental health screening of adolescents recorded after provider training using simulated patients in a Kenyan HIV clinic: results of a pilot study.Frontiers in public health · 2023Article
- Reliability and validity of a perinatal depression screening instrument in rural Mali.SSM. Mental health · 2022Article
- Article
- On the Relationship Between Item Stem Formulation and Criterion Validity of Multiple-Component Measuring Instruments.Educational and psychological measurement · 2022Article
- Article
- Is there an optimal screening tool for identifying perinatal depression within clinical settings of sub-Saharan Africa?SSM. Mental health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAfrican women face high rates of depression, particularly during pregnancy or postpartum or after a recent HIV diagnosis. The Patient Health Questionnaire-9 (PHQ-9) depression screening tool has been quantitatively validated and extensively used to identify depression and link individuals to care. However, qualitative work is necessary to identify important opportunities to improve PHQ-9 question comprehension and performance among Kenyan women.
methodsWe administered the Kiswahili or English PHQ-9 (based on preference) to 29 pregnant and postpartum women in Thika, Kenya. Following administration, we conducted cognitive interviews with a purposive sample of 20 women. We used analytic memos and data matrices to identify themes around scale acceptability, comprehension, and decision and response processes.
resultsMost participants preferred to answer the PHQ-9 in Kiswahili (N = 15; 52%). Among the 20 interview participants, 12 (60%) had scores ≥5, indicating depressive symptoms. Overall, participants found the scale acceptable as an interviewer-administered tool. Participants reported few problems related to comprehension but had difficulty answering items not relevant to their lives (e.g., "watching television") and double-barreled items (e.g., "poor appetite or overeating"). They were hesitant to endorse items related to "duties as a wife and mother" and suicidal ideation. Most participants had difficulty distinguishing between response options of "several days" and "more than half the days".
conclusionsWe detected several problems related to PHQ-9 comprehension, decision processes, and response processes. We provide recommended changes to instructions and item wording to improve PHQ-9 validity among Kenyan women.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.